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Public health surveillance: developing a pan-Canadian solution to protect Canadians

"Panorama represents the most significant improvement over the present legacy systems in public health information management in decades. It will get even better as implementation and upgrades continue."
- Dr. Perry Kendall, Provincial Health Officer, British Columbia Ministry of Health

In 2003, SARS illustrated the need for better digital health solutions to support infectious disease prevention, control and outbreak management. Since then, the Government of Canada and the provinces and territories have worked together on a number of fronts to improve public health capacity, emergency preparedness and surveillance.

Progress has been made in a number of areas, from expanding web-based communications systems that aid timely sharing of information with public health professionals to establishing national surveillance and reporting systems for communicable diseases. There has also been work to digitize and securely share laboratory results, to use emerging data mining techniques to identify outbreaks earlier from public sources of information, and much more. An important part of these efforts has been the development of a modern, effective public health surveillance solution to protect the health of Canadians.

Panorama, a comprehensive, bilingual, pan-Canadian electronic public health surveillance system, was created based on input from hundreds of public health stakeholders, representing every province and territory across Canada. Panorama was developed by IBM Canada, with funding from Infoway, to help support public health functions such as:

  • Managing immunization schedules and determining eligibility, tracking adverse reactions and identifying precautions
  • Managing vaccine inventory, to improve availability and reduce wastage
  • Assisting in identifying, investigating and managing cases and contacts of communicable disease, to help contain its spread and reduce risk to the public
  • Supporting surveillance, investigation, monitoring, management, analysis and reporting of communicable disease outbreaks
  • Notifying public health professionals so information about critical events and emergencies can be shared quickly
  • Managing public health work processes

Panorama modules are now live in provinces covering 75 per cent of the Canadian population, with several other jurisdictions in the planning stages. Various benefits are being reported by public health officials who use Panorama, including:

  • Increased efficiencies in the management of vaccine supply
  • Immediate access to reliable immunization histories, regardless of where the immunization was provided

In addition, preliminary evaluations of Panorama's vaccine inventory management module report that the harmonization of provincial systems improves vaccine order management and planning and that comprehensive and timely access to vaccine information helps to identify how much vaccine is available and at which locations.

There is also a focus on ensuring that point-of-care solutions are available for health professionals who are involved in patient care, including public health-related functions. For example, the growing use of electronic medical records (EMRs) is playing an important role in this area. In 2006, 23 per cent of primary care physicians in Canada used EMRs. By 2012, that number had more than doubled, to 56 per cent. This is important because, as we found out during the H1N1 outbreak in 2009, family practice clinics with EMRs were able to quickly identify high‐risk patients, schedule vaccination appointments and collect the data required by public health officials to track and monitor the outbreak.

Panorama is available to all Canadian jurisdictions for implementation. Its purpose is to improve the health of Canadians, on an everyday basis and in the case of future public health threats.

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