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This article was written by Tom Brodbeck for the Winnipeg Free Press. Published September 19, 2024. To access the original article, click here.
One of the biggest decisions the provincial government will have to make when it rolls out its new surgical wait time information system is how much data it plans to share with the public.
Shared Health gave journalists a lengthy and detailed briefing last week about its new surgical wait-list information management project. It’s pretty impressive, especially when compared to the ancient paper and fax systems most surgeons were using until recently.
The system forces surgeons who want to book operating room time to submit all their patient information to a central wait time database. From there, primary care doctors (who will also have access to the database), surgeons, hospitals and central organisers will have access to a wide range of data, including the number of patients waiting for surgery, types of surgery, priority levels, and how long patients have been waiting. It will allow primary care doctors to access a wide range of specialists to refer patients. That had never existed.
Under the previous system, surgeons managed their own wait lists, sometimes haphazardly. It wasn’t unusual for some patients who had waited months or years to get buried in the mess of paper-based wait lists kept by some surgeons.
No more. If a surgeon wants operating room time, they have to submit their complete list of patients awaiting surgery to the database so central planners can see how many people are waiting and how long they’ve been waiting.
The database will also detail available resources for each surgeon (such as operating room time and available hospital beds), which makes it possible to accurately calculate when patients can expect to get surgery. In theory, patients should be able to contact their surgeon or primary care doctor and find out exactly when they can expect to have their procedure done.
That did not exist under the previous system, which was mostly based on guess work and incomplete information.
What has not been decided is how much of this data will be shared with the public so people can assess how well the government is managing wait times.
Right now, publicly available data on wait times is retrospective — it only shows how long patients who had their surgery waited for it.
That is semi-useful. However, it excludes people who are waiting months or years for surgery who still haven’t had their procedures done. Also, it only includes a handful of surgical categories, such as hip and knee replacement and cataract surgery. The new database includes all surgeries.
Because the system measures all patients currently waiting for surgery, it will present a far more accurate picture of how long people are waiting. It’s real-time data.
Obviously, the government can’t release all the data because it includes information about individual patients. That cannot, and should not, be released under the province’s Personal Health Information Act.
However, the bigger-picture data should be made public on a dashboard so Manitobans can hold the government accountable.
At this point, it’s unknown what that will look like. When asked, Dr. Ed Buchel (Shared Health’s provincial specialty lead for surgery who led last week’s briefing), said that decision has not yet been made. It will be tricky.
The new database will show wait times are longer than previous thought. For the government, that’s a political challenge it will have to wrestle with when deciding what data to make public.
To be open and transparent, it should make all of it public, with the exception of individual patient information and possibly wait times for individual surgeons. The public doesn’t need access to the latter, but it should be able to see the broader numbers.
These are public records compiled by a government agency. The public has a right to those records under the Freedom of Information and Protection of Privacy Act. The database should not be used for internal use only. It should also be used to communicate accurate, up-to-date information to the public so it can see how health care dollars are being spent.
A decision on a new surgical wait-list dashboard probably won’t be made until next year after the database is complete. It was rolled out in Winnipeg first and is now being implemented provincewide.
This is good news for patients and for the health care system generally. The database will provide the government with reliable, data-driven information to help it make decisions about resource allocation and to improve outcomes. That’s something governments, which are notorious for using outdated software, or no software at all, don’t always have. This is a positive development.