Michael Hardner Posted June 22, 2009 Report Posted June 22, 2009 (edited) Recently, Ontarians were alerted to a newsworthy story about something called eHealth Ontario, and it's greedy consultants overbilling the province for doing not much of anything. I expect that those stories were the first time most of us had heard of eHealth Ontario or its predecessor 'Smart Systems for Health'. I have been blogging on this topic for years now, and I maintain that the problem is public apathy, married with media that is not suited to reviewing complex issues of government management. Ontarians, by their lack of interest in these matters, have indirectly allowed the Ontario government to continue in this manner for years. We still don't know what is going on, other than some tidbits of outrage that are lobbed out. Wait times for health care should be one of the most well known issues in the public eye, but it isn't. The Province has spent years managing the issue via press releases. And if we're hoping for media to lead the public on this issue, I hail back to an apt phrase I heard recently: journalists are good at reporting revolution, not evolution. The mismanagement of wait times has been happening for years, without any degree of alarm from our journalists. But now, a consultant billing thousands of dollars per day, then asking for tea money is news. Let's review: McGuinty promised standardized wait times in 2003 ! The Record Now let's look at the government's numerous own press releases on the topic since 2004: Ontario Wait Times News Releases Wait Times News ReleasesNews Releases and Backgrounders Oct. 17, 2008 Wait Time Strategy Expands Sep. 19, 2008 Improving Care for Ontario’s Youngest Patients May 30, 2008 Ontario Tackles ER Waits With $109 Million Investment May 2, 2008 New MRI will Reduce Wait Times in Ottawa May 1, 2008 Patients in Ottawa to Receive Cancer Care Faster and Closer to Home Apr. 18, 2008 Ontario is National Leader in Reducing Health Wait Times Apr. 17, 2008 Cancer Care Closer to Home Dec. 13, 2007 Ontario’s Wait Time Information System Receives Awards Nov. 22, 2007 Ministry of Health and Long-Term Care Moves to Monthly Reporting with its Wait Time Information System Oct. 12, 2007 Premier McGuinty Selects Alan Hudson To Expand Successful Wait-Times Strategy To Hospital Emergency Rooms Aug. 27, 2007 Strengthening Cancer Care for Barrie Families Aug. 20, 2007 McGuinty Government Approves New CT Scanner for Huron County Aug. 20, 2007 McGuinty Government Approves New CT Scanner for Huron County June 1, 2007 McGuinty Government Delivering Improved Cancer Care Services for Ottawa Area Residents May 25, 2007 Speeding Up Access to Cancer Care for Ottawa Families May 22, 2007 Ontario Government Reducing Health Care Wait Times May 10, 2007 Faster Care for Ontario’s Kids May 10, 2007 Backgrounder : Wait Time Data for Paediatric Surgeries May 10, 2007 Backgrounder : Improving Access to Paediatric Surgeries May 3, 2007 Getting Results for Patients in Hamilton May 1, 2007 McGuinty Government Improves Access to Cancer Care in Barrie Apr. 27, 2007 McGuinty Government Continues to Reduce Health Care Wait Times for Ontarians Apr. 20, 2007 Speeding Up Access to Care for Barrie Families Apr. 20, 2007 Speeding Up Access to Care for London Families Apr. 13, 2007 McGuinty Government Improves Access to Cataract Surgery for Northwestern Ontario Residents Mar. 27, 2007 McGuinty Government Moving Forward with Wait Time Guarantee Mar. 15, 2007 Patient Friendly Website and Independent Data Council Strengthen Wait Time Strategy Mar. 9, 2007 McGuinty Government Supports Better Access to Hip and Knee Replacement Service Feb. 26, 2007 McGuinty Government Supports Better Access to Health Care Services Feb. 1, 2007 Kirby Validates Integrity of Wait Times Strategy Dec. 7, 2006 Former Senator Michael Kirby to Review Wait Times Reporting Sept.12, 2006 Improving Access to Key Healthcare Surgeries and Procedures Across Ontario May 18, 2006 McGuinty Government Reducing Health Care Wait Times Apr. 28, 2006 McGuinty Government Reduces Health Care Wait Times and Invests $222.5 Million in More Procedures Jan. 13, 2006 McGuinty Government Reducing Wait Times for Hip and Knee Replacements Dec. 16, 2005 McGuinty Government Announces Ontario Wait Time Targets Dec. 12, 2005 First Ever Common Benchmarks Will Allow Canadians to Measure progress in Reducing Wait Times Oct. 24, 2005 McGuinty Government First to Give Ontarians Access to Current Wait Times Information Oct. 21, 2005 McGuinty Government Invests in new Cancer Radiation and Diagnostic Equipment Oct. 3, 2005 McGuinty Government Invests in additional cataract and hip and knee surgeries, and MRI scans May 27, 2005 McGuinty Government announces largest increases in a decade for cataract surgery, hip and knee replacements and MRI scans Backgrounder : Improving Access To Five Key Healthcare Surgeries And Procedures Backgrounder : Expanding MRI Services In Ontario April 6, 2005 Ontario Health Minister Welcomes Report on Wait Times that Sets Baseline For Government To Measure Key Healthcare Results Feb. 03, 2005 McGuinty Government Reduces Wait Times By Delivering 119,865 Additional MRI, CT, Cancer And Cardiac Procedures Backgrounders : Wait Times Strategy for MRI, CT, Cancer And Cardiac Procedures Dec. 20, 2004 McGuinty Government Launches New Website on the Province's Wait Time Strategy Dec. 14, 2004 McGuinty Government Reduces Wait Times for Key Surgeries, delivering 5,380 more cancer, cataract and hip and knee replacement surgeries. Nov. 17, 2004 McGuinty Government Provides Better Access to Key Health Services with immediate investment of $107 million for additional surgeries and procedures, new and more efficient diagnostic machines, as well as expanded hours of operations. Speeches Nov. 17, 2004 Speaking Notes Presented by George Smitherman, Minister of Health and Long-Term Care to OHA 80th Annual Convention Recently, the