National Health Information Seminar: Better data, better decisions October 2017

1. Canadian Institute for Health Information
cihi.ca @cihi_icis
Better Data. Better Decisions.
Healthier Canadians.
Behind the Scenes at CIHI
October 4, 2017 thenderson@cihi.ca
Tobi Henderson

2. 2
Outline
• About Canada and the Canadian
Health Care System
• About CIHI
• Information Quality at CIHI
• Where we’re headed

3. 3
Canadian Health Care System

4. 4
Canada Facts
• 10 provinces, 3 territories
• 2nd largest country in the world
(142 x larger than Ireland)
• 35 million people
• 17% 65 years or older

5. 5
Canada Health Act
• Canada's federal legislation for publicly funded health care insurance
• Outlines standards that provinces/territories must meet to receive transfer
payments
• 5 governing principles
‒ public administration, comprehensiveness, universality, portability and accessibility
• Sets out the primary objective of Canadian health care policy, which is "to protect,
promote and restore the physical and mental well-being of residents of Canada and to
facilitate reasonable access to health services without financial or other barriers.“
• Does not cover all services – mainly hospital and physician services

6. 6
Who is
paying for
these
services?

7. 7
Government roles in health care
Federal
• Upholding principles of the
Canada Health Act
• Regulation
• Health promotion, protection, and
disease prevention
• Direct services for some groups
• Financial support to
provinces/territories via transfers
Provincial/Territorial
• Administration of their health
insurance plans
• Planning, funding and provision of
care
• Regulating medical professionals
through self-governing colleges
• Allocating resources and
negotiating salaries and fees
for health professionals

8. 8
CIHI Overview

9. 9
What is CIHI?
• Canadian Institute for Health Information
• Independent, not-for-profit organization that provides essential information
on Canada’s health systems and the health of Canadians
• Led by a 16-person Board of Directors, with representation from across
the country

10. 10
Where did we come from? Pre-CIHI
“I was aware from the outset
that Canadian health
information was not in good
shape. My current
assessment is that it is in a
deplorable state… vast
amounts of health data are
recorded, but reliable
information is in much
shorter supply”.
Dr. Martin Wilk
Former Chief Statistician
Chair, National Task Force on Health Information
(1991)
1988: Creation of NHIC
1989: Creation of task force to
assess state of health information
in Canada
1991: Health Information for
Canada, 1991: A Report by the
National Task Force on Health
Information
Key recommendation: Creation of
an independent institute for health
information

11. 11
Where does CIHI fit?

12. 12
CIHI’s mandate

13. 13
CIHI’s journey
1994
CIHI
opens for
business
1999
Health information roadmap initiative
2003
Data quality
strategy
launched
1995
Privacy and
security
policy
adopted
2004
• Prescribed
entity status
under Ontario
PHIPA
• Signed BLAs
with all P/T’s
2013
Launch of
yourhealthsystem.ca
2015
Employees 112 454
2005
700
Databases 3 20 28
Budget $12 million $55 million $105 million
2001
First data
quality
framework
2007
Stable annual funding
New
strategic
plan
718

14. 14
New strategic plan (2016 to 2021)

15. 15
Priority themes and populations

16. 16
Data holdings

17. 17
Legislative landscape
11 of 13 provinces and
territories have health
privacy laws that:
• Provide detailed and
comprehensive guidance on
collection/use/disclosure of health
information
• Address specific healthcare
associated privacy issues
• Include use of PHI for clinical and
secondary purposes (planning,
billing, research)
All jurisdictions have some
form of written agreement
with CIHI:
• Bilateral agreement
• Specific data sharing agreement
(DSA)
• Set out terms under which CIHI can
collect/use/disclose PHI
• May include terms specific to a
jurisdiction

18. 1818
CIHI’s Privacy and Security Program
• Maintains the trust and confidence
of stakeholders
• Protects individual privacy, the confidentiality of
records and the security of information
• Privacy and Security Framework

19. 1919
External review of CIHI’s Privacy and
Security Program
• Prescribed entity under Ontario’s Personal
Health Information Protection Act (PHIPA)
• CIHI maintains International Organization for
Standards (ISO) 27001: 2013 certification

20. 20
Policies, procedures and standards
Examples
• Privacy Policy on the Collection, Use, Disclosure
and Retention of Personal Health Information
and De-Identified Data
• Privacy and Security Incident Management Protocol
• Privacy and Security Training Policy
• Information Security Policy
• Privacy Impact Assessment Policy
All available at www.cihi.ca

21. 21
CIHI data providers

22. 22
Who uses CIHI data?
• Funders
• Health ministries
• Regional health authorities
• Hospital administrators
• Clinicians
• Researchers
• Journalists
• Students
• Public

23. 23
Information products
Public indicators
Private reports
Analytical reports

24. 24
Our success factors
Independent…but
representational
Focus on stakeholders’ needs
Collaboration and
partnerships
Communication and
outreach
Corporate approach to
quality, privacy and security

25. 25
Information Quality at CIHI

26. 26
Fit-for-use: Information Quality at CIHI
https://youtu.be/rzl9T7647vo

27. 27
Data and information quality
Data
Data
Indicators
Reporting and
delivery tools
Data Quality
Information Quality

28. 28
Information Quality Plan
Objectives
1. Develop and launch an information
quality framework that brings together
and enhances CIHI’s quality
management practices
2. Improve the accuracy, comparability and
coherence of CIHI’s data and information
3. Improve the information (metadata)
about CIHI’s data sources and
information products

29. 29
IQ Plan objective 1 initiatives
Develop and launch an information quality framework that
brings together and enhances CIHI’s quality management
practices
1. Create an Information Quality Framework
2. Evolve and standardize data evaluation tools and processes
3. Reinforce CIHI’s quality culture

30. 30

31. 31
Future directions

32. 32
More timely, comparable and accessible data
across the health continuum
What
• Primary care
• Home care
• Community mental health
• Patient experience
• Patient reported outcomes
How
• Modernize our supply
‒ EHR and EMRs as new data sources
‒ Leverage new technology
• Link and integrate data
• More accessible
‒ Improve access to metadata
‒ Improve access for researchers

33. 33
Increase stakeholders’ ability to use information
to accelerate improvements in health care
• Transform CIHI’s digital presence
‒ Social media; Digital analytic reports; Infographics
‒ More intuitive user experience
• Analytical tools
‒ Health system performance indicators and case mix methodologies
• Engage with users to enable better use
‒ Capacity building
‒ Customized products

34. cihi.ca@cihi_icis thenderson@cihi.ca