Healing eHealth Ontario

As the situation at eHealth unwinds in the media, it’s apparent that the process by which large, complex public projects are procured and delivered is less than ideal. Understandably, the public is frustrated by what appears to be massive waste at a time of ballooning government deficits. No doubt people will be held accountable, but this problem has been building for some time and likely predates their involvement. We need to get beyond the politics and examine the range of root causes, big and small, before lasting change can occur.

Of the many interesting findings in the report released yesterday by Auditor General Jim McCarter, the one that really got my attention was the revelation that the eHealth program branch had "fewer than 30 full-time employees but was engaging more than 300 consultants." It’s not uncommon in the private sector to build a team of contract staff when delivering a large project, especially when the project is not in the normal course of business. However, a high percentage of contractors puts a great burden on the smaller group of permanent staff. The organization's policies and procedures, and the degree to which the small group can impress these onto the larger group, are what will make the difference.

The fact that policies and procedures need to be well documented and clearly communicated is obvious and barely worth repeating, but ensuring that these processes are consistently followed should not be left to auditors, because by then it’s too late. Management systems need to provide not just the structure that people work within, they also need to show evidence of compliance in real time. They also need to accommodate exceptions within the system, because they are inevitable. By shining a bright light on events as they happen, we have a much better chance of a positive outcome.