Government & policy
Auditor General slams eHealth Ontario
TORONTO – In a
Special Report that was released on October 7, Ontario Auditor General
Jim McCarter (pictured) describes Ontario’s almost decade-long,
$1-billion initiative to create an Electronic Health Record (EHR) as
“lacking in strategic direction and relying too heavily on external
consultants.” McCarter concludes that “Ontario taxpayers have not
received value for money for this $1-billion investment.”
Just prior to the release of the report, Ontario Health Minister David
The Legislative Assembly and the media have in the last several months
questioned contracts awarded by eHealth Ontario – the recently created
agency that took over responsibility for creating EHRs to deliver
better, more cost-effective healthcare to Ontarians – charging they were
often awarded without an open competitive process. McCarter said this
was “undoubtedly” the case.
He also found evidence of “questionable procurement practices” in the
Ministry of Health and Long-Term Care (Ministry) and at the Smart
Systems for Health Agency (SSHA).
The 50-page report, entitled Special Report: Ontario’s Electronic Health
Records Initiative, examines efforts by the Ministry and its agencies to
create an EHR – essentially a system of computerized medical records for
all Ontarians. Healthcare professionals would use EHRs to deliver
services more efficiently than at present. All 10 provinces and three
territories are working to create EHR systems, which one study says
could save Canada’s healthcare system $6 billion a year.
Among the findings in the Auditor General’s Special Report:
• Of the $1 billion spent so far on the EHR initiative, $800 million was
spent by the SSHA primarily to build a computer network for healthcare
providers that is expensive to operate and significantly underutilized,
mainly because of a dearth of available applications. Specifically, it
is costing $72 million annually to operate the network; and, on average,
users are utilizing less than 1% of the network’s available bandwidth
(or system capacity), with peak usage averaging only about 16% of
• Allegations earlier this year that eHealth Ontario awarded contracts
to certain companies without giving other firms a chance to compete were
“largely true,” as were allegations of “favouritism” in the awarding of
such contracts. For example, one firm that bid 500% more than the next
qualified bidder was invited to bid again, the only company offered such
an opportunity, and, after lowering its bid significantly, won the
contract. Another firm that was awarded untendered contracts on the
first phase of several projects was awarded many subsequent contracts
worth about $7 million to work on successive phases of those projects.
• There was a heavy, and in some cases almost total, reliance on
consultants. By 2008, the Ministry’s eHealth Program Branch had fewer
than 30 full-time employees but was engaging more than 300 consultants,
a number of whom held senior management positions.
• The recent replacements of the eHealth Ontario board chair and CEO
mark “the fourth such overhaul of leadership at eHealth Ontario and its
predecessor” and each of these overhauls brought with it its own period
of transition where progress on the initiative’s objectives was slowed
or, at times, virtually halted.
• Ontario is near “the back of the pack” in the development of EHRs
compared to the other provinces.
For more information and to view the full special report, please visit
Posted October 8, 2009