ARCHIVED - 2003 GOL Public Report
Making the Government On-Line Vision a Reality at Health Canada
Table of Contents
1. Introduction
Health Canada's Mission and Vision
Health Canada is responsible for helping the people of Canada maintain and improve their health. Health Canada strives to improve the health of all Canadians, while respecting individual choices and circumstances, and therefore seeks to put Canada among the countries with the healthiest people in the world. (www.hc-sc.gc.ca)
What We Do
In partnership with provincial and territorial governments, Health Canada provides national leadership to develop health policy, enforce health regulations, promote disease prevention and enhance healthy living for all Canadians. Health Canada ensures that health services are available and accessible to First Nations and Inuit communities. It also works closely with other federal departments, agencies and health stakeholders to reduce health and safety risks to Canadians.
Departmental Relationships
Health Canada's roles in all aspects of its work are anchored in a pair of key realities. First, a wide range of social, behavioural, physical and economic determinants interact to affect the health of Canadians. Therefore the Department uses a wide and strategic range of policies and actions to "maintain and improve the health of Canadians."
Second, progress on Canada's health priorities requires collaboration and coordination among many partners. For example, the Department works with the provinces and territories to ensure the long-term sustainability of Canada's health system, while safeguarding the principles of the Canada Health Act. Through its First Nations and Inuit Health Branch, the Department works with the Indian and Northern Affairs Canada, the First Nations communities themselves, and the provinces and territories to provide quality health services to First Nations in Canada. In developing a spectrum of departmental policies and activities, the Department works with the voluntary and community sector, health professionals, the private sector, and individual Canadians.
2. Health Canada e-Government Strategy and Vision
The vision for Health Canada in the area of e-Government is:
"Health Canada will be front and centre in the advancement of timely and trusted electronic health information and service delivery."
Health Canada will achieve this vision by:
- transforming information and services for on-line delivery;
- integrating information and service delivery methods (e.g. Internet, telephone, in-person);
- providing national leadership in the advancement of e-government concepts within the health community;
- ensuring a continued trusted relationship with Canadians by providing appropriate levels of protection for their personal information;
- confirming that the information and services being provided are those that are needed by Canadians; and
- working cooperatively with its federal/provincial/territorial partners and private sector stakeholders.
Steps are being undertaken in all areas of the Department to move Health Canada closer to achieving this e-vision. Since its May 2000 inception, the Department's Government On-line (GOL) Division coordinates and champions GOL activities.
3. Health Canada Advances the GOL Agenda
Health Canada is working to support the Government of Canada's service strategy goals of delivery of key services on-line and to integrate service delivery across channels. Health Canada is working to be in a position to provide trusted and authoritative health information by whichever method Canadians choose, be it in person, by fax, phone or via the Internet or e-mail.
As more federal and provincial jurisdictions become collaborators in the delivery of information and services on-line and, as Canadians continue to move on-line and away from other service channels, Health Canada will be in a position to support on-line goals. The Department is committed to the use of information and communication technology to improve access to client-centred and integrated services.
Health Canada is focused on a service delivery vision that includes:
- rethinking delivery of information and services;
- encouraging up-take of electronic offerings;
- increasing e-enablers and common business processes;
- achieving sustainability for on-line service offerings and integrated Web sites;
- engaging partners on service and policy fronts;
- creating new governance and accountability models; and
- building a flexible, adaptable workforce.
Health Canada is involved in a number of initiatives in support of the Government of Canada's Government On-Line objectives.
Canada Health Portal
As part of Government On-Line initiative, the Canada Health Portal was conceived to provide on-line access to health information, and eventually services, through a client-centric, single-window approach. Led by Health Canada, the Canada Health Portal was launched May 31, 2002 as one of the clusters of the Canada Site.
In addition to incorporating Health Canada subject matter, the Canada Health Portal is affiliated with several other federal government departments, the Canadian Health Network and the Saskatchewan Health Information Network (as a provincial pilot). The Canada Health Portal is one of the largest of the 17 Canada site subject portals.
The Canada Health Portal provides Canadians interested in health topics, single-window access to trusted and authoritative information. The Canada Health Portal includes information for specific sub-groups of the public such as seniors, youth, children, Aboriginal peoples, health-care workers, veterans and the international traveller.
