Many posters claim that Smitherman was the health minister who oversaw the formation of e-health and the handing out all those untendered contracts. He's also been accused of wasting $1B on electronic health records. I've heard that so many times, I believed it myself. But, apparently it is a false claim.
Smitherman moved to Energy and Infrastructure 3 months before e-health was even created so he had nothing to do with the untendered contracts or the exorbitant consultant fees. And that $1B that Smitherman supposedly wasted is actually the entire amount spent on creating electronic health records from 2002 to 2009 when the auditor's report was published. The Smart Sytems for Health Agency (SSHA) was created by the PC gov't in 2002 and began operations in April 2003. McGuinty and Smitherman got elected in October 2003.
Smitherman should probably have gotten a handle of that SSHA project sooner but it is absurd to think he'd be up to speed on it immediately. The SSHA had been active for only about 7 months when Smitherman took the job and it was just one very small part of the overall health portfolio. I don't think any minister would have chopped or reinvented a new project like SSHA without first giving it a year or two to get off the ground. At some point, he should have realized that the electronic records weren't being implemented fast enough but it was new technology and probably wan't very high on his list of priorities. The big initiative in the health ministry was to reduce wait times - not an easy task. The health ministry is a huge portfolio and, realistically, I doubt that anyone could get a good handle on it in less than 3 years if they started from scratch.
Smitherman has plenty of faults but I think this one has been exaggerated out of all proportion.
http://www.theglobeandmail.com/news...de-slurs-over-ehealthy-debate/article1762986/
The eHealth scandal, if it can be called that, unfolded in two chapters. In the first, newspapers revealed that the provincial government’s eHealth agency had awarded millions in untendered contracts to private consultants, some of whom had (horrors of horrors) charged expenses for things like tea and Choco Bites while collecting hundreds of dollars an hour.
Mr. Smitherman had no direct role in this. He was provincial health minister for 4 1/2 years, but Premier Dalton McGunity moved him to the Ministry of Energy and Infrastructure in June, 2008, three months before the government launched eHealth, to work on creating electronic health records for Ontarians. He was in no position to scrutinize eHealth when it handed out handsome contracts to consultants, much less to direct the money to his “lobbyist friends” – a slur if there ever was one.
The second chapter came when Ontario Auditor-General Jim McCarter issued his report on eHealth in October, 2009. Apart from criticizing eHealth for handing out consulting contracts without competitive bidding, Mr. McCarter reported that the government had spent an eye-popping $1-billion since 2002 to create electronic records. Despite all that time and money, he said, the network set up by the government still has relatively few users, so “the value of this investment, at least to date, has not been realized.”
http://www.auditor.on.ca/en/reports_en/ehealth_en.pdf
Appendix—Chronology of Events Relating to the
Electronic Health Record Initiative
April 1996
• Ontario government forms a Health Services Restructuring Commission to provide a framework and make recommendations for restructuring Ontario’s public hospitals and health service delivery system
• Commission identifies lack of integration, lack of health information, and difficulty in sharing health information as key problems
June 1999
• Commission submits the Ontario Health Information Management Action Plan to Minister of Health and Long-Term Care
• Action Plan recommends acceleration of information and technology investments so that health-care information can be better captured, shared, and analyzed
• Action Plan envisions “an integrated health information network with an electronic consumer record at its core”
• Action Plan also recommends creation of an independent, arm’s-length entity to provide strong central leadership, manage implementation of action plan, and allocate financial resources
September 2000
• First Ministers agree “to work together to strengthen a Canada-wide health infrastructure to improve quality, access, and timeliness of health care for Canadians”
• First Ministers also commit to develop Electronic Health Records and the common standards necessary to ensure the future compatibility of all the jurisdictions’ health-information networks
2001
• government of Canada creates and funds Canada Health Infoway as an independent, not-for-profit Shared Governance Corporation
