E-health key to health system improvements in Canada and Infoway's positive impact on interoperable electronic health records

Toronto, Montréal 26 April 2006The Ontario Health Quality Council's first report identifies electronic health records for all patients, health information management systems and telehealth, together known as e-health, as the key enablers for health care system improvements. Furthermore, an independent evaluation of Canada Health Infoway's performance shows that the publicly funded organisation has had a positive impact on the development of interoperable electronic health records in Canada.

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The Ontario Health Quality Council's report is based on the attributes of a high performing health system - Ontarians want their health system to be safe, effective, patient-centred, accessible, efficient, equitable, integrated, appropriately resourced and focused on population health - and indicators by which these attributes could be measured.

"Ontario's health system is performing well in a number of areas", stated Ray Hession, Council Chair. Survival rates for patients with cancer or heart attack are steadily increasing, surveys show a large majority of Ontarians believe our health system provides good or excellent care, and Ontario hospitals have shorter acute-care stays, use more day surgery and have lower costs per case than hospitals in most other provinces. There are promising initiatives underway in a number of areas; however, it is too early to evaluate them.

Ray Hession continued: "But in some respects, the system needs more work. We have found that inadequate information is limiting our ability to continuously improve quality, monitor performance and report on it." He noted the Council believes investing in e-health - using information technology to manage health, arrange, deliver and account for care, and manage the health-care system - will do the most to improve each of the attributes of a high-performing health system.

"We concluded that the key enabler for health system improvements is e-health", stated Ray Hession. "The implementation of e-health in Ontario requires a clear plan, appropriate governance and requisite funding."

"I want to thank the Ontario Health Quality Council for this thoughtful and extremely useful first report", stated Health and Long-Term Care Minister George Smitherman. "In order for Ontarians to be able to take part in a conversation about their health care, they need to know what's going on in health care. By pointing out those areas in which the system is performing well, and also those areas in which more work is required, the Ontario Health Quality Council is letting Ontarians in on the conversation."

The Ontario Health Quality Council is an independent agency funded by the Government of Ontario through the Ministry of Health and Long-Term Care. The Council reports directly to Ontarians on access to publicly funded health services, health human resources in publicly funded health services, consumer and population health status, and health system outcomes.

The other report, prepared by Ottawa-based BMB Consulting Services, states that progress has been achieved across Canada that "would not have been achieved without Infoway". The report's purpose was to evaluate Infoway's progress in line with its mission to accelerate the development of the electronic health record across Canada. Electronic health records, which help health care professionals make more informed decisions, are seen as a pillar of health care transformation.

"The report is independent confirmation that Infoway is making real progress in achieving its mandate and in providing value to Canadians", stated Arnold Steinberg, Infoway's Board Chair. The evaluation credits the organisation with the following achievements:

  • Demonstrating that there is a technical blueprint for pan-Canadian solutions and then focusing on the business and people aspects of technology through investments in change management and communications;
  • Developing a portfolio management approach through investment strategies and programmes, rather than focusing on individual projects;
  • Building stronger relationships and collaboration with jurisdictions through mechanisms such as three-year jurisdictional plans and the CIO Forum - quarterly meetings with provincial Chief Information Officers;
  • Engaging other stakeholders such as vendors and health care professionals' associations more directly and pro-actively;
  • Placing priority on investment in benefits measurement and adoption of technology by health care professionals; and
  • Streamlining business processes.

The report explains that although progress in the telehealth area has been slower, most stakeholders feel that Infoway has now adopted appropriate telehealth strategies and is gaining momentum in this area.

Infoway was required to have a performance evaluation carried out in 2006, after five years of operation, according to its Funding Agreement with the Government of Canada. One of the conclusions of the report was that "Infoway, through its corporate plans and then its delivery and reporting against those plans, has achieved progress for each of the Funding Agreement outcomes related to EHR."

In preparation for the report, BMB, which was selected through a competitive bid process, gathered information from a number of existing internal and external planning and reporting documents and conducted 51 interviews in the following categories: Deputy Ministers of Health, Infoway's Board of Directors, Chief Information Officers in jurisdictions, jurisdictional project leads, health care associations, industry associations and technology vendors and Infoway management.

"This positive momentum towards the development of a pan-Canadian electronic health record speaks to the remarkable efforts of our federal, provincial and territorial partners and the solid collaboration of health care professionals, technology vendors and other key supporters. Without them, none of this would have been possible", stated Richard Alvarez, Infoway's President and CEO.

Infoway is an independent not-for-profit organisation that invests with public sector partners across Canada to implement and reuse compatible health information systems which support a safer, more efficient health care system. These systems provide health care professionals with rapid access to complete and accurate patient information, enabling better decisions about treatment and diagnosis. The result is a sustainable, healthcare system offering improved quality, accessibility and productivity. To view the full report, you can visit Infoway's Web site.


Leslie Versweyveld

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