Speech - Manitoba ICT Symposium - Jeff Rohne, Interim President & CEO

February 10, 2009 -- Theme - eHealth Benefits: Fact or Fiction?

Good morning, and welcome to TRLabs' annual Information and Communications Technology Symposium. Welcome to Deputy Minister Clarkson, and our 16 speakers here today representing a diversity of healthcare voices. A special welcome to the Assembly of Manitoba Chiefs – who have brought some 100 attendees here today to share and exchange around the healthcare issue.

It's been said that one can measure how advanced a society is by how well it meets the needs of its weakest and most frail members. Healthcare is a cornerstone of how we meet that need.

Today, the healthcare system is arguably the most complex service mechanism western nations have built. But societal forces are converging to present us with a monumental challenge.

We spend a lot on healthcare - $180 billion a year, 11% of GDP, or $5200 per person last year in Canada. 4 of every 10 provincial budget dollars in Manitoba are spent on healthcare.

And we're going to spend a lot more on it. Why?

We're seeing cracks in the system despite our growing budgets. Between 1993 and 2007 the average wait time between a physician visit and a required treatment doubled to 18.3 weeks - nearly double the wait time that physicians consider clinically reasonable.

The Fraser Institute observes that provincial health-care spending continues to grow at an unsustainable rate that exceeds the rate of inflation and growth of the economy, and will consume more than half of all revenues in 6 of 10 Canadian provinces by 2035 unless changes are made. Without change, provinces are going to hit a wall where they have to choose between reducing other services such as education, or imposing further restrictions and rationing of health care.

The title of the Symposium – eHealth Benefits – Fact or Fiction – is therefore a provocative one. Many tout the power of ICT to bring efficiency of care and effectiveness of cost to the health care system. Why? Because in only 2 decades the sector has moved from obscurity to underlying the productivity of all of Canada's economic sectors. But is it panacea, or point of pain in addressing our healthcare challenges – a beast infinitely complex?

Maybe the better question to ask is – what do we need the healthcare system of the future to do for us?

Well – it has to sit on three foundations – affordability, efficiency and reliability. That it is a public good is a given.

We want quality patient care, minimum wait times, extension to remote, rural and aboriginal communities, and more distributed access to basic and advanced medical services. With chronic conditions we will want more frequent, decentralized interaction with the health system. We will want virtual doctors when needed, and be virtual patients as much as possible. Our medical records must be 100% secure. But we want to own them – and move them around with us. Prevention should be as important as treatment. We want to be more personally responsible for the health care choices we make. We want things to be as real-time as possible.

A technological revolution - networking, wireless, security, storage, connected media, and computing power among others - is advancing so quickly it enables consideration of the structural form and function of healthcare: how disease is treated, where disease is treated, and how healthcare practitioners interact with technology to provide patient care. We don't have to just tinker. We can re-engineer – if we put our minds to it. We couldn't say that 10 years ago……

TRLabs' eHealth vision is of a 'Million Little Hospitals' – a more distributed, individualized health system. TRLabs research activity aimed squarely at the vision is working in four key areas: Promotion and facilitation of wellness; Management of health information; Enhanced delivery of care; and Management of health events.

The ICT Challenge is complex. We need next generation applications. But to do that we need enabling, next generation networks to tether the system together. Always on, everywhere, always in movement.

This notion of the virtual healthcare team – one that includes the patient - is a tough task. Lack of caregiver time constrains technology adoption. In a hectic environment, if it isn't plug n play forget it. There's generational differences among potential technology users. There's the expenditure paradox: IT is both expensive and efficiency generating. There's a distinct technological difference between 'under the roof' and 'dispersed points of care'. There's market segmentation between patient, health care service provision, and health care system professional development and exchange. There's considerable variation in network capability across health systems – and many systems don't talk to each other well. Without absolute information security, applications development is a non-starter. Interoperability and integration are paramount. General institutional and personnel receptivity to IT solutions is lower than in other sectors.

While we're at it, we must also be ever mindful that the health-gap between the most and least healthy Manitobans, and Canadians, has been shown to be widening. Technology must be able to step into this gap. And we must never lose sight of the fact that technology is no longer just about creating the new gizmo. Market success will be determined by quality of experience, and quantifiable value in terms of lowering cost, providing better care, and/or generating more reliability.

To get from eHealth fiction to fact will not only take imaginative R&D, it will take a shift in mentality – one that moves from providing healthcare as purely a social good to one that thrives on an economic development model.

Most of the country's medical products and equipment are purchased abroad – generating one of Canada's largest sectoral trade deficits at roughly $6 billion a year. This trend-line is paralleled by a rapidly growing global healthcare sector.

Canada's healthcare system is internationally respected. A window of opportunity exists in which to enhance and leverage this asset. Our demographic is 20 years ahead of emerging economies like India and China. We can become a leading exporter of innovative health sector applications and networking technologies – if we put our elbow grease into it.

We need to grab the tiger by the tail – as hard a road as that might be.

To do this we need to break through the institutionalized nature of a publicly-funded system, which apprears to inherently limit access to industry collaboration, partnerships, and markets.

Government, industry and academia are converging interests in the sector. At TRLabs we feel we are uniquely able to catalyze these mutual interests to action. Not for profit. Technologically neutral. A 23 year track record of successful commercialization. An 8 year track record in eHealth – including the emergence of eHealth as one of three vertical R&D thrusts. We operate with three lines of business critical to success in this area: Applied Research; Applied Development - including Prototype Development and Technology Demonstration; and Testing and Verification. We're a relatively untapped watering hole for health authorities to engage industry through, and for industry, particularly SMEs to get access to health institutions they might otherwise not get.

At TRLabs we're deeply committed to serving as a guidepost for the leverage of our collective healthcare investment and expertise onto a global innovation and trade stage. Perhaps most importantly, in our endeavour we will have made strides in fundamentally influencing our economy …. and our humanity.

On behalf of TRLabs, thank you for coming today. Enjoy your day. In addition to hearing from our speakers, we hope you take some time to make new connections that may prove valuable to you down the road.

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