Since going "live" in May 2002, the Canada Health Portal went from 28,155 hits per month to a high of 319,111 hits for the month of January 2003. This represents over a 1,000% increase in the number of hits over a seven-month period. Over the same time-period, the number of visits to the Canada Health Portal went from 1,313 in June 2002 to a high of 14,385 in the month of January 2003.
The Canada Health Portal received favourable publicity by the Ottawa Citizen in October 2002:
Ottawa physician Garth Dickinson has an easy answer when patients are looking for information about health matters.
"I tell them about the Canada Health Portal"
he says. "I can send them there with confidence the information they'll find is good - and the fact that it comes from Canadian sources is a bonus."
The Canada Health Portal was the topic of the keynote address at an e-health conference in Germany and was of interest to a European media event sponsored by Treasury Board Secretariat held in early October 2002. The October Ottawa Citizen newspaper article further reported:
The Canada Health Portal is so good that it's attracted information from abroad... A Russian delegation, for example, has expressed interest in coming to discuss how Russia could develop a similar Web presence.
With the launch of the Canada Health Portal, Canadians will find it easier to locate federal, provincial and territorial government health information. The portal is a window to previously inaccessible or difficult-to-find information and services for those living in urban, rural, remote or foreign locations. Access the Canada Health Portal directly at www.chp-pcs.gc.ca or through the Canada Site (www.gc.ca).
@ Service Transformation
Health Canada supports the Government of Canada Service Strategy Vision that identifies the need to set a federal service delivery vision for citizens and clients that is client-centred and integrated across the whole of government and across service delivery channels. A service vision would require identifying opportunities for better service and increased efficiencies. Service transformation initiatives are being identified and Health Canada will continue to explore opportunities for service integration and delivery (e.g. Electronic Health Records, Telehealth and Pest Management Regulatory Agency's Electronic Registration).
Service Improvement Initiative
Treasury Board's Service Improvement Initiative applies to departments with significant direct service delivery to Canadians. The objective is to identify and report on quantifiable improvements in clients' satisfaction. With the goal of improving Health Canada's information-based services to Canadians, six key information services have become the initial focus for departmental service improvement: Canadian Health Network, "It's Your Health" publications (www.hc-sc.gc.ca/english/iyh), Pest Management 1-800 Information System, Non-Insured Health Benefits Drug Exception Centre, Health Canada's General Enquiries Lines, and the 24/7 Emergency Call Management System.
HC Online Web Site
Health Canada has an extensive on-line presence. The Health Canada Web site (www.hc-sc.gc.ca) contains a vast amount of information and receives more than 80,000 unique visits per month. In addition to providing information, publications and links supporting the delivery of the Department's mandate, the site offers forms that can be downloaded, access points for client feedback and interactive services.
To support the Government of Canada focus on on-line information and services delivery, Health Canada has undertaken a renovation of the Department's Web site. The primary goal is to organize departmental Web information and services to be accessible to Canadians in a logical and consistent manner. Information and services will be organized by subject rather than by organizational structure. This will allow content created by the various areas of the Department to be grouped together on the Web site, thus ensuring that the Department's clients have ready access to the full spectrum of Web content on a particular subject.
This client-centric approach increases the accessibility of departmental information and improves the distribution of information and services. This enhanced organization and management of the Health Canada Web site will also solidify the connection between Web content and the experts and professionals in the program delivery areas of the department, ensuring that the content of the departmental Web site is always current, relevant and accurate.
Privacy and Security
The health care field is an information-intensive sector. As such, Health Canada finds itself, at times, in the role of a custodian of sensitive and personal health information. The Department takes this 'public trust' role seriously, especially as it is helping expand the range of e-health services (e.g. Canadian Health Network) to Canadians. To ensure a continued, trusted relationship with Canadians regarding the handling of their personal information, the Department is updating its' privacy policies, procedures and training of staff. New privacy processes and tools, such as Privacy Impact Assessments are being used to identify privacy risks and related solutions.
Strengthening the Federal Identity
Closely related to the Health Canada Web site redesign is the implementation of a Government of Canada-wide Common Look and Feel Strategy. Common Look and Feel standards were adopted on the Health Canada Web site to strengthen federal identity, presence and visibility. As mandated by the Government of Canada authority, this transition was completed in December 2002.
