Innovation Is the Key

Guest blogger, President and Chief Executive Officer of Canada Health Infoway, Richard C. Alvarez has been a catalyst for accelerating the development of electronic health records in Canada. He has established strong, collaborative relationships with the federal, provincial and territorial governments and other stakeholders as the foundation for solid progress. He has articulated a broad national vision for reforming Canada's health care system through innovation and technology. On the international front, he has helped to position Canada as a world leader in health care renewal.

I read with great interest the Health Council of Canada’s Progress Report 2011: Health Care Renewal in Canada.  For those areas under the microscope in this year’s report, namely Wait Times, Pharmaceuticals Management, Electronic Health Records, Teletriage and Health Innovation, the Health Council deemed that progress has been made in comparison to the last time they reported on these areas.  In concluding its report, the Council urged governments and others to set targets and goals so that it would be easier for all, especially for Canadians, to judge the pace of progress in future years.  They so rightly summarized that in health renewal “money is the fuel” while “management gets the traction.” 

In the area of Electronic Health Records, the Board of Canada Health Infoway, in consultation with its members, decided on a “call to action” by aiming to have health records electronically available for 50% of Canadians by 2010.  As was reported by the Council, through the dedicated efforts of our jurisdictional partners, we came preciously close to achieving that goal at the end of 2010. 

And while we have a way to go to achieving the vision of a modernized health care system enabled by IT, already we are receiving some major benefits.

A little while ago, we established a benefits evaluation framework – the first of its kind – on the premise that “you can’t manage what you can’t measure.” Some of the benefits as they relate to pharmaceuticals management are listed in the report, but we are also seeing benefits valued at millions of dollars in the areas of diagnostic imaging and telehealth.

Looking at diagnostic imaging, more than 95% of the most common radiology examinations and reports in Canada’s acute care hospitals are now digital, up from approximately 38% only six years ago. When diagnostic imaging and Picture Archiving and Communications Systems (PACS) are fully implemented in Canada, they are expected to generate benefits valued at between $850 million and $1 billion per year.

And on the telehealth front, by the end of the 2009–2010 fiscal year, Canada had in place 5,710 telehealth systems in 1,175 communities.  Telehealth events saved Canadians living in rural or remote communities an estimated 46,846,500 kilometres of travel in 2010. This not only means travel distance saved, but also $70 million in personal travel costs, 5.6 million litres of gasoline and almost 13 million kilograms of CO₂ emissions avoided – the equivalent of removing 2,760 cars off the road.  

That said, there is more work to do. The Council rightly draws attention to the 2009 Commonwealth Fund International Survey which places us at the back of the bus among 11 countries, with only 37% of physicians using electronic medical records (EMRs) in primary care.  To address this gap, much of the last $500 million that Infoway received from the federal government has been devoted to seeking clinical value through the use of EMRs in primary care and ambulatory care settings. Key to these efforts is a renewed emphasis on clinician engagement. Beyond primary care, our country tends to perform better relative to its peers. For example, Canada is a global leader in the use of telehealth and compared to other OECD countries has one of the most comprehensive sets of health policy data. Nevertheless, there are opportunities for further progress in areas such a telepathology, telehomecare, and privacy-sensitive health system use of information.  

It is interesting to note that the Council chose to report on “Health Innovation” as part of its 2011 Report.  At Canada Health Infoway, we believe “innovation” is key to the sustainability of our health care system, which is why, this year, we launched a new innovation strategy.. Our clinical reference groups helped us identify focus areas for clinical innovation investments; focus groups and surveys of the public helped to narrow the priorities for our consumer health investments.

Finally, the Council urges government to accelerate the general health system goals of improved patient care, co-ordination of care, reduced errors, and improved efficiencies.  Effective use of information and communications technologies (ICT) is an enabler for progress in many areas, from patient safety to improving access to care. We look forward to working with partners from across the country to encourage the innovation that will make this possible. That’s why we recently launched a public ImagineNation challenge, asking for the best ideas to improve health and health care using ICT. I would encourage you to help us to accelerate the pace of change by reviewing the ideas that came in and voting for the ones that you think are most promising.  Where do you think there exist opportunities to invest in additional innovations in health care in Canada? 

Key Words: Innovative Practices, Electronic Health Records