ONE OF THE MOST important observations we've encountered concerning the current scandal afflicting eHealth Ontario came in a commentary by Dr. Michael Rachlis, a health policy analyst and an associate professor at the University of Toronto.

Published by the Toronto Star on June 12, the commentary should serve as a wake-up call to anyone who favours returning to the tried and true Canadian tradition of having an independent inquiry that will incidentally derail the project that's at the centre of the scandal.

The good doctor's observation is that the current controversy must be seen in the context of what's at stake in the project's objective: the long-awaited and overdue computerization of health records.

"With the headlines screaming scandal at eHealth Ontario and the media and opposition sensing blood, Ontario risks falling further behind on electronic health records," he wrote, adding:

"Of course, I understand how people who are losing jobs and savings can be angry at the symbolism of consultants who make more than $300 an hour billing for muffins. And there has been a lot of money spent on electronic health records in the past without much to show for the expenditures."

Noting that consultants usually have legal contracts that include payment for food while they're on the road, he reminded readers that those in charge, including eHealth chair Dr. Alan Hudson, and deposed CEO Sarah Kramer and her team "were incredibly effective in their previous work at Cancer Care Ontario and the provincial wait times initiative. And they had already accomplished a lot in their first six months at eHealth, including launching a pilot project to track prescriptions for 80,000 patients in Sault Ste. Marie and Collingwood. Finally, top-notch private sector IT people make a lot more than Kramer ever did."

His main point: You need high-quality, integrated electronic records to run a safe, efficient health care system.

He went on to illustrate how far we are behind: "On a 1981 visit to a Havana community health centre I was struck that each doctor had a binder with lists of patients with different chronic diseases.

"In what might have been an apocryphal story, a physician told me that in his guerrilla days, Fidel Castro saw a child die from asthma. Fellow guerrilla and physician Che Guevara informed Castro that the death could have been prevented with appropriate care prior to the attack.

"With a voice swelling with pride, the doctor said that Castro had created a world-class health-care system. And El Commandante insisted on the regular follow-up of all patients with asthma and other chronic diseases to prevent unnecessary deaths, such as the little boy's he had witnessed."

Dr. Rachlis said that when he returned to his practice, "I bought a binder and started keeping track of all my patients who needed routine followup. I discovered that I had more than twice as many patients with these conditions as I had suspected. My patients got better care. Probably some of them avoided heart attacks, strokes and kidney failure."

The next year, he visited Seattle's Group Health Cooperative of Puget Sound, established in 1948 and still run as a co-operative, which by 1982 had a fully integrated electronic health record with terminals in every office hooked up to an IBM mainframe computer. "The possibilities astounded me."

According to the just-released Ontario Health Quality Council's annual report, only 25 per cent of Ontario family doctors have electronic records, compared with 50 per cent in Alberta and 98 per cent in the Netherlands.

Even worse, it showed just 8 per cent of Ontario family doctors use their electronic records to follow up patients. "Thousands of patients with diabetes and other chronic conditions are dying unnecessarily," Dr. Rachlis wrote. "Thousands of X-rays are being redone every year because the one done a few days earlier isn't available. Castro would not be impressed."

Clearly, what we have is just another in a long list of crucial Canadian projects that became tainted — and often delayed — because of scandals over inflated costs or too much work going to friends of the government.

It started soon after Confederation, with the Canadian Pacific scandal that cost our first prime minister, Sir John A Macdonald, an election, continued with the pipeline scandal and C.D. Howe's "What's a million?" comment that brought John Diefenbaker's Conservatives to power, and more recently the sponsorship scandal that produced our current Conservative government.

The common theme in all the scandals is the importance of the projects — completion of our first transcontinental railway, bringing natural gas from Western Canada to our industrial heartland, and promoting federalism on the eve of a referendum that almost saw Quebec leave Confederation.

This time, let's hope that we get a commitment from Premier Dalton McGuinty, and support from the two opposition parties, that nothing will be done to further delay the essential computerization of all health records in such a way that they can be shared by all caregivers.