Thank you, Madam Chair, and my thanks to the members of the committee. I appreciate being invited here today.
You've already introduced me. I'm a practising internal medicine specialist at the Ottawa Hospital. I work there as the chief medical information officer. I've been in professional practice for 25 years and most of that time I've spent working on clinical information systems, in addition to taking care of patients.
I truly enjoy taking care of patients. I've worked at some outstanding institutions with truly wonderful people.
For the past quarter century, every single day of my professional life it's been obvious to me that health care is not terribly well structured. The way in which we deliver care is not quite what it should be. It's been obvious from the beginning. As time has passed, other industries have adopted strategies, technologies, and processes that have allowed them to prosper in ways that the health care system has not been able to do. Therefore, the gap, if anything, has grown wider over time.
I recognized this issue when I first started and the disparity continues to grow between what information technology can do for other enterprises and other types of industry, and what health care is less able to do.
I'd like to confine my remarks thematically. Everywhere you look in health care, you're confronted with what I call the fundamental paradox of health care. How is it possible that a system that is staffed by compassionate, intelligent, well-meaning individuals could not be meeting the expectations of the citizenry? If you read the papers, you're confronted by the fact that people feel the system is not doing what they want it to do, yet when I look at the people I work with, they're all extremely passionate about patient care. They truly and fundamentally wish to do their absolute best for patients. I have seldom met a nurse, physician, physiotherapist, or pharmacist who wasn't fully dedicated to doing the absolute best. So how is it that we are unable to create and implement a system that actually makes the citizenry satisfied and confident about the care they're supposed to receive?
People write to newspapers, and there are editorials and comments by pundits, but nobody seems to focus on this fundamental question that we should be asking ourselves. I'm prepared to offer my answer, for what it's worth.
My argument is that these people are so well-intentioned that we have to conclude that they cannot do any better than they are doing now. They are working as hard and as smart as they see themselves able to do. In most areas of health care, most people optimize the practice in their particular area. If you're a CCU nurse or an emergency nurse, you make sure that the workflow in your environment is successful for you and the patients you see, without necessarily understanding its implication downstream for other parties—other nurses, other physicians, or the patients themselves—as they transition from one area or cross gaps from one care area to another. These people are dedicated in what they're trying to do in a specific place, but they are unable to systematize care across a broader range of care avenues and create circumstances where the patients themselves feel they're being cared for along a continuum. Exhortations to these people to work harder, to work smarter, to follow guidelines, or polish more policies will not likely be effective, in my opinion. They are not able to change in that way.
My argument has been, for my professional career, that information technology can allow them to adopt new processes that will optimize care delivery along the continuum for the patient, not just locally for the individual practitioner in that specific encounter with that patient.
Some of the telehealth opportunities you've been hearing about already, as well as some of the other initiatives that are going on in hospitals and advanced institutions across the country, are trying to deliver these kinds of solutions, but they are very hard to do. Technology is not a solution in and of itself. I do not believe in buying technology just because it's technology. It has to be adopted to achieve specific purposes and accomplish specific processes for the patients.
In the work I'm doing at the hospital as well as work I've done elsewhere and talked about, we're trying to change the fundamental processes by which health care is delivered. Initiatives we have going on at the Ottawa Hospital include electronic ordering, which we don't see as a physician step. We see it as a process change inside the hospital. Our electronic ordering for diagnostic imaging at the Ottawa Hospital is paperless from end to end, from the creation of the order to receipt of the order inside the radiology department, to the execution of the order, to the speech recognition of the report, to the return of the report to our information technology here on my iPad.
This is how what we're talking about is a process change inside the system. Our lab electronic ordering process is the same. We go from electronic ordering of a lab test to labelling of the blood sample at the bedside by positive identification of the patient, to transporting that sample to the lab, to processing it through the analyzer using the bar-coded information on the sample, to the return of the results to the physician the same way. This is about changes in health care delivery processes.
We're doing electronic medication reconciliation, which is another project to alter the way in which the health care system documents patient medications and follows the patient's medication longitudinally from outside the hospital to inside the hospital to their return to the community. We use speech recognition technology to enhance the timeliness and accuracy of physician documentation and the documentation of our other health providers.
Once again, these are all examples of how technology is not an answer in itself but is an answer insofar as it helps us alter the way we deliver care and provides new tools for these well-meaning people to achieve better patient outcomes and better results for the system and more efficient care delivery. That's the way we see it.
The Ottawa Hospital has been blessed by having received support from government organizations such as eHealth Ontario and Canada Health Infoway for a number of the projects we're doing to enhance care delivery. We've been able to integrate the infrastructure we used at the Ottawa Hospital with the Hawkesbury district hospital. We've been able to connect the two so we support the information technology used inside Hawkesbury. We are rolling out access to electronic medical records to the primary care physicians here in the Champlain LHIN to allow them to see the records of their patients while they're inside the hospital.
These are small steps to begin with, but they're very important ones. I suggest to you that as a government committee you would want to focus on making sure that initiatives you support are focused not just on technology but on making sure that the people who are delivering these systems are going to achieve the process change we're looking for with deliverable outcomes for the patients. That's been the engagement we've had with government agencies to date and we truly appreciate the support we've received.
I thank the committee for the time to speak to you and advocate for continuing your efforts.