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Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations
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Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations

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National Aboriginal Health Organization and Canadian Institute for Health Information

National Aboriginal Health Organization and Canadian Institute for Health Information

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  • 1. Harnessing the Power of Health Information to Improve the Health of First Nations, Inuit and Métis Populations NAHO and CIHI November 26, 2009
  • 2. NAHO’s Vision • The National Aboriginal Health Organization (NAHO) is an Aboriginal-designed and controlled body committed to influencing and advancing the health and well-being of Aboriginal Peoples
  • 3. History of NAHO • Incorporated in 2000, NAHO is a unique not-for-profit organization founded upon, and committed to, unity, while respecting diversity. • With First nations, Inuit and Metis communities as its primary focus, NAHO gathers, creates, interprets, and disseminates health information, while using both traditional Aboriginal and contemporary western healing and wellness approaches. • At all times, the organization reflects the values and principles contained in traditional knowledge and traditional knowledge practices.
  • 4. NAHO’s Objectives • To improve and promote Aboriginal health through knowledge-based activities. • To promote an understanding of the health issues affecting Aboriginal Peoples. • To facilitate and promote research on Aboriginal health and develop research partnerships. • To foster the participation of Aboriginal Peoples in delivery of health care. • To affirm and protect Aboriginal traditional healing practices.
  • 5. The Canadian Institute for Health Information (CIHI) An Overview
  • 6. CIHI Vision To improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.
  • 7. CIHI Mandate • Coordinate, develop, maintain and disseminate health information in Canada • Provide accurate and timely information required for: – Sound health policy – Effective management of the health system – Public awareness about factors affecting good health
  • 8. CIHI At-a-Glance • Independent, not-for-profit corporation • 27 data holdings • Offices in six cities • Expertise in: – Data collection and analysis – Information standards – Education and outreach
  • 9. Strategic Directions • Data: Enhance the scope, quality and timeliness of data holdings • Analysis: Continue to produce quality information and analyses that are both relevant and actionable • Understanding and use: Foster understanding of CIHI’s data analysis and demonstrate the value and quality for stakeholder use
  • 10. CIHI’s interest in First Nations, Inuit & Métis Health Information • Striving to work with partners to provide information on First Nations, Inuit and Métis health and health services through CIHI data holdings, expertise and other support
  • 11. Broad Context
  • 12. Sources of Data for Health Information Surveys and Census Health-related Research Administrative Data Projects
  • 13. Sources of Data for Health Information -Broad coverage of Surveys and populations Census -Targeted topics -Limited participation, Health-related Research snapshot or periodic Administrative Data Projects collection, expensive
  • 14. Sources of Data for First Nations, Inuit and Métis Health Information - Post-censal (e.g., Aboriginal People’s Survey, Aboriginal Children’s Survey; Surveys and only off-reserve) Census - General population (e.g., Canadian Community Health Survey) - FN-specific (First Nations Regional Health-related Research Longitudinal Health Survey; only on- Administrative Data Projects reserve) -Inuit-specific (Qanuippitaa?, Qanaquippitali?, Living Conditions in the Arctic) - Métis-specific (MNBC Survey, Métis Settlement Census)
  • 15. Sources of Data for Health Information Surveys and Census -Academic and/or community- driven Health-related Research Administrative Data Projects -In-depth, detailed -One-time, limited scope
  • 16. Sources of Data for First Nations, Inuit and Métis Health Information Surveys and Census - Many community-based studies / research projects Health-related Research - Gap identified for Métis- Administrative Data Projects specific health research
  • 17. Sources of Data for Health Information -Potentially broad coverage of Surveys and populations Census -Cost effective Health-related Research -Challenges: identifying Administrative Data Projects individuals, data linkage -Data collected for different purpose
  • 18. Sources of Data for First Nations, Inuit and Métis Health Information -Vital Statistics Surveys and - Hospital and health services Census records - Clinical / functional Research assessments Health-related Administrative Data Projects - Reportable diseases -Disease registries -Electronic Health Record (future)
  • 19. First Nations Centre
  • 20. First Nations Centre Our Mission • The mission of the FNC is to advance First Nations health knowledge. The FNC respects First Nations aspirations for self-determination, distinctiveness and diversity. Working with First Nations, the FNC creates, promotes and shares health information and research. The FNC develops tools and processes that assist in building capacity and transferring knowledge.