Communicating with Canadians
Health Canada understands the importance of communicating with Canadians and departmental staff on changes associated with GOL. Dedicated communications expertise exists at all Health Canada working levels. Consideration will be given to communicating through broad-based advertising to promote e-services, including Internet-based marketing and targeted cross-promotions. Emphasis is being placed on coordinated and effective communications to all target audiences.
4. 'In-line' with the 'On-Line' Objectives
Health Canada has been at the forefront of providing Canadians with online health information. The Department is well established on the "information super highway" with its extensive public presence on the World Wide Web, as well as its collaborations with key health stakeholders and multi-jurisdictional partnerships with initiatives such as the Canadian Health Network and the First Nations and Inuit Health Information System.
Centre for Surveillance Coordination
The Centre for Surveillance Coordination, formerly the National Health Surveillance Infostructure, collaborates with public health stakeholders on the development, maintenance and use of health surveillance information, tools and skills that strengthen Canada's capacity for timely and informed decision-making. It is another initiative of the Canada Health Infostructure (http://www.phac-aspc.gc.ca/csc-ccs).
The Centre has made significant progress in transitioning from a number of pilot projects (which proves the concepts of networks and information management as applied to surveillance) to an infostructure, which supports advances in health surveillance systems undertaken by partners at the federal, provincial and local levels.
With their partners, the Centre for Surveillance Coordination is involved in promoting several surveillance tools and projects, and provides training programs to support these activities. Some of their activities include:
- Canadian Integrated Public Health Surveillance (CIPHS) Project: provides a model for the long-term standardization of public health data management which has organized the national public health community to a degree that has never been achieved before. The project is comprised of a number of computer applications and databases, including the Laboratory Data Management System and a public health case management system entitled Public Health Information System.
- Geographic Information Systems Infrastructure: the infrastructure for linking data from different surveillance and public health information systems enabling health workers to visualize and analyze in spatial format. One such project is the Web-based Public Map Generator Service that provides public health practitioners the ability to login and use data to generate maps to aid in the detection of health events in populations. They can also upload personal data to generate customized maps.
- Injury Surveillance Project: a prototype system for collecting injury surveillance data from emergency rooms on both unintentional and intentional injuries for all ages and involves 10 hospitals in British Columbia and the British Columbia Ministry of Health Services. Injury continues to be a major source of sickness, disability and death in many age groups even though much of it is considered preventable. This BC project has developed a comprehensive approach to injury surveillance that did not exist before.
- MotherNet: a system for collecting and analyzing data on the effects of drugs and other exposures on pregnant and breast-feeding women. MotherNet is being developed in collaboration with the Motherisk Clinic at the Hospital for Sick Children, Toronto and the IMAGe Clinic at Hopital Ste Justine, Montreal. MotherNet will give front-line counsellors and care providers a state-of-the-art patient management tool. In addition, MotherNet will enable the secure, confidential use of the accumulated data for research into evaluating treatments and identifying emerging threats.
- Skills Enhancement for Health Surveillance: an Internet-based training initiative for health professionals in local public health departments and regional health authorities across Canada. The need for a cost-effective method to train and upgrade the skills of public health practitioners has been widely recognized for years. To address this pressing issue, this project is working with front-line public health and academic collaborators to combine a thorough knowledge of the requirements of the professions with the latest developments in Web-based learning technologies and techniques.
The First Nations and Inuit Health Information System (FNIHIS)
The First Nations and Inuit Health Information System (FNIHIS) is a community-based electronic health information system used to support delivery of health programs in First Nations and Inuit communities. It provides timely access to health information for case management, program planning and health assessment.
The system has been developed by Health Canada's First Nations and Inuit Health Branch (FNIHB) in partnership with First Nation and Inuit communities and is a Canada Health Infostructure and Electronic Health Care Services System initiative. It is currently operational in 359 sites serving 427 communities. Full deployment to all 566 communities is targeted for 2005. The current version of FNIHIS comprises 12 subsystems including client core information, immunization, tests, medication and chronic disease. The tool allows for informed decisions about patients by health professionals providing care in on-reserve health facilities. A component providing additional functionality in diabetes and home and community care will pilot in the spring of 2003.
