They say you should never look a gift horse in the mouth, especially one worth $33 million, so it was with eager anticipation that I set about exploring the Government’s new health and wellness website. The site was unveiled last week and will be fully operational by 2015. It provides 2 new services, both aimed at “empowering” Albertans to make informed choices to stay healthy and access healthcare when they’re unwell.
The first initiative is MyHealthAlberta . Minister Zwozdesky says it’s tailored to Albertans, having been compiled and vetted “…during 75,000 work hours by physicians and professionals on 8,750 topics.”* A quick review reveals general information on disease diagnosis, treatment and finding a doctor, not unlike what you’ll find on the Alberta Health Services website or Netdoctor for that matter; as well as information on allergies, insect stings, shin splints and bedbugs. Assuming that Albertans are no more susceptible to pestilence and boils than the rest of the country, much of MyHealthAlberta is a duplication of existing information readily available elsewhere.
To be fair, MyHealthAlberta will become more Alberta-centric over the next 3 years. Albertans will be able to input their own health data (blood pressure readings, insulin levels, weight, etc) in order to track their progress over time. Eventually Albertans will be allowed to access their electronic health records. Both of these initiatives should enable Albertans to better understand their health and take responsibility for their own wellness.
Given that neither of these two initiatives will be in place for a couple of years, one questions whether Minister Zwozdesky’s $33 million announcement was premature and simply an effort to deflect attention away from more pressing healthcare problems such as the call for a public inquiry.
But back to the website. The second service is a new link that sets out wait times for 55 procedures which have been sliced and diced by region, hospital and physician for the preceding 3 months. It replaces a similar website which was taken down in Sept 2008, ostensibly because the 2008 website (which was based on information from the 9 health regions) was unreliable and inaccurate.
The wait time website is Minister Zwozdesky’s personal favourite. He’s been waiting for it for a “long time” and waxes eloquently about the site’s potential. “If we’re able to show you what the reported wait times are by physician and by facility, family physicians will be able to work more quickly with their patients to find specialists with shorter wait times and to ensure Albertans receive timely care where and when it’s needed.”*
Just think about this for a minute. Minister Zwozdesky thinks that the mere fact that wait times are posted on line will ensure that Albertans will “receive timely care where and when it’s needed”. Really?
I decided to test this theory by searching for wait time information for cataract surgery in Calgary. I sorted through my hypothetical level of eye disease (semi-urgent to non-urgent) and selected the time period within which 90% of the surgeries were performed. I hit the big green search button and found—nothing. The two physicians who perform cataract surgery in Calgary are shown as having completed 0 surgeries in the first 3 months of 2011. There was no explanation for this lack of data although there was an unrelated comment about the lack of diagnostic imaging data which requires system upgrades.
You’ll recall that in February 2011 Minister Zwozdesky announced that an additional 3000 cataract surgeries were added to the surgical roster. He also noted that the average wait time was 41 weeks in 2010 versus a target of 36 weeks in 2011.** Notwithstanding the availability of this information (from the Health Minister no less) as far as the on line cataract patient is concerned the wait time website is a complete bust.
Not prepared to give up, I tried a second search, this time for mastectomy wait times. I classified the search as semi-urgent and pulled the wait times to treat 90% of the patients in all Calgary hospitals. This produced a list of 20 doctors who performed between 1 to 64 surgeries within a 1 to 9 week wait time period. So what should I do—pick the doctor who performed one surgery over the last 3 months but could get me in within a week or the other doctor who performed 64 surgeries over the last 3 months and had a wait time of 5 weeks?
Obviously I’d need to work with my family doctor to get his views on which specialist would be the best choice. Ah, but there’s the rub. Minister Zwozdesky’s assurance that the website will ”…ensure Albertans receive timely care where and when it’s needed” is based on the premise that Albertan’s already have access to a family doctor who can help them make these difficult decisions. The website neatly side steps this issue by defining “wait list” as the period of time between when the specialist decides a procedure is required and when it is performed. It does not take into account the month it takes to get in to see your family doctor (assuming you have one—20% of Albertans do not) and the 1 to 3 months (or more) it takes to get in to see the specialist and run the diagnostic tests required to determine which procedure would be best in your case.
Bottom line: posting a link to wait times does absolutely nothing to “…ensure Albertans receive timely care where and when it’s needed”.
But wait, the Health Minister touts a second benefit of the wait time website. “This is a system that will make us more accountable to Albertans…an important way of measuring our health system performance”. Great idea. I’m all for accountability—but it’s virtually impossible to determine accountability by measuring performance against pre-set targets when the pre-set targets are not readily accessible. The website is not linked to national wait time metrics,***nor is it linked to the targeted wait times metrics already established by Alberta Health Services. Consequently, the wait time website fails as an accountability measure because it is nothing more than an incomplete snapshot of wait time performance over the last 3 months.
In the final analysis, the website is a very pretty shiny object with a $33 million price tag. It’s meant to distract Albertans from the more pressing question of what is wrong with the Alberta healthcare system. A public inquiry is one way to find out. By happy coincidence a public inquiry would cost about the same and take about as long (according to the Health Minister) as the fully operational MyHealthAlberta and wait time websites.
So where would you rather spend your tax dollars—on a process to uncover what’s wrong with our healthcare system and fix it, or on another bright and shiny object?
*Calgary Herald, May 5, 2011, p A6
**Edmonton Journal, Feb 11, 2011, online
*** Alberta is once again at the bottom of the heap when it comes to wait time performance. Alberta finished in a tie for 7th place ranking ahead of only PEI and Newfoundland despite being among the highest healthcare spenders per capita. CHCI 2010 pp 21,29