Smitherman to review e-health agency

Six new board members nominated to Smart Systems Agency’s mandate to create electronic health record system

Health Minister George Smitherman is launching an operational review of Smart Systems for Health, the little-known agency in charge of Ontario’s electronic health infrastructure.

Six new board members have been nominated to bring more accountability and “ new energy” to the governance structure of the three- year-old agency, whose spending practices have come under fire from a number of hospitals, doctors and healthcare critics.

“ You’ll see a calibre of candidate that gives us a strong capacity to oversee the operation of Smart Systems,” Smitherman said in an interview. He intends to send a letter to the new board outlining a “ clear set of expectations” about what he wants board members to focus on.

This will be reinforced by an operational review, he said. “We want to make sure the procedures guiding our operations at Smart Systems are setting a good measure for appropriate accountability related to the distribution of taxpayers’ resources.”

Smitherman’s comments follow a Toronto Star investigation into the province’s attempts to bring digital patient records to all Ontarians. It found that efforts to date have been riddled with delays and conflicting agendas, with hundreds of millions spent on electronic infrastructure and services that don’t interconnect and are benefiting relatively few. Smart Systems alone has burned through $260 million over the past four years, some of it on high-priced consultants who were not hired in an open and competitive tender process. The 300-employee agency, whose primary mandate is to electronically link the province’s 150,000 health- care providers, has also been criticized for its spending on one- off information technology projects that haven’t contributed to the higher goal of an integrated electronic health record system.

“This organization is somewhat akin to the dot- com problem of five years ago,” said Dr. Gordon Atherley, a physician and researcher of health-care information technology who has been a vocal critic of Smart Systems.

“ Their vision is so grand that they don’t actually get around to solving any particular problems.” New Democrat health critic Shelley Martel said it’s time to call in the auditor general because so much taxpayers’ money is at stake. “The government’s going to do an internal review, but where will that take us?” asked Martel. “ I would argue that a review by the auditor general is in order.” Smitherman said despite past stumbles, Smart Systems has made progress, putting in place what he calls the “ building blocks” of an electronic health record system for the province.

“ There’s much more that will be said and done in the coming period,” he said. The new Smart Systems board members up for nomination are before the standing committee on government agencies, which has a chance to review each candidate. The list includes Marc Kealey, chief executive of the Ontario Pharmacists’ Association, and Michael Lauber, former CEO of the Ombudsman for Banking

Services and Investments.

Smart Systems has

nine board members.

Smitherman said some

members will not be

asked to stay on after their term expires, while “ there may even be some that are revoked.” Atherley said he’s encouraged by the moves. “ If they figure out what ( Smart Systems) should do and what it doesn’t need to do because others can do it better, then we’ll have something sensible come out of it,” he said.