Marafioti, Hooper discuss eHealth at
– High-profile hospital CIOs
Lewis Hooper and Sam Marafioti
(pictured here, L to R) gave
talks at a December meeting of ITAC Ontario (the Information Technology
Association of Ontario –
www.itacontario.com). Speaking in his role as Vice-chairman of the
Ontario Hospital e-Health Council, Marafioti outlined the council’s
views on improving the workings of the healthcare system through
Marafioti is also Vice President and CIO at Sunnybrook & Women’s College
Health Sciences Centre, in Toronto.
Hooper summarized the initiatives being taken by his facilities – he is
Regional CIO for eight hospitals and four long-term care organizations
in eastern Toronto. They’re part of Local Health Information Network 9,
which stretches “from Victoria Park to Algonquin Park,” quipped Hooper.
Offering a strategic direction for hospitals in Ontario, Marafioti spoke
in favour of grass-roots projects rather than large, top-down solutions.
“Megaprojects are projects of the past,” he said. “The future will be
based on [smaller] building blocks.”
As well, in order to gain favour with the public, the benefits of
e-health projects must be made known. “We need to demonstrate the
efficacy of the investments,” said Marafioti.
Computerized solutions have tremendous potential for improving the
healthcare system, but need to become a
higher priority on the political agenda. “eHealth isn’t yet a government
priority,” said Marafioti. “It’s a ministry priority, but we haven’t
heard the message come from the Premier.”
By contrast, Marafioti observed that British Prime Minister Tony Blair
has spoken out on the need for electronic medical records. He said
high-level politicians in Canada must also promote
solutions as a way of modernizing the healthcare system in Canada.
Marafioti said there must be increased financing of eHealth in hospitals
and the healthcare system in general. “Funding of 1.8 percent [of
hospital operating budgets] won’t cut it.”
(Recent surveys by Canadian Healthcare Technology have found that
hospital CIOs across Canada feel 4 percent of operating budgets would be
needed to adequately finance eHealth in hospitals. Trillium Health, a
two-hospital organization in Toronto, announced earlier this year that
it would boost IT spending to 5 percent of its operating budget to
deploy Project THINK, which uses IT to re-engineer the organization.)
On a related front, Marafioti asserted that more work must be done on
eHealth standards: “They need to be much more precise, and we must
identify them in a more timely fashion.”
He mentioned that a recent Ontario Hospital Association survey
identified the capabilities of organizations across the province. There
are wide variations in this respect, he said.
Smaller hospitals, for example, are facing challenges in the area of
human resources and IT skills. As one solution, said Marafioti, “we’re
looking at the concept of [IT] SWAT teams that can move around the
For his part, Hooper outlined the major eHealth inititatives under way
in eastern Toronto. Of the 12 organizations he heads as regional CIO
(including the Scarborough Hospital, Lakeridge Health and Rouge Valley
Health), seven are using Meditech systems. However, Hooper commented
that even so, integration among the different Meditech versions and
components is no easy task.
Complicating the equation are the various types of long-term care
systems currently in use. Financial systems across the region include
Meditech, Infinium, Ormed and Great Plains. Overall, 53 sites are being
supported using a total of 294 applications.
Hooper noted that the eight hospitals and four CCACs for which he serves
as regional CIO together spend $25 million on IT, or about 2.1 percent
of the total operating budget.
Top tier projects include a regional Electronic Health Record, a
clinical portal, standards, disaster recovery planning, an enterprise
master patient index (EMPI), privacy and governance. As well, there is a
help desk initiative under way (Hooper observed it’s an area that’s been
“notoriously under-funded,” and that hospital staff sometimes refer to
it as the “helpless desk”.)
Other projects and technologies that are being implemented in the
eastern Toronto area include Microsoft SharePoint as a collaborative
tool. There’s also an effort to consolidate decision support tools, and
to develop an integrated system for smoothing the paperwork that’s done
when patients are transferred from hospital to long-term care. In this
area alone, noted Hooper, great productivity and performance gains will
Citing information from a study conducted in Kitchener-Waterloo, he
noted that up to 60 percent of patient data is
manually re-entered when patients
leave hospitals and enter the continuing care sector; using integrated
systems, that data could be automatically transferred from one
organization to another.
Improving data flows could also result in earlier discharges from
hospital, as well. He noted that patients who are ready to be discharged
often remain in hospital because the relevant paperwork hasn’t been
completed. Reducing this cycle time would result in faster discharges,
saving beds and improving hospital efficiency.
Hooper emphasized that technology is important, but that its purpose is
to support the transfer of knowledge in the healthcare system, knowledge
that ultimately leads to better patient care.