Enablers
There is systems level support for clear and effective information and communication infrastructures. In 2004, Health Canada reported the following:
“Electronic health records and telehealth are key to health system renewal, particularly for Canadians who live in rural and remote areas. Recognizing the significant investment that has been made and achievements to date, First Ministers agree to accelerate the development and implementation of the electronic health record, including e-prescribing.” For further information, see http://www.hc-sc.gc.ca/hcs-sss/delivery-prestation/fptcollab/2004-fmm-rpm/index-eng.php. For a critique review brief to the Senate of Canada, see http://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/brief_10_year_plan_e.pdf?la=en
The Accord on Health Care Renewal
An agreement on health reached in 2000 by the federal, provincial and territorial government leaders (or first ministers) set out key reforms in primary health care, pharmaceuticals management, health information and communications technology, and health equipment and infrastructure. At the same time, the federal government increased cash transfers in support of health.
In 2003, the first ministers agreed on the Accord on Health Care Renewal, which provided for structural change to the health care system to support access, quality and long-term sustainability. The Accord committed governments to work toward targeted reforms in areas such as accelerated primary health care renewal; supporting information technology (e.g., electronic health records, telehealth); coverage for certain home care services and drugs; enhanced access to diagnostic and medical equipment; and better accountability from governments.
Under the Accord, federal government cash transfers in support of health care were increased, and the CHST was split into the Canada Health Transfer for health and the Canada Social Transfer for post-secondary education, social services and social assistance, effective April 2004.
Further reforms were announced by first ministers in A 10-Year Plan to Strengthen Health Care in 2004. The federal, provincial, and territorial governments committed to a health care renewal plan that included work toward reforms in key areas such as: wait times management; health human resources; Aboriginal health; home care; primary health care; a national pharmaceutical strategy; health care services in the North; medical equipment; prevention, promotion, and public health; and enhanced reporting on progress made on these reforms.
To support the Plan, the federal government increased health care cash transfers including annual increases to the Canada Health Transfer from 2006-07 until 2013-14 to provide predictable growth in federal funding. Retrieved from: http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2011-hcs-sss/index-eng.php#a3
Public Health Agency of Canada supports the movement toward integrated communication infrastructure.
Time is on our side as the there is a worldwide progression toward a more electronic world.
One ministry level representative explained:
“Our movement toward public health-primary care harmonized electronic communication system has improved with the introduction of the Public Health Agency of Canada.
However, there are still limitations because the two systems have very different kinds of e-communication infrastructures.”
The advantages of a harmonized information and communication infrastructure are an encouraging aspect. Public health efficiencies that can be gained from a harmonized information and communication system are related to better case management, management of infectious disease outbreaks, improved delivery and tracking of immunizations, and better management of vaccine inventories. Further at the systems level, there is a great potential for population focused research and decision making based on utilization mortality and morbidity data.