Friday, June 2, 2017

--Jean-Luc Ferland, a spokesperson for Treasury Board President Scott Brison, welcomed the consultants' conclusions and recommendations, pinning much of the blame for the bad results on the former Conservative government.--------------In April 2011, then-prime minister Stephen Harper lauded the project to consolidate the government's IT systems and data centres, saying on the election campaign trail that year that "we know we can save all kinds of money there."--------------The consultants say Shared Services Canada is slow-footed, partly hobbled by complex procurement rules, so that an email solution it chose in 2011 and still has not completed has since been outmoded by new cloud services.-----------"Decision making cannot follow current approaches," said the document, obtained by CBC News under the Access to Information Act. "Execution must be based on agile, effective decision making, with clear and singular accountabilities. This is the antithesis of governance today."







Massive health information overhaul coming to Alberta


FIRST POSTED: MONDAY, APRIL 18, 2016 08:13 PM MDT | UPDATED: MONDAY, APRIL 18, 2016 08:19 PM MDT
Dr. Robert Hayward, Alberta Health Services chief medical information officerDr. Robert Hayward, Alberta Health Services chief medical information officer, at University Hospital in Edmonton on Monday. (Ian Kucerak)
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Patients tired of retelling medical histories, physicians frustrated with a cumbersome record system too reliant on paper, and administrators struggling to cut costs hope to benefit from a massive health information overhaul in Alberta.
The government has vowed to invest $400 million over the next five years to begin replacing most of the 1,300 unconnected technology platforms currently in use within Alberta Health Services.
The new, single clinical information system will be deployed across the province after an initial rollout in Edmonton facilities, where an antiquated, 30-year-old technology has been a festering headache.
“I came to Alberta in 1997 and I’ve been waiting two decades for this,” said Robert Hayward, chief medical information officer for AHS. “I am so excited. It’s something many governments have been promising for many years and finally we are seeing the light we need.”
Hayward described a clinical information system as a giant integrated data hub that serves every aspect of the health system a patient might touch, from drug prescriptions and diagnostic tests to rehab clinics and home care. He said the best systems not only offer information for individual users, but can also manage broad, systemwide data on admissions and discharges, and the management of beds and supplies.
For patients, Hayward said one of the biggest benefits will be the ability to have a single medical record that can be accessed by health providers at any point in the system. Currently, patients are often forced to repeatedly explain their health stories to different professionals, rather than having a seamless experience in which everyone is working from the same information.
“Having everything integrated will allow the patient’s narrative to go with them everywhere in the system and the plan we make about how to care for them will also go wherever they go,” Hayward said.
The system is also expected to have a portal for patients to access their own information.
For health professionals, the arrival of the system should modernize processes that are often described as excessively time consuming and prone to error.
As an example, Hayward described the experience of physicians working in Edmonton hospitals. Medications often have be discerned by reading a paper chart printed from computer technology so old that technicians have to brought out of retirement to fix it and broken monitors can no longer be replaced. Orders for medications, tests and specific types of care have to be written on pink pieces of paper.
“We feel like we have quite a primitive experience,” Hayward said. “It’s a totally unacceptable and expensive and prone to errors.”
In contrast, the new system will allow professionals to access patient data and securely communicate with each other on their mobile devices.
For administrators, the new technology provides an ability to amalgamate information from all over the system to detect trends, pinpoint problems and make better spending decisions.
Hayward said $400 million will “kick-start” the project by allowing AHS to issue a request for proposals. It’s expected the successful company will need a couple of years to install the new technology platform across the Edmonton zone, which is behind Calgary and plagued with a system at risk of failure.
Then, over the next 10 years, the idea is to extend the system all over the province so that every provider can use it, including small doctors offices. Hayward said cost savings from the first rollout of the technology will be used to fund the later stages.
“It’s a big project, but I would say it’s a bigger and more complicated project to keep floundering the way we are,” he said.
Dr. Carl Nohr, president of the Alberta Medical Association, applauded the government’s decision to invest in better information management.
“Right now we have bits of health care information about he same patient in lots of different locations,” he said. “We recognize change will take time and money and that there has been a lot of talk about this in the past, but we feel this is an important step in the right direction.”
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While it is important to have a single patient record that can be accessed by patients (and doctors one hopes) anywhere in Alberta I am curious why this was not set up with the NetCare system. Why do we have two information systems for the same set of patient data?
It's going to cost us $1.6 billion dollars and probably more to do this single repository of information. In addition, this is not a complete patient record as the data from family physicians won't be included so then this isn't a consolidated record is it?
We're paying a ton of cash for a product that is already defective. Why the poor planning in government? Why the poor financial estimates as well? The auditor general of Alberta has indicated that the cost savings for this project won't be as good as promised either and that the $1.2 billion savings aren't guaranteed:
http://www.edmontonsun.com/…/albertas-plan-for-a-new-16-bil…
“CIS itself as an initiative is hugely important. But we have not actually seen what kind of savings AHS expects to achieve from a scaled-back CIS, and whether those savings would cover the $1.2 billion.”
In the not too distant future, you’ll be able to book a medical appointment, track your cholesterol level, or check your blood tests in a new patient health portal through Alberta Health Services.
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Alberta to launch portal so patients can track health data online

