eHealth Isn’t Rocket Science…But Maybe it Should Be

For those of us in the eHealth area and working in Ontario, these are dark days. While the opportunities for electronic tools can make a substantial different to patient care, health promotion, and health innovation are greater than ever, the events surrounding eHealth Ontario, it’s former CEO, its governance, and its outputs have made eHealth a bad word in many circles. When a term that could stand for innovation, quality, accessibility and efficiency is equated with $25K speeches and Choco Bites, we’ve got problems.

But as Andre Picard wrote in the Globe and Mail, it wasn’t about the Choco Bites. The eHealth ‘boondoggle’ is about most everything, but what it was supposed to do. It became about the technology and not about designing a system to support the health and wellbeing of the public and the delivery of care by professionals. But when it became about the technology, we relied on well-worn and inefficient means of building it because people thought it was too important and too big not to trust to the ‘experts’. The problem is, the experts in this system are designing things to make money as their first priority, not health. The result? Large, inefficient systems that are technology first and people second, meaning they don’t do the job.

It is understandable that people might feel a little overwhelmed trying to imagine how a computer system could connect all the myriad paper records together to provide timely, accurate and secure information to physicians and care providers all across a large province like Ontario. It may be this very feeling that has inspired the decisions to pursue such outlandishly expensive electronic solutions that, to date, appear to have little value for dollar.

We’ve seen this before. The Canadian Firearms Registry was one example. So have been the examples of various database programs to support child welfare programs and track paroled sexual offenders. More often than not, these become big expenses with outcomes that are less than stellar.

Building databases is complicated, but it isn’t rocket science. Maybe it should be.

In the Shadow of the Moon is a remarkable documentary that looks at the race to the moon as told by the only men who had ever stepped foot on it. What stood out for me in that film was how, with some inspiration, determination, and resources, the U.S. was able to mobilize its talent to go from rockets that blew up on the launch pad to sending men to the moon multiple times to win the Space Race. This was a feat of innovation that was staggering. 40 years later, the Ansari X-Prize was awarded to the first team “to build and launch a spacecraft capable of carrying three people to 100 kilometers above the earth’s surface, twice within two weeks.” It set off a new phase in commercial space flight. Just as Charles Lindberg won the Orteig Prize, which initiated transcontinental air flight, the X-Prize has initiated a new industry. Yet, at the end of all that, we remember the people and the amazing things they did much more than the technologies they used to get there.

Maybe we need the X-Prize for eHealth. What if we enabled the power of collective thinking, self-organization, and the motivation that comes from winning a prestigious prize? What new ideas would we come up? How much money would we save? The X-Prize was $10M and kick-started a $300M nascent market for commercial space travel. eHealth Ontario has spent more that $650M and achieved little.

Bring on the rocket scientists, our health system apparently needs them.