Alan Hudson took over a $647-million white elephant, with instructions to fix electronic health records, based on his illustrious track record of whittling down key medical wait times.
In the end, it was Dr. Hudson who got the fix. He resigned Wednesday as chairman of eHealth Ontario - where he never collected a penny for his nine months of work - after a consulting and spending scandal went viral.
"He was eligible for a $600-a-day per diem, but he never accepted money, he never billed the government for his time," said Kevin Smith, president and chief executive officer of St. Joseph's Healthcare Hamilton. "That really says it all to me."
A former neurosurgeon and hospital president, Dr. Hudson now finds himself, at age 71, prematurely leaving one of the most high-profile posts in health care. His career, which has had many highs that include putting Toronto's neurosurgery program on the international map, co-ordinating Ontario cancer services and ratcheting down some provincial wait times, threatens to be remembered only for this remarkable low. He still leads the provincial drive to reduce wait times for certain medical procedures, a position to which he was appointed in 2004.
After the spending scandal - lucrative contracts awarded without competitive tenders and nickel-and-dime spending on snacks by consultants - captured headlines for a month, he resigned, telling one colleague Wednesday that he had become an impediment.
"He made a very conscious choice that said: 'I'm now in a position where the debate has moved off why we need an electronic health record to improve patient care and onto an unhelpful dialogue. And in the interests of patient care, I'm getting out of the way,' " said Dr. Smith, who spoke with Dr. Hudson Wednesday.
Earlier this month, Dr. Hudson's protégé, Sarah Kramer, resigned as chief executive officer of eHealth Ontario. Now, with Dr. Hudson's exit, the strategy is in tatters at a time when Ontario already lags well behind other provinces in replacing paper-based medical records with electronic ones.
Dr. Hudson has been a venerable force on Toronto's University Avenue, a stretch dubbed the "Alan Expressway" because his mark has been left on so many of its institutions: the University Health Network and Cancer Care Ontario - he was president of both organizations - and nearby University of Toronto, where he was chairman of neurosurgery and, earlier this month, was given an honorary degree.
At eHealth Ontario, where he had a $2.4-billion budget over three years, he and Ms. Kramer, whom he often described as brilliant, developed a strategic plan.
There were three areas of focus: a diabetes registry, an eHealth portal to centralize information on one website, and prescriptions done electronically to not only eliminate handwritten prescriptions but also eradicate many medication errors and save lives.
"He comes to eHealth Ontario, takes over an agency that, let's face it, has spent $700-million with very little to show for it, and is handed an agenda that says, 'Fix this,' " said Bob Bell, president and chief executive officer of University Health Network. "… In a short period of time, they [Dr. Hudson and Ms. Kramer]developed a strategy that is a compelling strategy, exactly the strategy we need to implement."
While not commenting specifically on Dr. Hudson, Ben Chan, chief executive officer of the Ontario Health Quality Council, said: "If you look at the [eHealth Ontario]strategic plan, the ideas around moving on a diabetes registry and moving on e-prescribing are certainly important steps in the right direction."
Nationally, Ontario is middle of the pack when it comes to electronic health records, with Alberta having moved on the issue twice as quickly. Still, Canada is far behind the United Kingdom and the Netherlands.
"Historically, we've been behind on implementation of electronic health records. We've got a lot of catching up to do and we can't afford to lose momentum," Dr. Chan said. "The quality of patient care is at stake."
With Dr. Hudson gone, there are worries that electronic health records - which were ideally to be available for every Ontarian by 2015 - may not be achievable until much later.
Rachel Bard, chief executive officer of the Canadian Nurses Association, said she hopes it is only a temporary setback.
"Let's learn from it and I would think, put the right accountability measures in place," Ms. Bard said. "I think it's the right thing to do [electronic health records]if we want to sustain and maintain the publicly funded system."
John Abbott, chief executive officer of the Health Council of Canada, said he thinks this is a hiccup and that in order for eHealth Ontario to be effective, it needs to be rolled out throughout the province.
And while Anthony Dale, vice-president of policy and public affairs at Ontario Hospital Association, thinks the goal of having an electronic health record for every Ontarian by 2015 is do-able, there are others, such as Dr. Smith who don't think so.
"It can't help but slow it down; leadership drives the train," said Dr. Smith, who is also chief executive officer of St. Mary's Hospital in Kitchener. "He's irreplaceable in his skill, style and impact. I know e-health would have moved better, faster quicker with him...There's no question, Alan was the phenotypical Alpha Male who got things done. This guy moves mountains."
With a report from Karen HowlettReport Typo/Error