Ontario government started getting some traction on reporting and reducing wait times, after spending some unknown large amount of money on the problem. It seems that the situation has improved, however it's not clear. The wait times on the Ontario MOH websites: Ontario ER Wait Times Ontario Surgery Wait Times However, these numbers are poorly explained, and there is no independent verification whatsoever. That amounts to self-reporting, ie. telling your boss how well you're doing at your job. Ontario seems to have had improved wait times, however, there is no trend reporting (some of that is provided at the Canadian Institute for Health Information website - a quasi-independent watch group - here: CIHI Wait Times Here's an example of the inconsistency of reporting. How are wait times measured ? How do we measure wait times?We measure wait times in 2 ways : * Surgical wait times: We track the time between when a surgery is ordered and when it is performed * Diagnostic scans (MRI and CT) wait times: We track the time between when a diagnostic scan is ordered and when it is completed. http://www.health.gov.on.ca/transformation.../wt_data.html#2 Now, go to an individual report and you will see a different definition: WaitTimes.net Wait time: The point at which 9 out of 10 patients have completed surgery or have had their exam. And there is at least one other definition. But besides the inconsistent definitions, there is the fact that there are still a significant number of non-reporting hospitals, and it's not clear how they average their numbers in the first place. Oh, and when you Google for Ontario Wait Times, you get THIS first, describing a "new" waiting list from 2005: New website in Ontario gives info on hospital waiting lists for surgery24. October 2005 20:18 Medical News Site It's scandalous and we're to blame for accepting this situation. Mike Harris was basically chased out of Ontario for trying to change things without enough planning or thought. In the case of water testing, it resulted in deaths in Ontario. But Harris' destructive methods were replaced by a persistent and complacent acceptance of the status quo. We need to come up with a new way to focus public attention on the terrible mismanagement and non-reporting that is happening in healthcare. If we don't care about such things (except for the fun scandals) then our media won't care either. I urge people to talk about these issues, to blog about them and to email [email protected]. Edited June 22, 2009 by Michael Hardner Quote Looks like someone has a new patronizing catch phrase ! Michael Hardner
Smallc Posted June 23, 2009 Report Posted June 23, 2009 Wait times are often measured in different ways. Often this is done because the entire system has not yet moved over to one standard metric. I think you;re trying to find a second scandal that doesn't exist. Ontario is making progress. That's made clear by all metrics. Ontario has one of the best systems in the country (if not the best). That's also made clear. Quote
Michael Hardner Posted June 23, 2009 Author Report Posted June 23, 2009 Clear ? How ? From bi-annual reporting by the people who have a stake in the results ? By a quasi-independent group that publishes rough statistics once a year ? There is no second scandal. The second scandal was the one that blew up. The first scandal is that it took (so far) 6 years to create a system to measure and manage wait times that is still wanting. How long should it take to move hospitals to one metric ? It is STILL not done. Quote Looks like someone has a new patronizing catch phrase ! Michael Hardner
Smallc Posted June 23, 2009 Report Posted June 23, 2009 So what should be believed, the multiple statistics that show things are getting better, or your hunch that they aren't? I know which one I'm going to believe. Quote
Michael Hardner Posted June 23, 2009 Author Report Posted June 23, 2009 I acknowledge that wait times may be improving, but if you're satisfied by how that has been achieved so far (ie a snail's pace, with no clear indication of costs, with no independent body involved) then people like you are indeed part of the problem. I'm not in favour of privatization, but I do not accept the way that things are being managed. Quote Looks like someone has a new patronizing catch phrase ! Michael Hardner
Smallc Posted June 23, 2009 Report Posted June 23, 2009 I accept that as a human system there are going to be problems. We seem to have found a problem now. I expect that it will be fixed. We can then move from there. We should always try to do better, but we can never ignore the fact that we have many limitations. Quote
Michael Hardner Posted June 24, 2009 Author Report Posted June 24, 2009 You really are missing the point. The 'problem' of people charging for tea only came to the fore as a sideshow. I guess you don't see 6 years to implement a waiting list management system a problem. I doubt you would have found it a problem if it took 20 years to do so. At what point will you stand up and say 'This Liberal government is wasting my money and providing me substandard services !' My expectation is that you don't know, and I guess I can't blame you for not knowing where that point is. So what I'm telling you is - that point was about 3 years ago and an unknown number of hundred million dollars ago. Quote Looks like someone has a new patronizing catch phrase ! Michael Hardner
Smallc Posted June 24, 2009 Report Posted June 24, 2009 And my question is, how do you know that? What gives you the ability to draw that line in the sand? Quote
Michael Hardner Posted June 24, 2009 Author Report Posted June 24, 2009 I work in the industry, but not exactly in healthcare. I'm taking the longest possible timeline I could imagine to do the work, then doubling it. Quote Looks like someone has a new patronizing catch phrase ! Michael Hardner
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