ElectronicHealthcare
Abstract
As Minister of Education, he introduced First Things First … Our Children, an initiative focusing on children and youth in education. As Minister of Environment, Mr. Mar served as co-chair of Climate Change Central, the public/private partnership formed in response to an international agreement on climate change. He also took action because of the public interest and formed a new provincial park in the Spray Valley to protect this mountainous part of Kananaskis Country.
Born in Calgary in 1962, Mr. Mar obtained his BComm (Finance) at the University of Calgary in 1984 and his Bachelor of Law at the University of Alberta in 1987. Until 1992, he practiced civil, criminal, corporate, commercial, and real estate law in Calgary, contributing to the Annotated Rules of Court, and was appointed Queen's Counsel in 1994. Mr. Mar is a member of Calgary's Chinese community, serving as director of the Sein Lok Society for Chinese culture, and as Vice President of the Chinatown Development Foundation, which operates a low-income housing facility. He has also served as a volunteer with Calgary Legal Guidance, which provides legal services to low-income clients.
Alberta Wellnet was launched in 1997. What is the status -
are you satisfied with its development, projects, and
focus?
Overall, I think Wellnet (www.albertawellnet.org/projects.html) has
been making reasonable progress. I try to temper my enthusiasm for
even faster progress with the understanding that Wellnet is
building from the ground up, and like any such task, the challenges
are considerable. Wellnet has already had significant successes.
For example, the provincial telehealth program has put Alberta at
the forefront internationally in this area, and the Seniors Drug
Profile gives caregivers better information about drugs taken by
the elderly. Two other significant ongoing projects are the
Pharmaceutical Information Network and the Provincial Personal
Health Identifier, the latter a big step forward in ensuring
patients are accurately identified for their records and care.
Wellnet now dovetails with the shared provincial Electronic
Health Record initiative under Infoway. How much did Alberta
contribute to the professional and public understanding of the need
for this national initiative?
We see Wellnet and the EHR initiative as a priority. We had already
revised Wellnet's mandate to focus specifically on EHRs when the
Premier's Advisory Council released its recommendations. In
Alberta, we've been promoting EHRs as part of our health reform
package and plan to have the first provincial EHR in Canada in
place in 2004. The work Wellnet had been doing helped lay a good
foundation for our current EHR work, and since we refocused the
mandate, Wellnet has become an integral part of making EHRs in
Alberta a reality. The pan-Canadian EHR initiative is a work in
progress and Alberta has been an active partner with the other
provinces and territories on the EHR initiative. In fact, Alberta
spearheaded the work that led to the formation of the Advisory
Committee on Health Infostructure, which reports directly to
Canadian Deputy Ministers of Health.
Do you agree with the Kirby Commission report that recommends
Ottawa pay for the EHR through Infoway?
We know from earlier deliberations of Deputy Ministers of Health
from across Canada that considerable funding from Health Canada is
needed for the EHR initiative. However, it's worth noting the
initiative also calls for EHR systems to be developed at the
provincial, regional and clinical levels. So investment is needed
from all levels of government, as well as regional health
authorities and other direct service providers.
Part of the Wellnet initiative included a review of Alberta's
health privacy legislation. Some people feel the consent provisions
are a barrier to health IT development. Do you feel there's a need
to move more to an implied consent model, rather than the
individual signed consent required in the current act?
First, let's be clear. EHRs are about improving patient safety and
access to care, and we see them as a critical component of
healthcare reform. But Albertans have to be confident that their
health information is well protected, and that their rights around
that information are intact. Alberta's health privacy legislation,
the Health Information Act, was designed with that in mind, and has
been in place since 2001. Based on our experience since then, we
have reviewed our legislation to determine a way to balance the
need for privacy protection with the administrative burden that
explicit consent places on care providers. Changes to the current
legislation are on the agenda for this year's spring session of the
Legislature. The changes will strengthen the need for all
custodians defined under the Act to take the necessary measures to
ensure Albertans' health information is shared only as is
appropriate. It's also worth noting that our Health Information Act
is scheduled for full legislative review in 2004, and that could
mean further improvements or refinements as well.
How are the regional health authorities dealing with the
challenges of IT across their territories?
Information technology does pose challenges for regional health
authorities, but as the cliché goes, challenges are also
opportunities, and many RHAs have been quick to recognize that. For
example, Capital Health Authority, one of Alberta's two largest
RHAs, recently announced it is working with a consortium of
information technology companies to have that integrated
region-wide EHR in place by 2004. I expect you will see more
innovative developments like this from other health authorities as
we move ahead.
How is the public engaged in and supportive of Wellnet and
issues of IT in health care? Is it much like the model of a
12-year-old teaching her parents how to program the VCR/DVD, and
actively helping people through change, or are the majority readily
adopting it?
So far, most of Wellnet's work has been done at a level where
patients benefit from the results without being directly involved
in the technology changes, so the type of communication you're
referring to has been relatively minimal. But that is changing as
we move ahead. For example, our Pharmacy Information Network (PIN)
pilot project involved extensive communication with Albertans who
were willing to take part.
The people who took part in PIN responded well, and that came as no surprise. In my experience, Albertans are by nature innovative, they "embrace change," as the saying goes. What they really want to know is, in making the change, has government done its homework? In the case of PIN, that meant making sure their personal health information was properly protected. And we've done that.
One interesting aspect of building a system for EHRs is the general public perception of how health information is currently exchanged. Overall, many people seem to assume that, with the advances in computer technology and its pervasiveness in our daily lives, EHRs already must be an integral part of the healthcare system! It will be interesting to see if any communications challenges develop out of that built-in expectation.
What do you hope that improved IT will do for the health
system as a whole?
When we talk about information technology and healthcare, it's easy
to lose sight of the fact that the end goal is a healthcare system
that is more responsive to patients. Information technology is a
means to that goal. It can help us get there by helping health
professionals make better and faster decisions, by making the
system more convenient for patients, and by making the system more
cost-effective and accountable to the public. We are in the process
of harnessing information technology to deliver a level of care to
patients that is really unprecedented in medical history. I'm
excited by the potential, and I think we're well on our way.
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