• Infoway’s members are Canada’s 14 federal, provincial, and territorial deputy ministers of health
• Infoway’s mission is to accelerate the development of electronic health information systems (such as Electronic Health Records) on a pan-Canadian basis
• Infoway’s goal is that 50% of Canadians will have an Electronic Health Record by 2010 and 100% will have an Electronic Health Record by 2016
2002
• Ontario government creates the Smart Systems for Health Agency (SSHA) by regulation under the Development Corporations Act
• SSHA begins operations in April 2003 with a mandate to support Ministry of Health and Long-Term Care programs; it begins to build a private network to connect Ontario’s medical community
2004
• Ministry’s eHealth Program Branch created to establish and maintain an eHealth strategy and oversee its delivery, including the development of EHR applications and databases
2005
• SSHA’s mandate clarified by regulation to one of providing and operating secure infrastructure to enable secure transfer of personal health information among sector providers and hosting personal-health-information applications
November 2006
• Deloitte Consulting completes critical operational review of SSHA, commissioned by the Ministry of Health and Long-Term Care and SSHA’s board of directors—by this time SSHA has some 1,400 network circuits deployed, costing more than $500,000 monthly to maintain
March 2007
• Infoway’s 2007/08 corporate business plan projects that, in terms of EHR progress, Ontario will be ahead of Northwest Territories, Yukon, and Nunavut but behind all provinces by March 31, 2008
August 2007
• Office of Auditor General of Ontario reviews SSHA’s efforts to address certain of Deloitte’s key recommendations and notes progress made in some areas while more work required in others
• Auditor General’s review identifies lack of an overall government eHealth strategy and Ontario’s slow progress in overall Electronic Health Records achievements as continuing issues
• federal and provincial Auditor Generals discuss possibility of collaborative audit of electronic health records
September 2007
• Ministry and SSHA sign an Affirmation of their Memorandum of Understanding
• SSHA’s mandate is to provide “the secure, integrated, province-wide information technology infrastructure to allow electronic communication among Ontario’s health service providers”
June 2008
• SSHA strikes a client experience task force to improve services to and relationships with clients, which identifies SSHA’s poor understanding of its customers and poor performance issues as key problems
August 2008
• Ministry makes submission to Management Board of Cabinet, seeking and obtaining approval for “the establishment of an Electronic Health Record of clinical information for every patient, and that could be controlled by the patient, by 2015”
September 2008
• federal and five provincial Auditor General offices agree to conduct a collaborative audit on Electronic Health Records initiatives across Canada, with each jurisdiction issuing its own report
• federal Auditor General is to combine observations from these reports with its own work on Canada Health Infoway operations and issue a Canada-wide report in 2010
• Ontario government creates the eHealth Ontario agency to combine the activities and responsibilities of SSHA and Ministry’s eHealth Program Branch into one organization responsible “for all aspects of eHealth in Ontario, including creating an Electronic Health Record for all Ontarians”
• Ontario government also forms the eHealth Ontario agency’s first board; no members from SSHA’s board are invited to join the eHealth Ontario agency’s board; Premier appoints board Chair
October 2008
• Premier supports Chair’s request regarding appointment of CEO after meeting with Chair’s recommended candidate
• Order-in-council is issued making CEO’s appointment official
March 2009
• Canada Health Infoway’s 2009/10 corporate business plan shows Ontario still lagging behind all provinces (although ahead of Northwest Territories, Yukon, and Nunavut) in developing Electronic Health Records
• Canada Health Infoway’s business plan indicates that 17% of Canadians have an Electronic Health Record available to their health-care provider
• Ontario government’s eHealth Strategic Plan published
• Strategic Plan describes activities to be undertaken from 2009 through 2012 and sets target of delivering a fully functional Electronic Health Record system by 2015
April 2009
• Ministry and eHealth Ontario sign a Memorandum of Understanding and a Transfer Payment Agreement setting out their respective accountability
May/June 2009
• significant controversy over possible sole-sourcing of consultants and related costs erupts in the Legislature and the media
June 2009
• eHealth Ontario agency’s CEO and board Chair resign
