Health Care Summit in Victoria – Premiers Discuss Evolution of Health Care Funding

“Finance Minister Jim Flaherty abruptly announced last month that Ottawa will guarantee health-care funding increases of six per cent until the 2016-17 fiscal year. After that, the annual increase will be tied to the nominal GDP, the monetary value of all goods and services produced within the country annually, including inflation. Funding increases of at least three per cent will be guaranteed.”

 

There has been recent controversy regarding future federal funding for provincial health care services. It is important to monitor policy changes, as they may affect how the market views privatization in health care, and we may see different provincial interpretations of what future health care delivery will look like.

A few highlights:

-The federal government  maintains that it is up to the provinces to administer health care, and thus appears unwilling to have the federal government “lead” the provinces in any innovation or reform. This leaves us with many fragmented approaches.

-At this health care summit, the idea of a future health care system that utilizes more private, for-profit health care service hasn’t been ruled out by the premiers. If the federal government wants the provinces at the helm of change, we might see different intepretations of the Canada Health Act (thus, a change in the infrastructure of health care delivery)

-There is concern that poorer provinces will end up with poorer care. As Nova Scotia Premier Darrell Dexter said, “Equal funding is not necessarily equitable funding.”

-Many premiers have expressed concern that the aging population’s cost to health care will steadily increase over the next few years. If this new round of funding is essentially a “flat rate” that doesn’t account for this growing cost, we may see a reduction in services available.

Innovation in Mobile Healthcare Apps

The market is inundated with mobile healthcare applications; there is an entire section dedicated to health care for professionals in the iPhone app store. For innovators looking to improve doctor/patient relations or patient adherence to treatment, there are a number of health portals, monitoring apps (i.e., for diabetes management), and other health information tools available to both physicians and consumers. As communication-based apps continue to expand within health care, how will the future of these apps look? Will we be seeing more patient-centric disease management tools, or more applications aimed at assisting physicians with their diagnoses, prescriptions, and up-to-date medical knowledge & breaking news? Dr. James Aw, medical director of the Medcan Clinic in Toronto, weighs in on the future of medical apps.

What Does the NHS IT Debacle Mean for Canada?

Recently, the U.K.’s centralized electronic health record program was acknowledged to have failed in its entirety and was scrapped.  Introduced in 2005, the £12 billion (about $20 billion CAD) program was created to move the U.K. health care system toward a single, centrally-mandated EHR. In what has been called the largest civilian IT project ever, the program has been criticized as being a waste of taxpayer’s money and failing in its core objectives.  With their government facing severe fiscal limits, U.K. taxpayers could no longer afford to take a “wait-and-see” approach.

To shed some light on what this means for Canada, we took at look at OECD’s data on national health expenditures and life expectancy at birth. We got the idea from The Baseline Scenario.


First of all, most of the data is relative to the OECD median life expectancy or health spending. The exception is the OECD trend, which is absolute and shows that over the period, OECD countries spent more and gained longer life expectancy. So, in absolute terms, the median is drifting upwards towards the right.

If a country stays clustered around the zero crossing for the axes (where the OECD median is), that country’s health expenditures are rising and health is improving for the population. This is the case for the U.K.  Their relative expenditures increased earlier but then drove aggressively back towards the OECD median. When money becomes tight, programs get cut. With about two-thirds of the IT program’s multi-billion dollar cost already spent and no foreseeable end in sight, the long-criticized NHS program was an easy target. The proposed alternative is to favour cheaper regional options chosen by the hospitals and GPs.

 

So here’s the thing for Canada. We’re in much better fiscal shape than the U.K., having escaped relatively unscathed from the latest recession. So we may be able to afford a little more time with our healthcare IT projects. Given current world economic stress, it might be inevitable that our healthcare spending will be aggressively driven back towards the OECD median.

The warning signs are there that Canada’s EHR initiatives could be likely targets. As the April 2010 Auditor General’s report points out, there have been modest advancements made, but not without significant criticism.  In what has been painted as a “dismal” picture, the initiative has taken flak for its comprehensive plans that are depicted as muddled, uncoordinated, and loosely interpreted by individual provinces.  While some provinces have seen more centralized EHR development than others (I.e. Alberta’s Netcare EHR), there is a long road ahead to reach the goal of pan-Canadian interoperability. Questions of timing, quantifiable progress, compatibility, benefits, and ultimate costs are burdening the initiative.

Infoway’s EHR effort needs to show progress and achieve stated outcomes.  And it needs to do it quickly. As U.K. health care has shown us, there isn’t time for the “wait-and-see” approach. Canada needs quantifiable results in the short-term, or the program will become a leading candidate for future budget cuts.

 

$72 Million eHealth Ontario Initiative

Earlier this year, eHealth Ontario announced ConnectingGTA, a pilot project to securely connect 700 service providers in the Greater Toronto Area. Connecting clinic, test lab and other systems reduces costs and improves services by creating a powerful network effect within Ontario healthcare. Patients and providers will benefit from ConnectingGTA, from better coordinated health care, more timely treatment, improved productivity, and reduced costs.

