Electronic Health Record: Running Late, Too Many Consultants

TORONTO , Oct. 7 /CNW/ - In a Special Report to be tabled today in the Legislative Assembly, Ontario Auditor General Jim McCarter describes Ontario's almost decade-long, $1-billion initiative to create an Electronic Health Record (EHR) as "lacking in strategic direction and relying too heavily on external consultants." McCarter concludes that "Ontario taxpayers have not received value for money for this $1-billion investment."

The Legislative Assembly and the media have in the last several months questioned contracts awarded by eHealth Ontario - the recently created agency that took over responsibility for creating EHRs to deliver better, more cost-effective health care to Ontarians - charging they were often awarded without an open competitive process. McCarter said this was "undoubtedly" the case. He also found evidence of "questionable procurement practices" in the Ministry of Health and Long-Term Care (Ministry) and at the Smart Systems for Health Agency (SSHA).

The 50-page report, entitled Special Report: Ontario's Electronic Health Records Initiative, examines efforts by the Ministry and its agencies to create an EHR - essentially a system of computerized medical records for all Ontarians. Health-care professionals would use EHRs to deliver services more efficiently than at present. All 10 provinces and three territories are working to create EHR systems, which one study says could save Canada's health-care system $6 billion a year.

    
    Among the findings in the Auditor General's Special Report:
    -  Of the $1 billion spent so far on the EHR initiative, $800 million was
       spent by the SSHA primarily to build a computer network for health-
       care providers that is expensive to operate and significantly
       underutilized, mainly because of a dearth of available applications.
       Specifically, it is costing $72 million annually to operate the
       network; and, on average, users are utilizing less than 1% of the
       network's available bandwidth (or system capacity), with peak usage
       averaging only about 16% of available bandwidth.

    -  Allegations earlier this year that eHealth Ontario awarded contracts
       to certain companies without giving other firms a chance to compete
       were "largely true," as were allegations of "favouritism" in the
       awarding of such contracts. For example, one firm that bid 500% more
       than the next qualified bidder was invited to bid again, the only
       company offered such an opportunity, and, after lowering its bid
       significantly, won the contract. Another firm that was awarded
       untendered contracts on the first phase of several projects was
       awarded many subsequent contracts worth about $7 million to work on
       successive phases of those projects.

    -  There was a heavy, and in some cases almost total, reliance on
       consultants. By 2008, the Ministry's eHealth Program Branch had fewer
       than 30 full-time employees but was engaging more than 300
       consultants, a number of whom held senior management positions.

    -  The recent replacements of the eHealth Ontario board chair and CEO
       mark "the fourth such overhaul of leadership at eHealth Ontario and
       its predecessor" and each of these overhauls brought with it its own
       period of transition where progress on the initiative's objectives was
       slowed or, at times, virtually halted.

    -  Ontario is near "the back of the pack" in the development of EHRs
       compared to the other provinces.


    For more information and to view the full special report, please visit
                             www.auditor.on.ca.
    

For further information: Jim McCarter, Auditor General, [phone]; Andréa Vanasse/Joel Ruimy, Communications, [phone]