Today it was reported that the Ontario Minister of Health has resigned, presumably on the wake of the eHealth scandal (which I discuss in an earlier post) that engulfed the current Liberal government since it was revealed that there were considerable questionable expenses made by eHealth Ontario. It’s all a mess, most notably because at its root eHealth is all about trust and that seems to be the element that is most absent in this political spectacle. The elected officials do not trust the bureaucrats at eHealth Ontario, while the public loses its trust in the elected officials. Mingled in with this is a problem with trust of the government to develop a reasonable eHealth information system on its own and the simultaneous distrust of the private sector to do it for a reasonable fee and deliver an effective and efficient service. So far, all these fears are well-grounded as played out in this scandal (and when you spend $1B on a system that can be delivered for a small fraction of that and wind up with little to show for it, it is a true scandal).
The irony in all of this is that eHealth is founded on trust. We trust that our records will be stored in a manner that is secure, but also accessible. We trust that the most appropriate use of health information gleaned from information we provide to health professionals or online will follow from having these systems in place. There are the tools and resources to do this and they are not that hard to develop. That isn’t to say that this is something one person can slap together in an afternoon on a PC, but it doesn’t take a billion dollars to do it either. In the United States, The Veteran’s Administration has its own eHealth University to train people on how to use the eHealth system they developed (and it is going to be open-source I might add, meaning that the world can take it and adapt it). They have put the resources into building trust among health care professionals by offering training, developing a transparent model, and in doing so, fostering trust in their patients.
eHealth in the public sphere is equally about trust. Social networks — the foundation of nearly all of the leading websites and tools from Google to Facebook to Twitter — are all based on trust. Karen Stephenson, a pioneer in the early research on social networks in organizations, says that trust and its ability to broker relationships serves as a kind of backbone of innovation, by leveraging social capital across organizational boundaries. From a systems science perspective, trust is the mechanism by which diversity can be better engaged in the system — whether that is diversity of ideas, opinions, cultural expression (example) , sexuality, and identity.
Marketers Chris Brogan and Julien Smith recently published a book that argues that marketing — the spreading of ideas about a topic or product — is essentially about creating and engaging trust agents. From a public eHealth perspective, this means providing ways to get people connected in a safe, secure manner that enables them to share their ideas, innovate and learn in a way that supports — even enhances — trust.
The challenge in Ontario is building that trust back up. eHealth has become a ‘four letter word’ and its name — fairly or unfairly — has been sullied by the events of the past few months. Let’s find some ways to build it back up and do it in a way that makes us all better for it. Ideas are welcome.
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