British Columbia鈥檚 auditor general says the Health Ministry鈥檚 new system for managing communicable diseases is a mess. Carol Bellringer鈥檚 report is a scathing critique of both the public and private agencies that managed the project. But it is also a reminder of far-sightedness that should not be lost along the way.
After the SARS outbreak in 2003 (SARS is a viral infection that can lead to pneumonia), public-health agencies across sa国际传媒 were shaken to the bone. Something close to panic gripped Toronto, where SARS was first reported.
In the end, 44 victims died, but as confusion reigned, 25,000 people were quarantined and a travel advisory was issued with devastating effects on the local economy.
Among the lessons learned, it became apparent there was no way for individual hospitals, health authorities or federal and provincial ministries to share information about infectious outbreaks. There was no system for tracking the movement of infected travellers, no database of available vaccines, no reporting system that would allow public-health officials to communicate in real time.
In the aftermath, sa国际传媒鈥檚 Health Ministry volunteered to become the lead province in creating a national reporting system that would fill these gaps.
The idea was to set up a countrywide information exchange, called Panorama. Each province would then modify its own database to hook up with the system.
IBM was hired, with a budget of $37.7 million, to build the national exchange. But it rapidly became clear that the off-the-shelf systems IBM owned were a poor fit. In the first of several questionable decisions, the ministry allowed IBM to negotiate a higher price 鈥� $66 million.
Then the project came in three years late, with 11,000 defects. Once more, the ministry relaxed contract terms to give the company a break.
With the national exchange finally in place, sa国际传媒 promised to install the first provincial hookup. And here also, costs ballooned. To date, the health ministry has spent $113 million 鈥� 420 per cent over budget 鈥� and the work is still not complete.
Worst of all, Panorama has major usability issues. It鈥檚 difficult to navigate, uses clinically incorrect language and hasn鈥檛 yet solved the problem that different parts of the country use different terminology.
In short, a massive disappointment. Perhaps because of this experience, only four other provinces, along with Yukon, are building their own portals, and most of those are only partially functional. The Public Health Agency of sa国际传媒 鈥� which should have played a leading part 鈥� has disappeared from the scene.
And yet, this is far too important a project to abandon. Because of the speed at which infectious outbreaks can spread, there is no other area of health care where a national database is so critical.
Meningitis is a case in point. For reasons that aren鈥檛 fully understood, sa国际传媒 hasn鈥檛 suffered a major outbreak of this often-fatal disease in years. (There was an isolated case in Victoria last month.)
But when a full-scale outbreak does occur, it demands an immediate response. Timeliness is vital, with days and hours possibly making a difference. Panorama was conceived and built with this kind of scenario in mind.
It is obviously a great misfortune that so many difficulties have cropped up. That is one of the costs we pay for having 10 provincial health systems with inadequate links.
But we can鈥檛 let these obstacles derail such an important project. What鈥檚 needed is a re-creation of the national consensus that got this ball rolling in the first place.
That is the message Terry Lake, sa国际传媒鈥檚 health minister, must take 鈥� and sell 鈥� to his colleagues across the country.
