eHealth Saskatchewan underfunded, memo says

REGINA – eHealth Saskatchewan, which manages the provinces healthcare IT system, says the provincial government has underfunded the organization for years, putting patient care at risk.

A briefing note prepared for Saskatchewan’s Minister of Health warns that eHealth, which runs the province’s healthcare IT system, has been underfunded for years and is at growing risk of failure, which could potentially affect patient safety.

According to CBC News, which obtained the document through an access to information request, the agency said that many of eHealth’s hardware and software systems are out of date and “major outages that impact patient care delivery are increasing at a rate of 25 percent per year.”

It says that as time goes by, the risk to patient will grow unless the government steps up with millions in additional funding.  “A major equipment failure which may disrupt service and risk lives appears inevitable with the current funding model,” the briefing note warns.

eHealth is a Crown corporation responsible for operating, maintaining and renewing all computer systems that serve the healthcare sector, from diagnostics to pharmaceuticals to patient records.

The document, from October,  goes on to highlight the areas that are at risk.

• Admitting charting and hospital registration systems.
• Laboratory diagnostics.
• Medical imaging diagnostics.
• Hospital pharmacy systems.
• Contact tracing.
• Vaccine inventory and public health services.
• MySaskHealthRecord.

The note says that despite the growing risk, government investment in the infrastructure hasn’t nearly kept up.  “Over the past five years, funding has remained virtually static.”

eHealth says it provides IT equipment and support for about 400 healthcare facilities across Saskatchewan. In a series of bullet points, the organization highlights problems it has identified:

• “Some of the equipment is so old, automated systems can’t be used to identify the PCs and laptops that are currently connected to that system.”
• “No archival records exist of what’s being used by whom.”
• About 25 per cent of PCs in the system are more than five years old and running on old operating systems which, “makes it impossible to apply the latest and most up-to-date security patches.”
• “The Electronic Health Record (which collects and manages all patient records) runs on an Oracle database and has reached the end of its useful life.” The note adds that the platform this record is based on has been around since 2010 and “is no longer supported.”

In its briefing note, eHealth tells the minister that an immediate and ongoing cash injection is required.

“To meet current expectations of customers and mitigate unacceptable risks to patient safety, eHealth will require an additional investment of $50 million per year above its historical base budget for the next three fiscal years,” the note says. The base budget from the provincial government is about $110 million annually.

According to a recent provincial auditor’s report, the current value of eHealth’s computer systems – including hardware and system development costs – sits at $6 million.

The briefing note suggests that some of these problems stem from the amalgamation of 12 health regions into one in 2017-18. eHealth was responsible for integrating all of the computer systems.

In the past, individual regions would fund outdated technology on an ad hoc basis, the note says. “Problems were solved through one-time capital allocations, taken from base budgets. Since amalgamation, this no longer takes place,” the note says, adding that since that time new investment has been limited.