Want to see the future of medical care in North America? Look no further than Alberta.
That’s the claim of proponents of an ambitious project called Alberta Wellnet. They believe that putting timely, accurate information into the hands of medical personnel will improve care, cut costs and make us healthier.
But critics of the project say it’s already burned through more than $100 million and has little to show for it.
What’s the truth, and where is Alberta Wellnet going?
“First of all, it’s not an information-technology project, it’s a health-care delivery project.” That’s the key message from Deputy Minister Dan Bader, P.Eng., who’s also the CEO of Alberta Wellnet.
He’s got a track record for getting things done, both in Alberta’s Public Works department and in dealing with the engineering profession. But Wellnet is by far the thorniest challenge he’s had to face. Health care is a truly hot potato for the Alberta government and every dollar spent on computer systems could be seen as one less going into patient care.
Bader has some convincing allies to help him show the value of Alberta Wellnet. One is Dr. Allen Ausford, a family physician practicing in Edmonton. He says that information technology is a vital tool to help him treat his patients.
For example, it’s vitally important that he knows what medications a patient is taking. But that’s not always easy. People forget to bring their pill bottles, or say they take “two red pills and a yellow one.”
Even worse, patients often see several doctors and get duplicate and even conflicting prescriptions. With more and more medications coming on the market, the problem will only get worse.
There’s also a compelling economic side to the story. Prescription drugs are the fastest growing component of health-care costs. New drugs, from TPA for heart attacks to Viagra for something else, are amazing, but they’re often expensive.
In 1999, for the first time, Canada spent more on medications than on paying physicians. The proliferation of drugs can cause brain fatigue in medical staff.
“Seventy per cent of the drugs I prescribe today did not exist when I graduated from medical school,” says Dr. Ausford. “A drug company might send me a notice about one of its drugs and the side effects, and I’ll read it and file it. But what I really need is to have that information at my fingertips when I’m seeing a patient.”
The proposed Alberta Pharmaceutical Information Network (PIN), a part of Wellnet, would do just that. If and when it becomes reality, your doctor, nurse or pharmacist would see a concise display of every medication you’re supposed to be taking.
Drug allergies and interactions would be highlighted, and best of all, prescriptions will eventually be entered by pointing and clicking. No more trying to figure out what the doctor was trying to scribble. No more wondering if it’s supposed to be Salinol (a nasal lubricant) or Sotamol (a heart rhythm medication.)
As everybody knows, the human and financial cost of an incorrect drug dose can be enormous. Studies show that 19-28 per cent of senior citizens who leave the hospital are readmitted because of medication-related problems.
The PIN is still at the early stages, but a simpler Wellnet project called the Seniors Drug Profile is already a reality. More than 48,000 Alberta seniors have been treated using the information in their computerized drug profiles. If it works for seniors, the designers reason, they should be able to make it work for all of us in a grander form.
To build public confidence, they’ve taken elaborate precautions to protect our privacy. All accesses will be logged, so if the clerk at your local pharmacy decides to snoop on the neighbours, there would be an incriminating trail.
Sensitive prescriptions, such as AIDS medications, mental-health drugs, and yes, Viagra, will show up as “blocked.” Only the doctor who prescribed the drug would be able to see it. Others would know there was something there, and the system would silently check for drug interactions.
Wellnet has a bunch of other worthwhile projects, such as a universal registry of newborns. This can help to catch inborn errors of metabolism like PKU, which is treatable if detected in the first week of life. Proponents of this system argue that if even a few babies are spared a life of mental disabilities, the registry will pay for itself in saved health-care and human costs.
Wellnet features an Integrated Cancer Care system which will make medical data, even X-rays and CAT scans, instantly available over the Alberta Supernet.
There’s also SPHINX, a data-analysis tool to help public-health officials understand events such as the recent outbreak of teen meningitis in Edmonton.
There are even more advanced health-care ideas on the drawing board, conjuring up images of Star Trek. Doctors walking around the hospital speaking into wireless, voice-responsive electronic pads. Wallet-sized smart cards that contain your complete medical history, and can speak for you if you’re unconscious. Online access to the world’s top medical experts, who can interpret a tricky CAT scan or even perform a delicate procedure by remote tele-surgery.
All of these advances are wonderful, but why does Alberta have to invent them all?
Because they don’t exist elsewhere, and we’re a “can-do” province.
The proponents of this system, which could eventually wind up costing almost a billion dollars, say that Alberta will pull ahead of every other jurisdiction in North America through its health informatics.
Our health-care will be better and cheaper, and Albertans will be in demand as consultants to show others the way.
And maybe, just maybe, your doctor will spend more time treating you instead of trying to decipher last year’s scribblings on your chart.
Web Watch:
www.albertawellnet.org
