Wait list management
Sarah Kramer outlines Ontario’s wait
time reduction strategy
By H. Dominic Covvey and Shirley Fenton
WATERLOO, Ont. – Long wait times for key health services have long
frustrated Canadians. Ontarians are no exception, but a major provincial
government initiative is aimed at changing what we kvetch about.
The first component of this initiative is increased funding for specific
procedures. The second is establishing accountability for actually
reducing wait times, and the third is a system to measure what happens
and monitor achievements. The system is called the Wait Time Information
System (WTIS) and Sarah Kramer is the one making it happen.
Sarah is a VP and CIO at Cancer Care Ontario (CCO), focusing on
implementing CCO’s ambitious Information Management Strategy. Recently,
Sarah took on a leadership role in developing and implementing the
information architecture to support the Ministry of Health and Long Term
Care’s Access to Services and Wait Times Strategy.
In late September, Sarah was the kick-off speaker for the 2005-2006
Smarter Health Seminar series, hosted by the Waterloo Institute for
Health Informatics Research at the University of Waterloo. She entitled
her talk, “Standing on a Burning Platform: Implementing a Province Wide
Wait-time Information System.”
There are quite a few aspects of WTIS that easily generate concern.
First of all, it is a big undertaking, starting with five “pilot”
hospitals and then incorporating all 77 that received funding to
increase their volumes and hopefully reduce wait times.
Five specific services will be monitored: hip/knee replacement, cataract
surgery, cardiac surgery, cancer surgery, CT/MRI. The system addresses
only “Wait-2”, which is the time from when the care provider decides to
order one of these services and when the patient actually receives the
The wait to get an appointment with a specialist is not captured. Care
providers will be expected to enter data, including the scheduled date
for the service, through a web-based interface, although the data is
intended to be obtained eventually from the institution’s scheduling
One concern here is ensuring that the date of the service request is
accurate. Later dates would give the appearance of shorter wait times.
Another issue is the tool used to compute a patient’s priority in the
wait list for a service.
It was pleasing to hear that the final specification of the priority is
in the hands of the care provider, although the priority system does
suggest a priority based on assessment tools being constructed for each
service. Finally, many are already aware that the WTIS depends on the
existence of an Enterprise Master Patient Index (EMPI) system that has
only recently been put on a fast track.
If you would like to see Sarah Kramer’s presentation, go to
http://hi.uwaterloo.ca and select
WIHIR Online Presentation Archive.