'They always say no news is good news, but the best news is to see that your test is negative'

CBC News Posted: Jan 06, 2017 6:00 AM MT Last Updated: Jan 06, 2017 6:00 AM MT
Alberta Health is launching a patient portal in early 2017 to give the public access to personal health information.
Alberta Health is launching a patient portal in early 2017 to give the public access to personal health information. (CBC)
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In the not too distant future, Albertans will  be able to book a medical appointment, track their cholesterol level, or check their blood tests in a new patient health portal through Alberta Health Services.
Health Minister Sarah Hoffman says the new system is intended to put more power into patient hands.
"Getting results from their lab tests to making sure they (patients) know that a referral has been received by the specialist, that's a piece of technology we're hoping to get into the hands of many Albertans."
Hoffman said pilot projects to test the portal were conducted throughout 2016 and Alberta will proceed slowly, to ensure it's safe and secure. Once available, she says, the additional information will offer peace of mind to anxious patients.
"I know if I've had a referral or a test, they always say 'no news is good news', but the best news is to see that your test is negative or you've had a clean bill of health."
The gradual digitization of health delivery has been in the works for more than a decade, as physicians were encouraged to convert walls of paper files to computer folders.

Key priorities

Canada Health Infoway, a non-profit agency funded by the federal government, has committed $22.4 million to Alberta Health to support the personal health portal project since 2011.
Shelagh Maloney with Canada Health Infoway says patients will become empowered.
Shelagh Maloney with Canada Health Infoway says patients will become empowered by gaining more access to their personal health information (supplied)
Shelagh Maloney, vice president of consumer health at Canada Health Infoway, says Canadians have identified key priorities, including access to lab results, a medication list, and the ability to renew prescriptions through "E-visits or E-consults."
"One of the myths is people won't understand the information when they see it," said Maloney, who emphasized patients will learn how to interpret their results.
"If you have a chronic disease, you might not understand your lab result the first time or the second time you see it. But when you're accustomed to seeing it, you know not only what's normal, but what's normal for you."
Security is at the forefront of the health information launch and Maloney says audit tracking has now become highly sophisticated providing for more personal information protection than having everything on paper.
"But people have to be diligent and they have to be very careful in terms of who they provide access to. It's like online banking."

Final preparations underway

Alberta Health spokesperson Lisa Shankaruk said the Personal Health Record project was first piloted in 2013, with 200 chronic disease patients taking part. Since then,1,000 additional selected patients have tested the system through an early enrolment.
"The Personal Health Record technical work is complete and final preparations are underway to launch the system to the public in early 2017," she said in an email.
Shankaruk said MyHealth.Alberta.ca will be the public access point for their personal health records.
This fiscal year the project cost is expected to be $9.5 million.
Sunnybrook Health Sciences Centre in Toronto was the first in Canada to offer its patients virtual access to their health records in 2011, using an online network called MyChart. However, Ontario does not have a provincewide patient portal.
Nova Scotia plans to go online with its patient portal midway through 2017, and Saskatchewan ran a six month trial last year for 1,200 residents.

Alberta's plan for a new $1.6-billion health-data system may contain serious flaw, auditor says


