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It is important to understand the effects Canada's investments in digital health are having for individuals and on the health care system. To that end, Infoway developed a Benefits Evaluation Framework and strategy in 2006, which has since been applied against projects across Canada. Infoway supports evaluations in investment projects and commissions select research to broaden the understanding of the impacts of digital health technologies. Resources and lessons are available, as are reports and publications from many evaluations.

Once sufficient progress has been made around deployment, adoption and evaluation for a given area of investment across Canada, Infoway often commissions a summary benefits evaluation study to understand and communicate the impacts at the national level. Four such independent studies have been commissioned in recent years.

While these national level studies illustrate the current value being delivered by the investments made by Infoway and its jurisdictional partners, emerging evidence also demonstrates the momentum that is building in these and other respective areas as clinicians increasingly adopt and use the technologies that have been implemented. The reports also identify critical success factors for achieving the full potential of the digital health technologies being studied.

Four national benefit evaluation studies have been carried out since 2008:

EMR Evaluation

In 2012, Infoway commissioned its fourth pan-Canadian study, to determine the current and emerging effects of implementing electronic medical records (EMRs) in community-based practices in Canada.

This study, entitled The emerging benefits of electronic medical record use in community-based care, shows that since 2006, use of EMRs in primary care has doubled while efficiency, safety, and other benefits valued at more than $1.3 billion have been seen by community-based clinicians and the health system as a whole.

The study also demonstrates the potential of EMRs to improve communication among members of the care team, as well as communication between providers and their patients.  

While it illustrates how the benefits of EMR use are accruing today, the study also shows the even greater potential that lies in expanded adoption of EMRs and in the richer use of these systems including the use of advanced features such as tools and alerts prompting follow-up; and use of EMR data that will help clinicians with illness prevention and chronic disease management.  

Related resources:

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Telehealth evaluation

In 2010, Infoway commissioned its third benefits evaluation study, this time on telehealth. As outlined in the report, Telehealth Benefits and Adoption: Connecting People and Providers Across Canada, telehealth has delivered a number of access, quality and productivity benefits for clinicians, patients and the health care system.

Amongst the study findings, the report uncovered that Canada has one of the largest telehealth networks for videoconferencing, globally. In 2010, 5,710 telehealth sites were being used in at least 1,175 communities across the country. That year, nearly 260,000 sessions where held on the network, often involving two or more clinicians collaborating on patient diagnosis, monitoring and treatment.

Total Number of Telehealth Sessions in 2010
Total Number of Telehealth Sessions in 2010
Click image to enlarge it.

Of the total telehealth sessions, nearly one-third (94,000) are estimated to have been from rural and remote communities in Canada. These events saved Canadians approximately 46.8 million kilometres of travel, representing 5.6 million litres of gasoline and nearly 13 million kg of CO2 emissions (equivalent to 2,760 fewer cars on the road). The study estimates that telehealth helped patients save $70 million in personal travel costs.

The territories, including Nunavut, Northwest Territories and Yukon, demonstrate the highest per-capita penetration, illustrating how important telehealth is in these vast, predominately rural and remote areas.

Total Number of Telehealth Sessions in 2010 - per 10,000 Population
Total Number of Telehealth Sessions in 2010 - per 10,000 Population
Click image to enlarge it.

The report also indicates that Telehomecare has demonstrated significant value and future potential, providing improved quality of care for patients with chronic diseases and avoiding utilization of emergency and hospital services valued at over $20 million annually.

Findings of the report suggest that telehealth is becoming a mainstream way of delivering care. Based on historical data from telehealth programs assembled for this report, telehealth use has grown at a rate of over 35% annually over the past five years. Assuming growth of 20% and 40% per year, 1.2 million consultations could be reached within five to 10 years.

Related resources:

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Drug information systems (DIS) evaluation

Our second benefits evaluation study detailed the net quality and productivity benefits being realized as a result of investments in second generation drug information systems (DIS), with a focus on the resulting improvements to patient safety.

Drug Information Systems Use and Benefits
Drug Information Systems Use and Benefits
Click image to enlarge it.

The study estimated overall benefits valued at $436 million as of March 2010, from use of drug information systems and early adoption of e-prescribing. Of that amount, about $252 million came from improved safety and quality of care: fewer adverse drug events, reduced prescription abuse, increased medication compliance and improved patient and provider satisfaction.

The remaining $184 million came from increased provider productivity - greater pharmacist efficiency and fewer call-backs - and improved drug cost management.

Breakdown of Generation 2 DIS Benefits to March 2010
Breakdown of Generation 2 DIS Benefits to March 2010
Click image to enlarge it.

Download the report summary or the full report.

Other data shows there has also been significant growth in the number of users of the systems. In March 2005 there were an estimated 10,000 users of these technologies. By March 2011, the number had tripled to more than 30,000 estimated users across Canada.

Once fully implemented across Canada, these second generation DIS could result in up to $1 billion a year in benefits. Benefits could potentially be as high as $2.3 billion annually once third generation DIS (systems with advanced functionality, such as allowing authorized providers to electronically prescribe to a patient's pharmacy of choice) are fully implemented and optimized across the country.

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Diagnostic imaging (DI) systems evaluation

In the case of diagnostic imaging (DI) systems, the evaluation illustrated there were about 20,000 users of the technology in March 2005. As of March 2011 that number had doubled to an estimated 43,000 users.

Diagnostic Imaging Systems Use and Benefits
Diagnostic Imaging Systems
Use and Benefits
Click image to enlarge it.

Once Canada's investments in digitizing diagnostic imaging are complete, the productivity of the country's radiologists will increase to a level that could otherwise be achieved only if there were 500 more of these specialists working across Canada.

DI systems are also improving productivity for doctors and technologists, as well as improving remote reporting capabilities and access to care. DI systems also cut turnaround time by 30-40 per cent, meaning patients got their diagnosis faster, and their treatment started sooner.

Download the report summary or the full report for more information.

Clinician benefits

Health care professionals, including doctors, radiologists and technologists, all benefit from the PACS systems. The elimination of a film environment is helping to offset the physician shortage. That’s because health care professionals are being provided with the electronic tools they need to improve their productivity and efficiency.

» Physicians

  • Increased productivity level is equivalent to adding up to 500 physicians to the health care system.
  • Increased capacity of between 6 million and 7 million 10-minute physician consults delivered annually.

» Radiologists

  • 25 to 30 per cent improvement in radiologists’ productivity.
  • Increased productivity level equivalent to adding more than 500 radiologists to the health care system.
  • Increased capacity of between 9 million and 11 million exam reports at the current professional resource level.

» Technologists

  • 25 to 30 per cent improvement in technologists’ productivity.
  • Increased productivity level equivalent to adding up to 2,900 technologists to the health care system.
  • Increased capacity of between 8 million and 10 million exam reports at the current professional resource level.

» Patient Benefits

  • Elimination of up to 17,000 unnecessary patient transfers annually.
  • Enhanced remote reporting capabilities, improving access to radiologists by 30 to 40 per cent for remote geographies and populations.
  • 30 – 40 per cent improvement in exam report turnaround times provides quicker clinical decisions and subsequent patient treatment thus reducing patient wait times and patient lengths of stay.

» Other Benefits

  • Once fully implemented across the country, it is estimated that PACS will generate $850 million to $1 billion a year in health system. efficiencies through increased clinical productivity and reduced patient transfers, duplicate exams and film costs.
  • Reduced film, storage space and staffing expenses can cover the costs of implementing and operating PACS.
  • Avoidance of 800,000 to 1.3 million unnecessary exams annually.

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