ITAC Online - The Health Informatics Issue - November 2010
In ITAliCs

CrITical care

For nearly 50 years, Canada’s healthcare system has made up a key part of our national identity both on the world stage and within our own borders. Access to an effective and efficient public healthcare system has become a basic Canadian civil right.

As technology advances and our population ages and grows, there is immense pressure on both the Canadian government and private sector to remain one step ahead of the demand for healthcare services. And to do this, we must integrate ICT solutions in ways that unite industry players, instead of dividing them, while creating and maintaining the public policy necessary to encourage this.

In this month’s issue of ITAC Online, we profile three companies who won major awards at 6th Annual Canadian Health Informatics Awards Gala, hosted by ITAC Health and Canada’s Health Informatics Association (COACH), earlier this month. These companies are celebrated for contributing in a significant way to the advancement of public policy discourse on issues such as data digitization standards, as well as by being responsible for implementing impressive ICT-enabled healthcare solutions.

As these small case studies prove, we have the innovative capacity in Canada to create the healthcare system we need, and deserve. We have the brainpower and the facilities – what we must focus most heavily on now is developing the will. The will to invest, the will to think ahead, the will to lead in an evolution of sound information technology solutions for healthcare.

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Swifter, higher, stronger

Mike Clarke, General Manager, GE Healthcare IT Canada

One might think equating the Olympic motto to a corporate initiative is a bit of a stretch. But if you saw the services GE Healthcare provided for the 2010 Olympic and Paralympic Winter Games in Vancouver, you might think again.

In fact, the company’s work was innovative enough to earn them the 2010 Health Informatics “Project Implementation Team of the Year” award.

Mike Clarke is General Manager of GE Healthcare IT Canada, and is a member of the ITAC Health Board of Directors. He said the project started when the Chief Medical Officer for the Vancouver Organizing Committee (VANOC) conveyed a desire to take the medical services provided at the games to a whole new level.

“In a very collapsed timeframe, we brought in a whole range of advanced technologies,” Mike said. “While there is one-third the amount of athletes at the winter games [compared to the summer games], there are eight times the amount of trauma cases due to the nature of the events.”

To deal with these numbers, GE’s workforce was on the ground supporting 80 product lines installed in more than 120 infrastructure projects spanning the 19 venues of the Vancouver Games.

One of those projects involved outfitting two polyclinics, or temporary hospitals – one in Vancouver and one in Whistler – with high-tech healthcare equipment and a fully furnished mobile medical unit (MMU). The MMU is a trauma centre on wheels, with 12 trauma beds, a fully functional operating room with two surgical beds, and 72 hours’ worth of surgical supplies.

“The two polyclinics were both fully accredited hospitals, and it’s a huge task to get fully accredited,” Mike said. “They were serviced with mobile OR’s – big tractor trailers with pumps outside – so you had the capability to do surgeries, diagnostic image tests, ultrasounds, cardiology procedures and so on. We provided all the IT technology in and around that to support everyone from radiologists to sports medicine physicians and experts.”

All event venues were also connected via a 10MB connection to the Olympic Care Network, which allowed remote diagnosis in extreme circumstances like severe head or spine injuries.

“You could call in, say, a muscle-skeletal expert or a neuron-surgeon from Vancouver, and have immediate access to them through that network,” Mike said. “Those remote experts would be able to see the trauma case as the doctor is seeing it – whereas before, the best communication line was over the phone. Then that specialist could bring in, say, a neuro-radiologist, and all of a sudden you’ve got a whole team looking at that case – working together to determine if the patient could be treated in the polyclinic or if they had to be air-lifted somewhere else.”

The benefits of these services were many. The numerous healthcare stations paired with the ability to diagnose remotely not only cut down on travel time and costs, but they also allowed the athletes to return to competition quicker, and made the jobs of clinicians and technicians easier and more efficient.

“At the end of the day, we’re tool makers,” Mike said. “And to the extent that we can put good tools into clinicians’ hands that make a difference, we get pretty excited about it. That’s the emotional side of healthcare – whether you’re a healthcare professional or not.”

