The Alberta government expects to spend upwards of $1.4 billion to implement electronic health records provincewide -- including another $66 million this fiscal year -- for a system the auditor general says has been poorly managed.
The Tory government has been working on implementing electronic health records for more than a decade, with the digital files designed to reduce wait times, improve access and efficiency, and increase patient safety and participation in care.
Electronic health records allow health professionals to view a patient's medical history, lab results, diagnostic images and prescribed medications.
But adopting them comes with a whopping price tag.
The province has spent $674 million on the plan since 1999, and will pump another $108 million into it over the next three years (including $66 million in 2010-11).
The final bill is expected to reach about $1.4 billion by the time the project is fully implemented -- although the province isn't certain when that will be.
"It's just such a massive undertaking. Ye a h, the costs are a little higher than we might have hoped and it has taken a little longer than we might have hoped," said Howard May, spokesman for Alberta Health.
"But we're not going to apologize for doing it," May said. "How do you put a price tag on saving lives?"
Adopting the electronic health records is one of Alberta Health's top priorities for medical improvements, he noted, but also because it will save the system several millions of dollars in efficiencies on an annual basis.
Health Minister Gene Zwozdesky wasn't available to comment.
The $66 million allocated this year is being invested in developing programs that allow physicians to submit patient information to the EHR database; completing a system that will share diagnostic images; and bring community pharmacies online for submitting dispenses.
Cash will also go to a new Personal Health Portal initiative (Phase 1 is expected to be launched by the spring) that will allow patients to access clinical information from their records and be more accountable for their health.
Future EHR dollars are earmarked for a provincewide electronic prescription process; collecting and sharing immunization records; developing an electronic referral system that links family physicians to specialists; and creating personal health records for all Albertans that include test results and information patients upload themselves.
Health policy experts believe the electronic records are critical to improving safety and cost efficiency in the system.
"It's an important and worthwhile investment," said John Sproule, senior policy director at the Edmontonbased Institute of Health Economics. "It is seen as essential and vital for the future of health care."
Yet, Canada lags far behind other parts of the world in implementing electronic health records, according to recent reports.
A 2009 study from the Commonwealth Fund, an international health think-tank, found that 95 per cent or more primary-care doctors in the Netherlands, New Zealand, Norway, United Kingdom and Australia all used electronic health records.
In Canada, that number was only 37 per cent, while the United States was at 46 per cent.
In Alberta, the government estimates 34,200 users access the EHRs annually, or about 57 per cent of the estimated 60,000 potential users in the health system.
Approximately 20 per cent of the users are physicians, 30 per cent nurses and 10 per cent pharmacists, with the remaining users including administrative and clinical-health professionals.
The provincial government has received about $80 million in federal cash to help synchronize the EHR systems, with another $50 million potentially on the way.
As the costs have grown, so, too, have the holes in implementing the system, Alberta's auditor general said in a scathing review last fall.
In his final report as auditor general, Fred Dunn highlighted a litany of problems facing Alberta Health and its implementation of electronic health records.
The department had no integrated delivery plan, demonstrated poor project management as well as shoddy oversight of users accessing sensitive patient information.
"The (Health) Department cannot demonstrate that it is achieving expected results," said the report.
Alberta Health also didn't track or report on the mounting EHR costs, nor could it explain how savings would be achieved by implementing the initiative. The province also couldn't identify when the project would be completed or what the final bill would be.
"When we asked the questions, 'What does it look like, when will it be finished and how much will it cost?' we couldn't get an answer," Dunn explained at the time.
Alberta Health has since responded to the AG's recommendations, explaining the government has improved its oversight, adopted an integrated delivery plan and clamped down on who can access patient information.
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Autor(en)/Author(s): Jason Fekete
Quelle/Source: The Calgary Herald, 26.07.2010
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