  • 21. Gaps in FN data • In the Census, undercoverage was higher among Aboriginal people than the general population due to the non- participation: – 1996 -77 reserves – 2001 - 30 reserves – 2006 – 22 reserves • Statistics Canada does not collect data for the general population surveys on reserve. • Caution must be used in comparing data from different sources. Administrative data bases such as the Indian Registry are not directly comparable to Census data.
  • 22. FN Data Challenges • Small population, dispersed across Canada most remote regions, but also represented in cities. • Self-reporting for origin and identity may be influenced by political events and trends resulting in data shifts and “Ethnic mobility” • Diversity – national pan-Aboriginal approach not sufficient and mechanisms for recognizing diversity are challenging statistically. • Non-responding communities • Lack of survey data on First Nations communities • Ownership, Control, Access, Possession (OCAP)
  • 23. Inuit Tuttarvingat • Inuit Tuttarvingat is the Inuit-specific centre of NAHO • Our mission is to advance and promote the health and well-being of Inuit individuals, families and communities by working in strong partnerships to collect information and share knowledge. • Governing Committee members from: – Inuvialuit Regional Corporation; – Nunavut Tunngavik Incorporated; – Nunavut Regional Board of Health and Social Services; – Nunatisavut Government; – Inuit Tapiriit Kanatami; – Pauktuutit Inuit Women of Canada; and – National Inuit Youth Council.
  • 24. • 50,500 Inuit in Canada • 80% of Inuit live in 52 Arctic communities • Spread across nearly 40% of Canada
  • 25. Naasautit: Inuit Health Statistics Project 2008-1o • Two and a half year national project funded by the Aboriginal Health Transition Fund • Six-way partnership to increase use of population health statistics – Inuit Tapiriit Kanatami, Inuit Tuttarvingat – NAHO, and four regional Inuit organizations • Developing capacity (staffing, training, supervision) for using health data in Inuit regions – to March 2010 • Creating a national Web site and data directory of health statistics – launch in winter 2010
  • 26. Inuit Data Issues • Geographic (Inuit inhabited regions) versus Inuit-specific data – bias is toward inflated health status when you include non-Inuit • Confidentiality (privacy) and confidence (data quality) issues for small population numbers • Fewer health services in the North/transfer to south for care • Two provinces (Quebec and Newfoundland & Labrador) and two territories involved (Northwest Territories and Nunavut), plus southern cities • Interest in linking land claim beneficiary lists to government admin databases
  • 27. The Métis Centre of The National Aboriginal Health Organization
  • 28. Métis Centre of NAHO Our Vision 2010-2015 • The Métis Centre develops and shares knowledge to support the health and well- being of Métis people.
  • 29. Métis Health/Well-being Data/Information • Numerous data gaps exist • Data/information is fragmented • Data not easily accessible • Data not adequately used
  • 30. Addressing Métis Health Information and Data Challenges • Métis Centre literature and statistical databases • Provincial/regional/local surveys (MNBC Poll, 1998 and 2006 Métis Settlement Census) • Academic engagement • Provincial data linkage projects • Ethics • APS Consultations
  • 31. NAHO, Health Human Resources and the Aboriginal Health Human Resources Initiative (AHHRI) • NAHO partnership with HC-FNIHB and CIHI to develop a comprehensive framework on Aboriginal Health Human Resources • Broadly defined, Health Human Resources are all the people who working within the health care system (CIHI, 2007). • NAHO partnership to develop a comprehensive framework, which includes: – Core components that lead to First Nations, Inuit and Métis participation in health careers. – Data elements and sources for a health human resource Minimum Data Set (MDS).