FIRST POSTED: FRIDAY, MAY 26, 2017 07:37 PM MDT | UPDATED: SATURDAY, MAY 27, 2017 09:33 AM MDT
merwan3Alberta auditor general Merwan Saher said in a report it appears that a $1.6-billion health-data information system for Alberta Health Services was scaled back to exclude information from family doctors’ offices.
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Benefits expected from the rollout of a $1.6-billion health-data system over the next decade could be undermined by the exclusion of family physician offices from the project, the province’s auditor general says.
Such an omission not only calls into question the government’s strategy to pay for the new system, but also casts doubt on its overall value to health professionals and patients, Merwan Saher says in his latest report.
“The initial idea behind (the information system) was that two-thirds of its deployment cost would be covered through gains in efficiency, higher service quality and reallocation of resources from other areas,” Saher says in the 76-page report released Thursday. “The experiences of other health-care systems show these benefits come only when primary care data is linked to hospital data.”
Costs and savings
The NDP government announced its plans for a new clinical information system a little over a year ago, touting the project as a huge leap forward in how health data is managed and shared.
The project will replace most of the 1,300 unconnected technology platforms currently used by Alberta Health Services, allow comprehensive patient records to be accessed at any point in the system, and manage broad system-wide data on admissions, beds and supplies, the government said.
The province has committed $400 million over five years to kick-start the project, allowing the technology to be rolled out in Edmonton before the rest of the province.
The government has said the remaining $1.2 billion in costs will be covered through savings and efficiencies generated by the new system.
Some of these savings will come through decommissioning old technology platforms no longer needed. But the government also expects the new system to produce clinical savings, in which better information will help reduce unnecessary tests, medications and hospital stays.
Saher's report said the government’s original vision for the clinical information system was to connect all health providers. But the project now appears to have been scaled back to exclude information from family doctors’ offices.
Unclear if benefits will be realized
Without that primary care data, the new system will be missing key aspects of patient records, the report says. As such, it is unclear if the project will produce all the benefits and cost savings initially touted.
“Better management of chronic conditions, improved continuity of care, reduced adverse drug events … you can’t achieve these things without primary care,” said Sergei Pekh, audit team leader in Saher’s office.
“CIS itself as an initiative is hugely important. But we have not actually seen what kind of savings AHS expects to achieve from a scaled-back CIS, and whether those savings would cover the $1.2 billion.”
Pekh said the government is now working on a plan to extract certain data from electronic medical records maintained by each family physician and upload them into a separate information system called Netcare.
From there, the intention is to link that data into the new clinical information system, “but there is no documented plan to achieve this,” Pekh said.
In a statement Friday, Health Minister Sarah Hoffman said the goal remains integration and sharing of information across the health system, including primary care.
“The new clinical information system will result in savings by reducing duplication of IT systems and operations across the hundreds of platforms it will replace. These savings do not depend on the replacement of family physician office systems,” the statement said.








Major waste of money at the federal level trying to do what it can't do. And at the Alberta level we are given chatter that we will get a patient records information portal but without the data from our family physicians what sort of record are we getting? An incomplete one.
Saher's report said the government’s original vision for the clinical information system was to connect all health providers. But the project now appears to have been scaled back to exclude information from family doctors’ offices.
Unclear if benefits will be realized
Without that primary care data, the new system will be missing key aspects of patient records, the report says. As such, it is unclear if the project will produce all the benefits and cost savings initially touted.
“Better management of chronic conditions, improved continuity of care, reduced adverse drug events … you can’t achieve these things without primary care,” said Sergei Pekh, audit team leader in Saher’s office.
“CIS itself as an initiative is hugely important. But we have not actually seen what kind of savings AHS expects to achieve from a scaled-back CIS, and whether those savings would cover the $1.2 billion.”




http://www.cbc.ca/news/politics/shared-services-canada-it-gartner-consultants-email-brison-harper-management-1.4143071


U.S. consultants slam Shared Services Canada for failing projects

Review of Ottawa's plan to consolidate computer systems, email finds weak and hobbled managers

By Dean Beeby, CBC News Posted: Jun 02, 2017 12:12 PM ET Last Updated: Jun 02, 2017 12:31 PM ET
A spokesperson for Treasury Board President Scott Brison said "the former Conservative government failed to put in place the basic fundamentals for success at the time SSC was created."
A spokesperson for Treasury Board President Scott Brison said "the former Conservative government failed to put in place the basic fundamentals for success at the time SSC was created." (Adrian Wyld/Canadian Press)
Ottawa is in way over its head by attempting a massive transformation of its information-technology (IT) systems under Shared Services Canada, says a scathing indictment of the agency's failings since 2011.
The government of Canada "has vastly underestimated the size, scale and complexity of this effort. … They are attempting the largest and most complex public-sector shared-service implementation ever considered," concludes a $1.35-million report by international consultants.
"We … lack confidence in the ability of SSC (Shared Services Canada) and the GC (Government of Canada) to successfully execute the plan."
The Jan. 12, 2017, report by consultant Gartner Inc. was ordered by the federal government last August, after repeated failures of the Phoenix payroll system and complaints from departments about Shared Services Canada's inability to deliver technology upgrades, including new email systems.
U.S.-based Gartner brought together a five-person expert panel to examine the agency and its projects, a group that included executives experienced in public-sector digital transformations in California, Massachusetts and Northern Ireland, as well as the former IBM executive who handled big projects within that firm.
Shared Services Canada outsourcing
A $1.35-million consultants' report, obtained by CBC News under the Access to Information Act, says Shared Services Canada is in way over its head trying to manage a massive transformation of technology. (Shutterstock)
The report lauds the project of consolidating the federal government's information technology, including creation of a single email system, but says "very little progress" has been made in the last six years because of persistent management failures.
"Decision making cannot follow current approaches," said the document, obtained by CBC News under the Access to Information Act.
"Execution must be based on agile, effective decision making, with clear and singular accountabilities. This is the antithesis of governance today."
The report repeatedly underscores the enormous scale of the consolidation project, likening it to combining the infrastructure of between 30 and 40 large banks.

