Canada Health Infoway: Better Health Through Digital Technology

Better Health Together through new technology. That’s what it’s all about. An important trend in health care these days is patient-centred care and convenience. The idea is that in a world driven by technological innovation, patients should be able to securely access their full medical records online. Many in the healthcare community refer to this as digital health care. Digital health brings great efficiencies to health care by lowering administrative costs, providing more timely treatment and improving the doctor-patient relationship by making it more accessible and transparent. Australia and Denmark have been recognized as leaders in this field. However, Canada is starting to turn heads with some exciting and innovative developments.

Founded in 2001 by Canada’s First Ministers, Canada Health Infoway (Infoway) is an independent, federally-funded, not-for-profit organization whose role is to improve health and health care by collaborating with every province and territory to propel Canada’s move from paper to digital health. Infoway, together with the provinces and territories, is investing to support their efforts to significantly increase the number of clinicians, physicians, nurse practitioners, primary care centres, outpatient clinics and others to adopt and use electronic health record (EHR) systems. The advanced use of EHRs will allow clinicians from coast-to-coast-to-coast to access more complete medication profiles, immunization reports and hospital discharge summaries, among other data. The system also helps healthcare providers communicate more effectively with patients seeking health services.

Creating EHRs means that patients’ medical records will be securely available to, and shared among, authorized health-care providers. Infoway’s investments in EHRs are working and they are dramatically changing the way we manage health information in every province and territory. Accountability mechanisms in place have resulted in some 25 independent audits of Infoway in which findings have been largely positive.

Richard Alvarez, President and CEO, Canada Health Infoway, says that: “Infoway uses a phased and gated funding model, which allows for the release of funding only when pre-set milestones are met. Our project management office is central to ensuring transparency, and accountability remains at the forefront of every project we invest in.”

In November 2013, this emphasis on accountability earned Infoway the distinction of being named the first government-funded organization in the world to win the global, 700,000-member Project Management Institute’s Project Management Office of the Year award. Infoway is the first and only Canadian organization to hold this title.

Infoway is jointly investing in digital health with the provinces and territories and is supporting their efforts to significantly increase the number of clinicians adopting and using an electronic medical record (EMR) system. The intent is to encourage clinicians to use EMRs in physicians’ and nurse practitioners’ offices, primary care centres and outpatient clinics. These EMRs will connect to the jurisdiction’s EHR system.

How will Canadians benefit?

EMRs give health care providers a more complete picture of their patients’ health. As of March 31, 2013, more than 14,000 physicians and nurse practitioners are participating in EMR programs, while more than half of Canadian family physicians currently use an EMR. As well, about 25,000 health care providers who work in busy specialty clinics will be given easier and more secure access to patient information gathered from inside and outside the clinic. This is due to the joint efforts of Infoway and the provinces and territories.

Infoway recently launched its Better Health Together public education campaign, which illustrates, from the perspective of Canadian patients, ways technology is changing health care. Similar to the way technology has improved banking or the way we connect with family and friends, digital health is creating a more connected health-care team. Networks of systems are being created to securely connect and share health information with authorized care providers. And increasingly, these sophisticated networks can provide the tools and information to empower patients to better understand and manage their own health. Online access to personal health information, such as lab results, current medications and other vital data, helps health professionals provide safer and more effective care, allowing patients to track their progress and ease their anxiety. This system is as different from traditional models of health care delivery as 3D-printing is to the standard printing press. These new systems will provide secure and timely access to the vital health information of Canadians.

An engaged clinical community is essential to the successful move from paper to digital in health care. Infoway’s Clinical Council includes patient representatives and health care professionals who provide the organization with advice on engaging the clinical community about matters related to the use of digital health technologies.

These reference or working groups are made up of a variety of medical professionals. From physicians and nurses to pharmacists, different disciplines are represented. These groups discuss and brainstorm what is already positive within health care systems and how these methods and systems can be improved upon by using technology to advance communication.

Founded by Infoway, the national Clinician Peer Support Network is made up of health care professionals who share best practices with peers, enable learning and identify barriers to the transformation that Infoway envisions, offering possible solutions to overcoming them.

Of course, with any personal information exchanged electronically, privacy is a major concern. Infoway has an EHR blueprint in place that is being used by the provinces and territories in their EHR development. The blueprint includes a section dedicated to privacy and security requirements that accommodate jurisdictional differences across the country.

Alvarez is well aware of the privacy concerns and notes that: “Privacy provisions are central to the design and development of electronic health record systems and we are fortunate to count the jurisdictional privacy communities among our collaborators. This helps ensure that the privacy and security standards in place reflect local laws and needs.”

Infoway has established multiple initiatives to address privacy concerns, including the Privacy Forum and Health Information Privacy Group, to ensure that non-technical security issues are addressed. All Infowayfunded projects that involve personal health information must go through a Privacy Impact Assessment. These assessments are completed by project sponsors and submitted in confidence for Infoway to review. Taking the issues and concerns of privacy very seriously, Infoway has also conducted public opinion surveys and opinion polls, organized focus groups and consulted widely on the subject of electronic health information and privacy. Results showed that 91 per cent of Canadians support the implementation of EHRs, while still expecting their privacy to be respected whenever these systems contain personal health information (according to What Canadians Think: Electronic Health Information and Privacy Survey 2012, conducted by Ipsos Reid).

Ultimately, the direction that Infoway is heading in is the way of the future. In an age where digital technology is so prevalent in our society, it only makes sense to use it to improve our health care system. Providing easier access to health records across the country will reduce wait times, change the way clinicians work and improve communication among clinical peers. And that would be a great victory for public health care and patient-centred care in this country.