  • 32. Minimum Data Set: Beginning Stages • Consisted of conducting environmental scans at both the national and regional levels. • Purpose of scans was to determine available information sources and document the current status of HHR serving FN/I&M communities across Canada. • These data sources would support the development of a MDS which would form the foundation upon which need-based HHR planning for FN/I&M planning can occur
  • 33. Overall Analysis • Needs-based HHR planning requires access to longitudinal data. • In the same way that the supply of health providers changes over time with migration and attrition, so too does the health needs of a community. • Collecting HHR, demographic and health needs data that is collected on a regular basis over a period of time permits trend analysis and improves the legitimacy of planning outcomes.
  • 34. Final Thoughts • It is difficult to examine the need for health services without acknowledging that the health of a community is influenced by determinants other than the health care system. • A MDS that is based on the health needs of the population must take into consideration the health status of the community (physical and mental health, as well as non-health system determinants of health) and focus on culturally specific patterns of service delivery or healing practices.
  • 35. Success Stories
  • 36. Success Story • First Nations Regional Health Survey (RHS) Phase 1: Data collection in 2002 -2003  22,000 people responded 238 communities participated Phase 2: Data collection in 2007- 2008  Partnership with First Nations Information Governing Committee for the RHS, the Assembly of First Nations, and the Canadian Institute of Health Research (CIHR) , Institute of Aboriginal Peoples Health.
  • 37. Importance of the RHS • RHS respects the principles of OCAP (ownership, control, access and possession) • First Nations Peoples decide how information about them is collected, managed, analyzed and disseminated. • Ensures that the distinctiveness of First Nations is respected
  • 38. RHS Quick Facts Snapshot of health and living conditions in FN communities on the following topics: • Marital Status and Family • Dental Care Structure • Smoking and Tobacco Use • Education and Employment • Drug and Alcohol Use • Language and Tradition • Health Care Access • Housing • Non-insured Health Benefits • Chronic Disease • Disability • Diabetes • Mental Health • BMI and Obesity • Sexual Health • Injuries • Seniors
  • 39. Nunatsiavut Government • Established December 1, 2005 • Regional Inuit Government • Governs 5 Inuit communities: – Nain – Hopedale – Makkovik – Postville – Rigolet
  • 40. Department of Health and Social Development • Program areas: – Non-Insured Health Benefits – Injury prevention – Addictions – Communicable Disease Control – Healthy Children – Home and Community Care – Sexual health – Healthy lifestyles
  • 41. Administrative Data Provincial Federal/Other • CRMS • Statistics Canada (APS/ACS) • NL Cancer Registry • Inuit Health Survey • Meditech • Inuit Oral Health Survey • Centre for Health Information (Live Nunatsiavut Birth/Death) • NIHB systems – Deltaware • Communicable Disease and Citrix Database • Community Accounts
  • 42. Access • Current availability : on an as needed basis • Provincial health data is limited: Aggregated Not Inuit specific Accessible by request only Databases are not linked Data is incomplete
  • 43. Identifier Utility • Identifiers: NWT and Nunavik • Ensure client confidentiality and data security • Aim - One comprehensive record: Using software that can interface across jurisdictions Accessible to health care providers on various points of the care continuum
  • 44. “If it doesn’t get measured, it doesn’t get done”
  • 45. MÉTIS NATION OF ONTARIO Chronic Disease Surveillance
  • 46. Who are the Métis… • The Métis Nation evolved in the historic north-west in the 18th and 19th centuries. Born of a mixture of French and Scottish fur traders and Cree, Ojibwa, Saulteaux, and Assiniboine women, the Métis in the north-west developed as a people, distinct from either Indian or European.
