Wanted: Workable ways to reduce wait-times
Health care wait-times are such a contentious issue for the country's politicians that they have reached agreement on increasing the use of information technology to reduce delays in seeing specialists and receiving hospital treatment.
The federal and provincial governments are collaborating on ways that IT can cut the waiting for many services such as cancer treatment and hip replacement by better navigating the complex interplay between the availability of medical personnel and an aging population.
Earlier this year, Prime Minister Stephen Harper announced an agreement on wait-time reduction guarantees with the provinces and territories. Each province and territory is working on specific health IT initiatives that could become best practices for the rest of the country.
Ottawa is bankrolling a lot of the work through several programs for testing and adopting IT in health care, including $612 million for the Patient Wait-Times Guarantee Trust and $30 million for wait-times pilot projects. As well, Canada Health Infoway received $400 million in the March budget to extend electronic health initiatives.
Two steps, one leap
"Our investment in Infoway will help transform paper records into bits and bytes so patients and their doctors have access to this essential data whenever and wherever they need it," Harper said. While there is no magical solution for paring wait-times, the ever-present prospect of a federal election means the issue gets regular attention.
While there is plenty of expertise in government bureaucracies, hospitals and the medical professions, the IT community can also play a key role in tackling wait-times beyond providing software and technology tools, says Michael Green, president and CEO of Agfa HealthCare Canada.
"The industry can help in process re-engineering that demonstrates how to implement good business practices," he said. "We can help show hospitals how to operate as effectively as they can."
For starters, there are two key steps that can be taken. One is the full adoption of individual electronic health records. The other is getting hospitals plugged into regional or provincial electronic health networks that share information among institutions on what services and treatment capacity are available.
Infoway naturally has a lead role in finding ways to improve wait-times through IT. President and CEO Richard Alvarez says greater use of IT will yield speedier access to health care. His organization has targeted a host of areas where it will invest the $400 million.
For example, it is working with Ontario on a comprehensive wait-time information system for hospitals and clinics. If it comes up with a best practices system, then it will benefit the rest of the country, says Alvarez.
IT could make booking health care as easy as ordering airline tickets, he adds.
Green says innovations such as a province-wide scheduling system to know what resources are available would be an invaluable tool for GPs. "They should be able to schedule referrals (with specialists and hospitals) directly by being able to look at the available slots in appointment schedules."
The system could pull patients off waiting lists if there are cancellations in appointments.
Yardsticks
In addition, the performance of the health care system has to become measurable, Greens says, so hospitals and governments can see what is actually happening. "Then you can start setting meaningful standards."
Tom MacIntosh, senior research fellow at the Canadian Policy Research Networks, which organizes annual conferences on the wait-times issue called the Taming of the Queue, says better resources, data collection and management techniques are among the ways that wait-times will be reduced.
In a report on the 2007 conference, he says the situation is improving, but it will take time to complete all the initiatives. "In the final analysis, we are likely a long way from being able to say we have eliminated wait-times as a serious issue for the health system in Canada.
"But we can say that we know more about and have done more to reduce wait-times in the last few years than the system is often given credit for."
Green says the health care system invests one per cent to two per cent of its resources in IT, while business spends four per cent. "Any big operation has to maximize the use of its resources."
Doctors should be able to get a global view of the system from their office so they can determine when and where best to send patients needing further treatment.
Alex Binkley is a freelance journalist based in Ottawa. He can be reached at alex.binkley@sympatico.ca
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