Tag Archives: E-Health

Former Infoway boss frustrated by slow implementation of health care IT

Photograph of former Canada Health Infoway CEO Richard Alvarez at Breakfast With the Chiefs.

Richard Alvarez, former President and CEO of Canada Health Infoway, says slow pace of change among low-lights of his 10-years on the job.

When it comes to information technology, many Ontario medical practices are still more “Leave It To Beaver” than “Jetsons.” In that respect, Canada is falling behind other developed countries in integrating health care through new technologies.

Richard Alvarez, the recently departed President and CEO of Canada Health Infoway has many regrets over what he has been able to achieve after 10 years at the helm of the agency charged with coordinating federal and provincial investment in health care innovation and information technology.

Speaking at Longwood’s “Breakfast With The Chiefs” last week, Alvarez remained careful about his choice of words before a room full of the health sector’s leading decision-makers.

He needn’t have bothered.
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Will new health care technology bring a utopia or dystopia?

It’s easy to get carried away with the continual promise of better health care through technology. From the IBM Watson super computer to vending machines that dispense pharmaceuticals, we are likely on the cusp of a new wave of technology that will vastly change the way we deliver health care. Whether that is for better or worse is up for debate.

The public largely buys into the dream of transformation through technology. Even with all the questions raised about problems with electronic health records, for example, surveys still show substantial public support. Are we even aware of what the trade-offs are?

Richard Alvarez, President and CEO of Canada Health Infoway, told an audience this morning that the next big thing will be personal health monitors, easily accessible devices that can be picked up at department stores like Walmart.

Speaking at Longwood’s Breakfast with the Chiefs alongside Dr. Jennifer Zelmer, vice-president of clinical adoption and innovation at Canada Health Infoway, the two argued that technology can be a case of the good, the bad and the ugly. Not surprisingly given the speakers, the presentation got specific on the good and much more vague on the bad and the ugly.

Canada Health Infoway is an independent not-for-profit corporation created by Canada’s First Ministers in 2001, and funded by the Government of Canada. CHI has a mandate to work with governments, health care stakeholders and the technology industry to “improve access to health information for better care.”

After enthusing about personal health monitors, Alvarez pondered who would pay for these items, harkening back to a quote they began the session with from futurist William Gibson – “the future is already here, it’s just not very evenly distributed.” What role does government play in levelling that playing field?

Richard Alvarez, President and CEO of Canada Health Infoway

Richard Alvarez, President and CEO of Canada Health Infoway

The speakers highlighted the ability of technology to make health care more accessible to remote communities, especially ones that face difficulties recruiting specialists. Zelmer specifically made the claim that Telehealth saves Canadian patients from driving 47 million kilometres at an estimated cost of $55 million. The opportunities are certainly much broader. Alvarez said with digital scanning it was possible for pathologists to work out of a single center in Canada. It was interesting that none of the audience members picked up on the implications of this – if it could all be done out of a single center, what’s to say that this center even had to be in Canada? That should be enough to make any pathologist nervous.

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Is the OHA next to experience public wrath over executive bonuses?

It seems there are two choices with regards to executive compensation.

The first is to simply place executives on salary and expect them to do the job they get paid for. That’s how rank and file employees get paid.

The second is to divide compensation, setting out a certain amount as “base” salary, the rest as bonus based on established performance benchmarks.

The Local Health Integration Networks can also claw back a percentage of a hospital CEOs salary if the hospital fails to live up to the terms of its accountability agreement with the LHIN – not that we are aware of this ever taking place.

The LHINs themselves may be a bit gun-shy about using these powers given they themselves are struggling to meet their own performance targets. The Erie-St. Clair LHIN, for example, missed 11 of 14 performance targets for 2010-11.

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Former senior bureaucrat Gail Paech resurfaces at OLTCA

Inside Queen’s Park reports that Gail Paech has been named interim CEO of the Ontario Long Term Care Association.

Paech is well-known in Queen’s Park circles.

She was at the center of controversy in 2009 when it was learned the McGuinty government was hiding the salaries of senior bureaucrats in hospital budgets.

The former CEO of Toronto East General Hospital, Paech was serving as associate deputy minister of economic development and trade but drawing her $291,997 salary from the University Health Network. The recommended maximum for an ADM was $188,950 at the time.

Paech was also Health Results Team Lead for System Integration. She developed the strategic policy framework to support the government’s decision to create the Local Health Integration Networks.

During the e-Health scandal Paech was described by the Toronto Star as being “influential in the program.” In fact, while Sara Kramer took the fall, Paech was in fact the program lead for e-Health. At the time she told the Star it was “not my practice” to award any untendered contracts.

The Ontario Long Term Care Association claims to represent the “full mix of long term care providers”, although it is considered by many to be the primary organizational voice of for-profit nursing homes. It claims to have 430 institutional members. This organization is separate from the Ontario Association for Non-Profit Homes and Services for Seniors.

There is no indication of what Paech’s salary will be.