  • 47. Following the annexation of the north-west by Canada in 1869, the political economy of the Métis was destroyed. Both the Manitoba Act (1870) and the Dominion Lands Act (1879) recognized Métis claims to Aboriginal title, but the federal government moved to unilaterally extinguish these claims through individual land and grants scrip.
  • 48. • Denied the recognition of their collective rights, the Métis became Canada's "forgotten people". Only in Alberta was any action taken to alleviate Métis distress through the establishment of Métis settlements by the provincial government in 1938. The Métis were officially recognized as one of Canada's Aboriginal Peoples in the Canadian Constitution of 1982.
  • 49. • Most Métis live in western Canada, both in remote and urban communities and in Métis-only and mixed communities. There are over 300 Métis communities; most are English-speaking with some northern communities using Cree or Michif. The Métis are distinguished by their unique Michif languages. • The Métis have never received the benefits governments grant to Status Indians and Inuit. In its final report the Royal Commission on Aboriginal Peoples stated "it is unjust and unreasonable to withhold from Métis people the services and opportunities available to other Aboriginal peoples".
  • 50. • The Métis are a Nation still struggling for recognition and/or equitable support by governments, particularly the Federal Government.
  • 51. Métis Today The Royal Commission on Aboriginal Peoples noted the life experiences of Métis People in Canada are: • “…markedly different than that of First Nations or Inuit. Their rights, ignored and abused for generations, are in urgent need of recognition and restoration. As one of the Aboriginal Peoples of Canada, Métis people want to be recognized as having their own unique cultural and political traditions. They are seeking a nation-to-nation relationship with Canada. As with other Aboriginal peoples, land and self-determination are central issues. Métis people are seeking to rebuild their own institutions and organizations based on the foundation of their culture.”
  • 52. MNO Health Branch Services • Long Term Care • Aboriginal Healthy Babies Healthy Children • Responsible Gambling • Substance Abuse • Aboriginal Healing and Wellness • Mental Health Demonstration Project
  • 53. Population Health Issues • Métis not covered under the Indian Act 1876 and are ineligible to access health programs and service, education and social programs available to First Nations and Inuit • Access and provision of health care for Métis people remains the mandate of provincial and territorial health care systems • Lack of infrastructure, resources and funding • Growing physical health problems in Métis communities • Lack of access to health programs and services
  • 54. Population Health Issues • Lack of Métis population specific health data and information – Inaccurate or incomplete data sources, inability to extrapolate or access data, or no data – Use of term “Aboriginal” in health literature when data apply to First Nations (on-reserve, off-reserve) and Inuit only – Most statistical data available stems from Census Canada’s Aboriginal Peoples Survey (APS) • Limited opportunity for Métis to self-identify as Métis – Lack of Métis identifier on health care cards – Differing opinions on how to identify and count Métis in Canada • Minimal Métis-specific health research
  • 55. The Need for Chronic Disease Surveillance • Lack of Research for Métis – need an evidence based approach to decision making and to inform policy and initiatives • APS data was the only source of data available but caution is required as it is based on self-reported and self-identifying respondents • Goal is to improve health status and well being of Métis people in Ontario – we need to know what health issues affect Métis people • Most chronic diseases are preventable therefore this provides an opportunity for MNO Health Branch to focus on prevention and health promotion
  • 56. MNO Health Branch Research • Diabetes Surveillance 2004 • MNO Health Branch Survey 2005 • Mental Health Research – Suicide Prevention survey and Aboriginal Children and Youth Mental Health Scan • Our Health Counts (current) • Indigenous Knowledge Network Project (current) • Healthy Messaging, Cultural Competency and Métis Specificity • Youth Identity Project
  • 57. Past Work on Chronic Disease Surveillance • Funding received from Health Canada under the National Diabetes Surveillance System • Partnership with ICES to conduct diabetes surveillance – project started in July 2004 • Data sources included using the MNO citizenship list and linked with Registered Persons Database, Ontario Diabetes Database, OHIP records of physician and service delivery, CIHI records of hospital and emergency department use and ODB records of prescription and drug claims (over 65) • Analysis included linkage to RPBD to apply health identifier, linkage to ODD to determine diabetes status and linkage to other databases to evaluate processes and outcomes of care
  • 58. Past Work on Chronic Disease Surveillance Initial database sent to ICES included 13,000 citizenship records • Preliminary results found that approximately 18% of the MNO citizenship list unmatched due to missing information • This was found to be significant in that the earlier records in the MNO Registry were most likely those of our now more elderly population and that this information was vital to the data collection • MNO began to work with PHAC to undertake a “scrubbing” exercise of the Registry data as part of the next project
  • 59. Current Work on Chronic Disease Surveillance • Project funded March 2008 by PHAC – began “scrubbing” of data during the spring/summer • 2,740 files were corrected and an additional 3,027 new records were checked • Partnership developed with ICES to conduct chronic disease surveillance • Carry out an Knowledge consolidation exercise through which informal Métis-specific health information in Ontario is assembled.