The “Project Implementation Team of the Year” Award was one of two pieces of hardware GE took home earlier this month. They also won “Company of the Year,” in part due to projects implemented through their “Healthymagination” program – a multi-year corporation-wide initiative which is committed to streaming $6 billion of what otherwise would have been discretionary funding across all of GE, directly into GE Healthcare for new technologies and services. This means an added $6 billion worth of research for product and service development, marketing and ICT systems development.

And when you’re in the business of saving lives, that’s money well spent.

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Transformers… of healthcare

Michael Green, Agfa HealthCare, North America

The Waterloo region is an ICT hot-bed in all categories – healthcare included. And one of Canada’s brightest lights in healthcare ICT, Agfa Healthcare, proves it.

Agfa was the winner of two Canadian Health Informatics Awards this year: the “Corporate Citizenship for a Multi-National Company” Award, as well as the “Healthcare Transformation” Award.

Michael Green is the Lead for Agfa HealthCare in North America, and is also Chair of the ITAC Health Board of Directors. He said it was an honour to be celebrated at this year’s gala.

“Agfa HealthCare is committed to creating technologies that improve the efficiency and effectiveness of patient care. This effort is central to Agfa HealthCare's success in the Canadian Healthcare environment,” Michael said. “However, such efforts cannot be done in isolation. That is why partnerships with organizations such as ITAC and our collaborations with hospitals, governments and academics through programs such as our Agfa HealthCare Institute are paramount to our success.”

The idea behind the Agfa HealthCare Institute is to provide healthcare ICT solutions across the continuum of care, working with Canada’s technology, medical, academic and government communities. The institute is meant to act as a “living lab” for existing and new innovations to solve healthcare problems. The institute has already developed partnerships with the University of Waterloo, the National Research Council of Canada, the Canadian Digital Media Network, the University of Laval, and Ontario’s Student Competition in HealthCare Innovation.

“These efforts in collaboration all lead toward fostering a world class healthcare ICT sector in Canada that both increases the vibrancy of market conditions and leads to the continued attraction of top talent,” Michael said. “Our success as a country in providing healthcare will depend on the advancement of such partnership models. We are proud that Agfa HealthCare in Canada has been at the forefront in such community based engagements, as recognized by our citizenship award at this year by ITAC Health.”

Agfa is also dedicated to re-investing in its people, Michael said. In January, 2009, the Ontario Government announced a $29.6 million governmental grant to support the growth of the company's research, development and regional operation centres in Toronto and Waterloo. The grant supports a total of nearly $200 million investment by the company in its Ontario operations, creating 160 new positions and re-investing in 276 existing jobs. In 2010, Agfa announced the ground break for its new Research & Development Centre at the University of Waterloo’s TechPark, which will create an additional 40 or so positions and provide Agfa with the additional resources needed to support its next generation of enterprise-wide healthcare solutions.

Michael said the company is bracing itself for growth, and that he looks forward to contributing ICT solutions to the Canadian healthcare system for many more years.

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The gold standard

Eric Gombrich, CEO of EMIS Inc.

For Eric Gombrich, CEO of EMIS Inc. – the wholly-owned Canadian subsidiary of the UK’s largest electronic medical records (EMR) company – a more efficient healthcare system in Canada requires not only a digitized system, but one that is standards-based. And it’s a message he drives hard.

EMIS Inc. recently won the 2010 Canadian Health Informatics “Corporate Citizenship” Award for its work in educating stakeholders across the Canadian healthcare industry on the methods and considerations of adopting global EMR standards.

“Compared to other parts of the world, there is an underlying problem in the health IT sector in North America, Canada in particular. The data we are accumulating when doctors or nurses write prescriptions or notes is not standardized in any way,” Eric said. “We’ve started to implement technology in Canada’s healthcare system to effectively get rid of paper – by most often turning the paper into PDF-like files. But as we try and connect up the whole healthcare system via these disparate computer systems, we’re running into huge problems. You have physicians that use their own acronyms, symbols, etc., which isn’t a problem when the physician is practicing by themselves. But when you take that doctor’s charts – paper or digital – and make them available to another physician, over the internet, or over some proprietary network, the receiving physician or nurse doesn’t necessarily know what those acronyms and symbols mean, or can’t interpret what they see in a clinically safe way. So they repeat many of the procedures or tests, imposing inefficiencies into the healthcare system.

