Canada’s EHR Progress
About Canada Health Infoway
Canada Health Infoway (Infoway) is an independent, not-for-profit organization funded by the federal government. We work with every province and territory to accelerate the development and adoption of electronic health record (EHR) systems in Canada.
We don’t actually build the systems or carry out the projects, we invest in them. Our role is to set the national standards (for example, making sure that the many systems across Canada can all communicate with one another), develop the vision, goals and strategies that everyone can follow, and help fund solid and successful ventures.
Why we’re here
Experts around the world agree that moving to EHRs results in tremendous benefits; better and faster care for patients, savings of time and money for health care systems.
However, world-wide experience also shows that it’s not an easy job. Building secure, complex systems and getting every health care practitioner to adopt them takes a lot of time and effort.
That’s why Infoway is here – to set the overarching direction for the country and to help the provinces and territories get the job done.
Why it matters
Because putting good EHR systems in place will help ensure you and your family will get the high quality health care you need, where and when you need it.
Instead of having medical records scattered in many locations, Canadians will have all their health information accessible at the same time. It will mean less waiting time while finding or requesting your files … no needless repetition of tests and treatments … avoiding errors such as prescribing drugs that interact badly with your other medications … and complete access to your records anywhere you go in Canada, anytime.
Because EHR systems make health care systems more efficient, it reduces the workload on practitioners, freeing them up to see more patients and spend more time providing care.
This better, faster, cheaper world of health care can be ours if we meet the challenge of creating and adopting EHRs across Canada.
How we fund projects
Provinces and territories come to us with specific projects they would like us to help fund (we will fund up to 75 percent of qualifying projects). We evaluate the projects and, if they adhere to our strategies and technology blueprint, we negotiate specific funding agreements.
Our rules are tough: no funding without delivering the agreed upon results. We establish maximum consulting rates and a budget for each project. If consultant fees exceed our limits or project costs are higher than agreed, our efforts to cap these expenses work to protect the federal investment.
Usually, we’ll provide 20 percent of the funding up front as seed capital; another 30 percent during the development phase, as long as milestones are being reached; and the final 50 percent once the systems have been adopted and are in use. We don’t fund operations or networks, (so, for example, we’ve not had any contracts with Ontario’s Smart Systems for Health Agency), only specific projects that take us closer to having electronic health records for all Canadians.
How we protect your tax dollars
While we’ve been provided $1.6 billion in funding by the federal government to date, we have spent about half of this money so far. That’s because we operate under the strict rules outlined above – we only fund projects that meet our rigorous criteria, and we hold back half of the money until we see proof that technologies are being used.
We also work with vendors to drive down costs. And we enable knowledge transfer between jurisdictions to encourage the exchange of best practice activities.
The Auditor General of Canada recently reported on our operations and found that Infoway has made real progress, that we have operated with ‘due regard’ for public funds, and that we have good systems in place for managing projects and funds.
Our ambitious goals
Infoway’s vision is to bring the proven benefits of electronic health records to all Canadians – to improve quality and accessibility of care while reducing wait times and costs.
We have two specific goals for accomplishing that mission. The first is that, by 2010, every province and territory and the populations they serve will benefit from new health information systems that will help transform their health care system. This is happening now.
The second goal is a call to action. It states, “by 2010, 50 per cent of Canadians and by 2016, 100 per cent of Canadians will have their electronic health record available to their authorized professionals who provide their health care services.”
We know these goals are ambitious. We set our sights high deliberately; to give everyone involved the incentive to move fast, try hard and work smart. While there may be delays as provinces secure funding, update their laws to enable EHRs, and while health care practitioners learn to adapt to the new systems, we’ll strive to hit our milestones.
In terms of this goal, progress stood at 17 per cent at the end of March 31, 2009. By March 31, 2010, we anticipate progress will stand at 38 per cent. By the end of 2010, we estimate we will achieve – or be very close to – our target of 50 per cent. Ours is a collaborative effort and so we’re working with our provincial and territorial partners to do whatever we can to achieve these targets.
Making real progress
To start, Infoway has been working with experts from across Canada and from every health care field, and with all governments, to set standards and policies that make sense. This effort helped us build a pan-Canadian blueprint that allows each government to build a system that meets its needs while ensuring it will be part of a seamless web across the country.
Infoway has also helped finance critical core registry and repository systems to house Canadians’ health data. These aren’t systems that patients can see or touch, but they are absolutely essential for health care providers. Every Canadian province and territory has some of these systems in place, with Alberta and Prince Edward Island having the key aspects of EHRs in place today.
So far, we’ve helped get almost 300 EHR projects completed or underway across Canada. The results are improving the quality of health care, reducing wait times, avoiding costly and dangerous errors, improving access in remote and rural communities, and cutting costs for taxpayers.
For example:
- Thanks to systems we’ve helped fund, about three quarters of X-rays, MRIs and other medical images in Canada are produced in a digital format, which is cheaper to produce, easier to store and can be accessed by health professionals in different locations at any time. With these digitized images, radiologist productivity has increased by some 23 percent, saving an estimated one billion dollars a year, and getting patients their tests and treatments faster.
- In British Columbia, we are upgrading and enhancing the province’s existing PharmaNet system which gives pharmacists electronic access to complete health records. Last year, 2.5 million potential cases of drug interactions were avoided that could have led to serious complications or even death.
- In Alberta, the WebSMR system we helped fund has improved post-surgical reporting from a month in most cases to less than an hour 91 per cent of the time. That’s a significant breakthrough in post-surgical care.
- In Ontario, Infoway’s support has helped create and expand the new Ontario Telemedicine Network so that over 2,000 health care professionals are now delivering care to over 660 rural and remote sites and aboriginal communities throughout the province.
We’re pleased to say these are only a few examples of how our efforts to support EHRs are improving health care across the country. See more examples of how EHRs are delivering tangible results today.
Lots of work still ahead
We’re building a system that will transform the way that health care is delivered across Canada. This is a very complex, enormous task; you could easily compare it to building the TransCanada Highway or the national railway.
People often point to the financial services industry as a good example for us to follow. However, it took 10 to 20 years for innovations such as ABMs, credit cards and online banking to go from introduction to having a significant portion of the population using them.
Around the world, even the leading electronic health records efforts have taken an average of 10 to 15 years to design and implement. That’s even in jurisdictions with smaller populations or far fewer square kilometres to cover, and those that are spending a lot more money on EHRs per person.
With every province and territory controlling its own health care system, success relies on the collaboration of 14 governments. And that’s just what they’re doing, showing that everyone understands how important EHRs are to improving health care for all Canadians.
Together, we’re determined to build best possible health care system – one that is available when and where you and your family need it, that provides high quality care, and that does not waste your tax money.
Electronic health records are helping to accomplish all of these goals and Canada Health Infoway is proud to be a key part of this effort.