Slow-footed

The consultants say Shared Services Canada is slow-footed, partly hobbled by complex procurement rules, so that an email solution it chose in 2011 and still has not completed has since been outmoded by new cloud services.
"The world in 2016 is much different from how it was in 2011, and the expert panel and Gartner believe developments such as cloud services should be given much more prominence in SSC's future," said the 198-page report.
Some of the document is redacted, including key financial information. The authors make a series of recommendations, chief of which is the appointment of a deputy minister for IT for all of government, to whom the head of Shared Services Canada would report.
In April 2011, then-prime minister Stephen Harper lauded the project to consolidate the government's IT systems and data centres, saying on the election campaign trail that year that "we know we can save all kinds of money there."
'The project was set up to fail through underfunding, lack of service standards, and poor planning from the previous government.'- Jean-Luc Ferland, spokesperson for Treasury Board President Scott Brison
The new agency charged with carrying out the transformation, Shared Services Canada, was announced on Aug. 4, 2011, after Harper won a majority.
But two projects in particular went off the rails in the early going, one to consolidate cell and telephone services, the other to consolidate email services. Both have been plagued by delays, among other problems.
And the new agency was immediately required to cut costs as part of a government-wide effort to wipe out the federal deficit by 2015.
Shared Services Canada data centre
Shared Services Canada is the department responsible for the federal government's IT services, including its data centres. A new report says the federal government must create a new deputy minister of IT, to help get the troubled agency back on track. (Shared Services Canada)
Jean-Luc Ferland, a spokesperson for Treasury Board President Scott Brison, welcomed the consultants' conclusions and recommendations, pinning much of the blame for the bad results on the former Conservative government.
"As the report makes clear, the motivation and objectives behind the creation of Shared Services Canada are even more relevant today than they were when it was conceived in 2011," said Ferland.
"The report is equally clear that the former Conservative government failed to put in place the basic fundamentals for success at the time SSC was created. The project was set up to fail through underfunding, lack of service standards, and poor planning from the previous government."

No timeline

Ferland said the government is still reviewing the recommendations, alongside those of the auditor general, House of Commons committees and other consultations. He did not provide a timeline for solutions.
"Our government's ambition is to provide exemplary service to Canadians while making a seamless transformation to the age of digital government — not booking false savings, arbitrarily hobbling the public service, or cutting corners."
Last year, Finance Minister Bill Morneau added $383.8 million to the budget of Shared Services Canada over two years to help it resolve a raft of problems.
The outside experts who contributed to the Gartner report were William Oates, former CIO of Massachusetts; Ron Hughes, former chief deputy CIO for California; William Wickens, chief executive of North Ireland Shared Services Organization; Luc Portelance, former president of the Canada Border Services Agency; and Sal Calta, former IBM executive.
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Julie Ali
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  • Julie Ali
Why am I not surprised by the report of the lack of project management skills in the federal government resulting in poor deliverables.

In Alberta for some odd reason we have NetCare for health care workers. We also have another system where patients will be able to access their health data but this system is still not in production and has been held back so that there can be mobile access to it.
 All health providers were supposed to be linked province wide but now they aren't going to be using the family doctors' information.

This omission of primary care data seems to be rather significant and I fail to see how useful a patient health information portal is going to be without the data from the family doctors.

This is a project currently estimated at $1.2 billion. I am curious what the final expenditures will be. I doubt that the project management at the GOA is any better than the project management at the federal government.

I fail to understand why the GOA didn't just make a OneSystem out of NetCare with access provided to professionals and citizens from the same system. Would this not have saved us $1.2 billion now? Using NetCare patients could have had the benefits of the single medical record accessed anywhere in the province without the duplication of systems and costs. Poor governance at it's best in Alberta which is repeated at the federal level. I am beginning to feel that the entire public sector should be outsourced.« less

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