“It’s crucial to the future of the Canadian healthcare system that we follow suit with other countries, and adopt a set of global terminology standards,” Eric said.

And he said there is a lot of work that needs to be done in Canada to do so.

“This is a fairly well-known issue, and one of the key roles Canada Health Infoway has is identifying standards that should be used for this data – and they’ve done that to an extent, with a fair number of stakeholders,” he said. “The good news is that the standards which have been identified here in Canada align with the exact same standards that are being utilized around the world. Where we are struggling right now as a country, particularly for many of the homegrown applications, is that vendors often don’t see the business case for adopting the standards, or understand them well-enough to implement them.

“Conversely EMIS Inc. was born in the UK, where standards have been implemented for almost two decades. As a result, the UK, like other countries who have adopted standards, is way ahead of Canada in terms of how IT is improving care for patients, and reducing costs for tax-payers,” Eric said.

The company’s experience and knowledge uniquely positions EMIS to provide leadership in Canada. The company not only has world-class, leading technology, but it has a particular set of experiences and infrastructure within the company to manage these standards in an ongoing way. So through his company’s experience, expertise and employees, Eric is taking the message forward.

“The actions we were nominated for at this year’s award gala are the continued efforts we’ve made at our own expense, coast to coast – even though we’re only commercially active in BC and Alberta at present – to educate different stakeholders at all levels (Ministries, CIOs, universities) on adopting, understanding, using and working with these standards,” he said. “And it’s more than the knowledge, it’s the financial investments we’ve made as well – supporting our employees when they give presentations, travel to conferences and so on.”

EMIS possesses the real-world experience of working with physicians and nurses in their use of these standards, Eric said, which is crucial to making a difference.

“It’s not difficult to add a field in an application allowing the user to enter a standardized code into the database,” Eric says. “We see that happening in some cases here in Canada. But to design the application at its core so it takes as much of the burden of the standard off the user, and allows them to focus on the patient takes unique skills. It also takes an infrastructure of knowledge within the company that we don’t see in Canada yet. But the faster we see the adoption of these already-defined standards across the entire Canadian healthcare IT sector, the faster we will see innovation and advancement within and across the industry, and the faster we will see things like wait-times be reduced.”

“The fact that every province and territory is controlling their own IT strategy and infrastructure neglectful of the standards is causing vendors to focus in micro-markets,” he said. “For example, if I want to sell in different parts of Canada, I have to go through a certification process in each province which not only requires financial investments, but is divergent of the requirements in markets I’m already in. So rather than EMIS putting money into introducing some of the world-class technology we have in the UK and around world in Canada, we’re putting money into getting certification which is not based on standards.”

In contrast, all the vendors in the UK support the same standards.

“To give you an idea, we can literally move an entire physician’s office from an EMIS system to one of our competitors’ systems in a matter of minutes in the UK,” Eric said. “Just consider this for a moment; one of my customers can make the decision to end their contract with EMIS, and go to a competitor with very little barrier. That forces EMIS to not only provide superlative service, but to continually innovate and provide more value to our customers if we expect to keep them. Conversely, in Canada vendors can’t even do an electronic referral from a GP to a specialist for one patient today, because we don’t have these standards. We do this day in and day out in the UK. Even worse, if a physician in Canada is dissatisfied with their vendor, and they wanted to use EMIS’ software, they can’t, for 2 critical reasons; one is that EMIS may not be certified in that user’s province despite the fact that over 40 million patients are already served through our products and that we’re certified around the world and in Alberta and British Columbia; and secondly, because there is no way to move his data from his existing vendor to another vendor in an effective and meaningful way. In other words, his vendor has him hostage because we’ve not mandated that vendors adopt standards as part of the certification process.”

Eric said standards can often be the elephant in the room, and that it must be addressed; otherwise, money invested in the Canadian healthcare system will be allocated improperly.

“The metaphor I use regularly is we’re running around stringing wires all over, hooking telephones to them, but we haven’t dealt with the fact that we have a Japanese-speaking person on one end, and a Greek-speaking person on the other,” he said. “Until we deal with this, it doesn’t matter how much money we throw into running the wires – or going through the ether and going mobile – if the recipient doesn’t understand the message, what good is it?”

