Questions:

Paul, can you answer the following questions based on the discussions and presentations at the June 19, 2006 Gardiner Roberts LLP conference on Health Informatics, which you attended?

1.       There are some givens, for example we know that:

·         “The health system” is a misnomer—there are really islands of automation and function;   the system as a whole is quite dysfunctional.

·         Strong project management skills are missing in the sector—there are too many inexperienced people in the industry (“kids buying servers as though they were Xboxes”).

·         There is a real lack of trained professionals in the field.

·     There is a supernal structure that does not lead to anything. Are those huge structural elements being invested at the expense of people and skills?

·         Vendors do not play together; it is not in their interest.

·         $10 – $15 billion has to be spent on health informatics in Ontario, According to Dominic Covvey.

·         Organizations are not investing in people with soft skills.

These ideas point to a lack of coherent strategy. What strategic vision could you start to sketch out to deal with these related issues? What project management capabilities would be required for an investment of that magnitude and complexity?

2.     You were the first CIO of Canada.  If you were offered a similar portfolio for the health care sector in Ontario, would you accept the job? Why, or why not? What would your first 100 days look like, and what could be accomplished six months, one year and three years into the job?  What shocks would you send through the system? How would you manage the multiple stakeholder groups that would be involved—how would you build a picture of what they would get?

 3.     Is the EHR the Holy Grail?  How would you move the quest for it forward?  Are there other areas to concentrate on now?

 4.     What are the real business drivers for health informatics, when there have been no demonstrated benefits?

 5.     How can a rigorous set of SLAs or benefits related to technology, resources, change management, and other aspects of the whole system be related to patient outcome?

6.     Could you sketch out the project management skills that hospital-based HI professionals should be bringing to their work?  What would the soft and hard skills be?  Would you include clinical skills, industrial and management engineering?

7.     How would you foster leadership from clinicians, CEOs, support staff and administration staff, integrating their efforts to achieve critical results?

8.   How are we going to relate to technology optimists or pessimists in health care?

9. There is not a cohesive health informatics strategy for the Province of Ontario. How might one come about?