RE:RE:RE:RE:RE:Telus acquisition of NightingaleI vividly remember the waste in Ontario and BC. I also remember fiascos in New Brunswick, Nova Scotia, Alberta and Manitoba. 10 years ago Infoway released their second version of the blueprint for a pan-Canadian interoperable framework. 10 years later after countless CHI funded projects, we have a handful of provinces each running a disparate electronic health record (EHR) system; each supported by behemoth public servant based IT/administrative bureaucracies; each supported by an army of contractors.
Provinces will argue that their EHRs are beneficial and comply with the blueprint. The reality is that it will take stupid amounts of money, resources and time to link these systems. Provinces and eHealth groups are also unlikely to lobby (or fund) linking systems across provincial boundaries. This is the crux of the problem. Provinces still perceive the data belongs to them; and lobby/fund projects based on their political wants/needs.
As for electronic medical records (EMR), there is no doubt that they are beneficial. Physicians and clinics realized this long before CHI was birthed and their report released. The challenge has always been getting private practice physicians to fund an EMR. CHI funding certainly helped with this.
I believe 10 years ago Telus got into the EMR business simply with the vision of being an application service provider for the medical community. Decisions were based on amount of profit that could be added to the bottom line by scooping up EMR vendors. I think what's held them back is that in their pursuit of profit, they gravitated to scooping up weaker EMR vendors with weaker products. QHR with a strong vision, product and expanding customer base was probably not interested in selling out. Telus probably wasn't prepared to go hostile as risk was too high.
Over time, I think both QHR and Telus have seen a much bigger opportunity. Through their partnership I predict we will see interoperability occurring between physician offices and ambulatory care clinic EMRs long before we see (if ever) interoperability between provincial EHRs. Canadians will also have access to their EMR records long before they have electronic access to their provincial records.
All of this will occur in the absence of CHI funding (or with minimal funding). Once that happens, tough questions will be asked about cost/benefit/sustainability; and the QHR/Telus nationally architected solution will quickly expand to absorb and replace traditional provincial solutions.