  • 60. Current Work on Chronic Disease Surveillance • Funding received from Public Health Agency of Canada to conduct Chronic disease surveillance in the Métis population using MNO Registry data • This year, we will be conducting surveillance in 3 areas: Diabetes, Cancer and Cardio-vascular disease • Data sources included using the MNO Citizenship list and linked with Registered Persons Database, Ontario Diabetes Database, OHIP records of physician and service delivery, CIHI records of hospital and emergency department use and ODB records of prescription and drug claims (over 65)
  • 61. CHRONIC DISEASE SURVEILLANCE • # of records – 17,000 citizens and 5,000 potential clients to be included • 2 new staff hired – CDS Coordinator (Toronto), KT Consultant (Ottawa) • We have developed a multi-disciplinary advisory committee to provide input into the project • The diabetes run is at the analysis stage, and we are currently formalizing Data-sharing agreements and statements of work for the cancer and CVD studies • Cancer surveillance will be incidence only because of the small sample size • Expected completion date March 31, 2010
  • 62. Power of Data: CIHI success stories
  • 63. Measuring care in Saskatchewan’s Long Term Care Facilities… • Standardized clinical/functional assessments for submission to CIHI’s Continuing Care Reporting System • Using Quality Indicators to .flag areas for improvement in .the quality of care
  • 64. …Leads to Improvements in Care • Region 1: high use of anti-anxiety & hypnotic drugs – Conducted medication reviews with physicians, pharmacists and nursing staff 25% – Use of anti-anxiety & hypnotic drugs decreased 10% • Region 2: high rates of daily physical restraint – Staff reviewed care plans and developed a protocol for restraint use 35% – Daily physical restraint decreased 20%
  • 65. CIHI data on birthing… • More than 800 women with low-risk pregnancies were travelling to Ottawa to have their babies instead of staying closer to home, in Winchester.
  • 66. …rejuvenates regional service •Winchester District Memorial Hospital decides to repatriate the births to revitalize its obstetrics program. • The hospital secures funding and changes its expansion plans to add new space.
  • 67. Quote Me ! “The data—turned into information—was critical. It drove decisions.” Trudy Reid Winchester District Memorial Hospital
  • 68. NAHO/CIHI Partnership • NAHO and CIHI have entered in to a Collaboration Agreement which identifies areas of mutual interest on which to work to positively impact the health of First Nations, Inuit and Métis. – There is currently no organization that collects epidemiological and health information from First Nations, Inuit, and Métis reliably across Canada – There are major challenges/problems in partnering with First Nations, Inuit and Métis communities to collect and distribute community specific health research (CHR) in an environment of rapid economic, social and demographic change. – Challenges with engagement, collection and analysis of CHR have led to a lack of coordinated effort between stakeholder groups regarding health policy among First Nations, Inuit and Métis communities. – There is also a continuing pressure to meet this increasing diversity of expectations in an environment of decreasing/restricted financial, economic, and staff resources.

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