Here’s the project’s big challenge: getting this network effect kick-started. While Canadian health care is notoriously slow at adopting technology generally, there has been significant investment in systems already. This is not a green field situation, so to speak. So, not only are there technical challenges, but also a political, social and economic ones, too.

The breadth of the challenge is one of the reasons Cliniconex is excited. We’re looking forward to contributing and collaborating with Mohawk College and Coral CEA, who co-issued a press release about their intentions yesterday.

ConnectingGTA’s first phase completes in 2013.

Stock Trader Alert App Selected by Orange Business Services – Trading Solutions

“GENBAND, a leading developer of IP infrastructure and application solutions, today announced that the Cliniconex Stock Trader Alert application, which was developed as part of GENBAND’s GENFuzion™ Developer Challenge, has been selected by Orange Business Services – Trading Solutions, the leader in voice and electronic trading infrastructure and services for trading communities.”

“We look forward to presenting this innovative stock tracking solution to our customers in the financial market, ” Lionel Grosclaude, CEO, Trading Solutions.

GENBAND press release here.

 

Ottawa Business Journal takes note of Cliniconex

In the Oct 3rd edition, the OBJ picked up on the GENFUZION award.

“After building its automated notification software around the needs of the medical community, Ottawa-based Cliniconex is branching out with a new application for stock traders.

The company’s Stock Trader Alert was developed as part of Genband’s GENFuzion Developer Challenge and will be used by Orange Business Solutions – Trading Solutions.

The alert system automatically connects stock buyers with traders over the phone once a stock hits a certain market threshold and enables faster communication, as well as a greater volume of stocks bought and sold.

“Our development team was able to create a working prototype within three weeks and demo the product within six weeks,” said Anthony Mar, CEO of Cliniconex in a statement.”

A full length article – Cliniconex dials into growing e-health sector - on page 11 of this week’s Ottawa Business Journal (here’s the Digital Edition) expands on the e-health sector.

 

 

Coral CEA at CIX Tonight.

Here’s a shout out to Brian Forbes, Executive Director at Coral CEA, an Ontario based not-for-profit that is focused on communications enabled applications. He’s a panelist at the Canadian Innovation Exchange at the Chateau Laurier Hotel tonight. Here’s their press release.

The presser has a blurb on our recent launch and a tidy quote from our CEO.

Our Award Winning Stock Alert Demo App

Cliniconex solutions serve more than healthcare!

A few months ago, we had an opportunity to build a prototype application for Orange Business Services – Trading Solutions / Etrali North America. We took it up with the help of Coral CEA, who hosts the GenFUZION developer community for the Genband A2 platform, which the app used for its alerts and calls.

The stock tracker demo shows how communication enabled applications (CEAs), like our appointment reminder service for healthcare clinics, help people exert a little more control of what’s happening around them. When a stock crosses a threshold, one of two actions occurs. The first is a simple alert: “Your stock is down 10%”. The second is an automatic call made between two parties, a broker and a trader for example, to accelerate buy and sell decisions.

The demo made its debut at the SIFMA Financial Services Expo in New York in June, 2011, in the Orange/Etrali booth. During the show, one of the end points was an Etrali turret, which they were launching in North America. The app helped position Orange as a leading edge financial services vendor.

(Blast from the past: Did you notice the Nortel logo on the voice over IP app?)

And the prototype came in second in the GenFUZION Developer Challenge!

First Cliniconex for Developers Application Installed

This month, students at Algonquin College developed, tested and installed the first reminder application to use Cliniconex for Developers. The application, being evaluated at Algonquin Health Services, takes appointment reports from an Electronic Medical Records (EMR) system and then uses the Cliniconex for Developers API to initiate voice reminders via the remote Cliniconex Core Application.

As part of a 3-month project class, the team of Robin Murphy, Long Huo, Junxian (Pam) Li, Juanita Stairs, Yong Lian (William) Zhu took about 40 hours to develop the application and a couple of weeks to test it. They also delivered project documentation as well as a superb user manual.

The application has two buttons – one to point to an appointment report created by Practice Solutions, the EMR used at Health Services, and one to initiate processing. How’s that for a simple user experience?  One of the reasons the interface can stay simple is that error handling is done by the Cliniconex Core App, which ensures error conditions, such as re-processing the same report, are handled properly.

It’s pretty effective, too. At the training session with the clinic, the receptionists were excited to see appointments confirmed in the time it took them to run the application and then log into the Cliniconex Core App to look at the call reports.

Algonquin Student Reminder App’s Two-Button Interface

The team garnered a great final mark and some fine reviews from the clinic staff. They also showed how easy it was to use Cliniconex for Developers to deliver real life reminders in a live situation.

Thanks to the Algonquin Research and Innovation program for their help in getting this project going, especially John Omura who scouted potential users for us; Professor Mel Sanschagrin who supervised the team; and Wayne McIntyre, director, and Cathy Trueman, clinic manager, at Algonquin Health Services for their support.