The situation isn’t all bad, Eric said. While this issue was understood by maybe a dozen or so leading figures in the industry two years ago, he said discussions on the topic today can involve up to a couple hundred stakeholders – meaning the semantic and terminology standards issue in Canada is more widely accepted as a legitimate issue today.

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Board Member Profile: Meet Susanne Flett

Susanne Flett, President, Healthtech Consultants

When Susanne Flett graduated from the MBA program at the University of Western Ontario, she vowed that her first job out of school would be a managerial position. And that she found as Manager of Diagnostic Imaging at St. Michael’s hospital in Toronto.

There, she planned and implemented one of the first clinical computer systems in the city, and jokes that in the process, she learned everything that could possibly go wrong firsthand.

From there, she moved to the Ontario Hospital Association, where her boss approached her with an interesting undertaking: to deal with all the calls they were getting about computers. So Susanne started calling their members, eager to help, and in no time she was leading a team of eight consultants all working on cost-effectiveness strategies – with a keen interest in systems.

She called her group’s work the OHA’s “computer consulting program,” and typically, her consultants would create flow charts for every process within the hospital’s operations. And in 1983, when the OHA decided to get out of the consulting business, it was time for her to branch out on her own.

As a private consultant, Susanne took on many roles with a variety of different healthcare organizations, from CIO to IS Director. For the first seven years, her practice consisted of two people. But in the last two decades, the evolution of the market forced her to hire. Today, Healthtech Consultants employs 60 full-time staff, as well as 25 associates.

“Over the years, I’ve literally done every type of project imaginable in every type of healthcare organization,” Susanne said. “I’ve been down in the trenches in terms of implementation, right up to strategic planning, and frankly, I’ve loved virtually all aspects of these projects.”

Susanne’s role at Healthtech has changed as the company has grown and now acts as an advisor, rather than a consultant, on many of Healthtech’s large projects. She also now spends more time managing the business and providing overall leadership to enable the company to continue to grow.

From day one at St. Mike’s, Susanne has believed in the power of ICT products and services in revolutionizing healthcare – in fact, that’s one of the main reasons why she implemented that very first clinical system. And over the years, she says the way ICT is used to impact healthcare systems has changed dramatically.

“In the early days, systems were very transaction-oriented – whether they were financial systems, admission systems, health records, supporting basic processes and transactions, registering patients, collecting demographic information, or tracking where they were and what kinds of services were provided,” she said.

“Then in the mid-80s, we saw the introduction of systems into clinical areas – departmental systems and labs – but again, it was very transaction-oriented like diagnostic imaging and pharmacy. In the late-80s, order-entry systems became more common; and in the 90s, clinical documentation, as well as many components of electronic medical records (EMR) and other automation systems became available.

“These days, with the introduction of clinical systems, what we’re seeing is systems with greater capabilities and functionality. They are not simply transactional; they now provide real intelligence – drug interactions, clinical decision support capabilities and so on.”

But even considering all this, Susanne said the most exciting transformations in healthcare ICT today are happening somewhere else.

“The greatest transition – with the most potential to truly transform healthcare – is on the consumer side. We’re now starting to see patient portals which provide opportunities for greater connectivity between patients and providers, quite often through case managers, as well as support to these patients when managing chronic disease,” Susanne said. “These systems can provide direct feedback on physiological monitoring test results, as well as change behaviour, through tele-health capabilities, portals, and other enabling technologies.”

Despite the availability of these world-leading technologies in Canada, she said we are significantly behind in terms of ICT adoption in the healthcare industry.

“The technology is available, but healthcare has not adopted it to the extent that it should,” she said. “Many of the strategies currently in place are not working, and focusing on building large silo systems has not served the industry well. We need to refocus the strategy to utilize technology in supporting the patient’s circle of care – i.e., those local services provided as patients move between the hospital, primary care physician, specialists, rehab, long-term care and community services – because that’s where the majority of transactions take place. Rather than trying to boil the ocean with limited success, refocusing on the circle of care would put us in a much better place.”

Susanne said she looks forward to encouraging a broad range and scope of ICT adoption in Canada’s healthcare system through Healthtech Consultants. We’ve got the tools, she said – it’s just a matter of using them.

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ITAC Events

December 2, 2010

ITAC/CWC Speaker Series Event with Microsoft’s Patti-Ann Marzocco

December 9, 2010

ITAC Board of Governors Dinner - Toronto

For a full event listing, and to register for ITAC events, go to:


Industry Minister outlines status of Digital Economy Strategy for Canada

On November 22, at the annual conference of the Canadian Chapter of the International Institute of Communications (IIC), Industry Minister Tony Clement reported on the status of Canada’s Digital Economy Strategy (DES), and announced some key specific measures that are very much welcomed by ITAC and Canada’s ICT industry.

Read the full ITAC news release here.

The full transcript of Minister Clement’s speech is available here.

More background information on this Digital Economy Strategy update is available here.

ITAC Board of Governors Dinner – Toronto

As newspapers, magazines and publishing houses around the world reel from the game changing impacts of the internet and social media, the Globe and Mail has invested in a bold new approach to its daily engagement with Canadians, a program called the Globe Catalysts, that may very well chart a path forward for other news organizations. Not only has it redesigned and rejuvenated its print edition, it has enlivened and enriched its online offering. It has also established a social media position that represents a serious commitment to build community out of the glorious babble of democratic discourse.

Why the Globe took this historic step and how they did it will be the subject of ITAC’s next Board of Governors dinner gathering. Angus Frame, Vice-President of Digital Media at the Globe and Mail will join Jen Evans, Founder and Chief Strategist of Sequentia Environics to provide an inside view of how a 138-year old institution has transformed itself for the 21st century. This promises to be a lively discussion that may very well have an impact on how your enterprise views its content and its community. Don’t miss it!

When: Thursday, December 9, 2010, 6:00 pm Reception / 7:00 pm Dinner
Where: Westin Bristol Place Toronto Airport Hotel, Plaza Room, 950 Dixon Road, Toronto
Cost: Individual tickets - $225.00 + $29.25 HST / Table of 8 - $1,600.00 + $208.00 HST
Contact: Micheline Levesque at (613) 238-4822 x 245 or email:

Register for the Board of Governors Dinner online.

ICT Investment Gap between Canada and US Grows to 40%

Canada, which has a long history of under investing in productivity-enhancing information and communications technology tools and services, particularly in comparison with the United States, showed no improvement in its performance in 2009.  In fact, the investment gap has grown from 37.2 percent to 40.5 percent.  According to a new study by the Centre for the Study of Living Standards (CSLS), Canada’s rate of ICT investment per worker in 2009 was 59.5 percent of that of the United States.  In 2008, it was 62.8 percent.

Read the full ITAC news release here.

Read the CSLS report in full here.

Other News and Events

CIX 2010

The Canadian Innovation Exchange (CIX) is on the hunt for Canada’s Hottest Innovative Companies in Information and Communication Technology, Clean Technology, and Digital Media.

Being recognized as one of Canada’s Hottest Innovative Companies is a tremendous accolade and will enable you to:

  • Showcase your innovative company in front of industry experts at CIX

  • Meet with potential partners, customers, investors and your peers in facilitated meeting exchanges

  • Achieve broad media recognition as one of Canada’s Hottest Innovative Companies

  • Gain insight into the market as industry experts, visionaries and trailblazers share their knowledge and experience

Join Canada's innovation community at the Canadian Innovation Exchange, December 7, MaRS, Toronto Ontario.

Social Media for Government Conference – Toronto – January 31, 2011 to February 3, 2011

Social Media for Government Training:

“How To Engage Your Employees And Citizens By Using The Latest Web 2.0 Technologies To Drive Communication Results”

Access the conference agenda here.

Mention “ITAC” to receive a special $200 discount!

Catalyst Canada Honours 2011 – October 18, 2011

Catalyst Canada is thrilled to announce that nominations are now open for The Catalyst Canada Honours 2011 – Celebrating Champions of Women in Business.

Catalyst is seeking champions in three categories, Company/Firm Leader, Business Leader, and Human Resources/Diversity Leader, who have shown exceptional personal commitment to the advancement of women.  If you know anyone who is a role model for diversity and inclusion in your company or firm, please nominate them by December 20, 2010.  For nomination forms or to find more information, including last year’s champions, please visit our website.

The Catalyst Canada Honours 2011 is set to be held on October 18, 2011, at The Fairmont Royal York in Toronto.