The longer-term vision of FNIHB is to expand the FNIHS to integrate information captured in other care settings, such as the home, physicians' offices and provincial/territorial health facilities into the system. This integration will, in essence, create a primary care Electronic Health Record that is linked with provincial/territorial health records and responds to information needs in priority health areas. The primary benefit of using electronic records over paper records is that access to information is limited to authorized and authenticated users on a "need to know" basis. Electronic Health Records will allow providers to access a patient's health information from a variety of locations and to share that information more easily with other potential users such as specialists. Electronic Health Records is viewed internationally as one of several methods to improve health care delivery and potentially reduce the cost of care.
Telehealth for First Nations and Inuit Communities
Telehealth is the delivery of health care, through electronic means, at any distance. As a result of the initial implementation phase of the Provincial-Federal TeleHealth Program, Alberta now has the largest aboriginal telehealth network in the world and is the only Health Canada region to provide high-speed connectivity to all health centers/nursing stations. Telehealth programs have been deployed in 21 First Nation Communities and bi-directional satellite access provides e-mail and Internet access to health care workers in 41 First Nation communities. First Nations communities in Alberta now see the value of e/telehealth services in bridging the gap, not only in geographic distances, but, more importantly, in providing enhanced access to health care service delivery.
The initial mandate of the Alberta First Nations Telehealth Program (AFNTP) was to develop the technical infrastructure to provide both videoconferencing and Internet access to Alberta First Nations health workers throughout the province. This is now complete. Part two of the overall mandate, sees the AFNTP facilitating the development of telehealth programs and maintaining a Health Portal for the benefit of health care workers in First Nations communities. This is now underway.
The Program has adopted a theme of integration throughout the first phase, and has fully positioned the telehealth program to be integrated into mainstream Health Canada service delivery after the GOL funding period.
Remote Community Connections
For remote and First Nations and Inuit communities, the ability to communicate on-line at high speeds is essential in delivery of federal government services. A number of federal, provincial and territorial departments have this requirement. Although implementation of this capability is not specifically a Health Canada responsibility, efforts are being made to co-ordinate the overall requirements of the departments for connection to remote areas.
Health Canada has initiated the Remote Satellite Distribution Project, through the auspices of FNIHIS, in order to provide high speed Internet access for health care workers in isolated and semi-isolated communities - communities that do not, at present or in the near future, have access to community-based broadband solutions. In total, 148 communities will have received a bi-directional satellite solution that will provide access to Internet, e-mail and multiple e-Health tools by mid-April, 2003.
Canada Health Infostructure Partnership Program (CHIPP)
Initiated in 2000, CHIPP is a one time, $80 million, cost shared incentive program, aimed at supporting collaboration, innovation, and renewal in health care delivery through the use of information and communication technologies. CHIPP supports projects in two strategic areas: telehealth and electronic health records.
Telehealth projects have brought remote screening for diabetic complications for First Nations living on reserve in Alberta and have introduced telemedicine services in over 30 disciplines for 47 Northern Ontario communities. Access to psychiatric care using video-conferencing technology for rural and remote communities in Ontario and British Columbia has also been accomplished. The CHIPP has also assisted in the development of a comprehensive, standards-based electronic health records system to support the information management needs of mental health service providers in British Columbia. By the end of March 2004, projects funded through CHIPP will have contributed to the renewal of health care delivery to all Canadians using modern information technology.
Pest Management Review Agency - E-Registration and Approval
The Pest Management Regulatory Agency (PMRA) regulates the sale and use of pest control products in Canada. It conducts science-based health, environmental and value (including efficacy) assessments of each pesticide before determining if it should be approved for use in Canada. By seeking to minimize the risks associated with pesticides, the PMRA helps protect human health, safety and the environment. The PMRA is developing on-line processes for its core businesses.
Since its creation in 1995, the Agency has been committed to improving processes and to achieving efficiency gains in the review of submissions. The PMRA has conducted business process analysis and implemented continuous process improvements including advances in electronic registration capacity. The electronic capability involves the national and international pesticide community, including industry and regulatory agencies. An intensive consultative and development process has been undertaken with international and domestic partners, which includes pilot phases.
Canadian Institutes of Health Research - ResearchNet
Canadian Institutes of Health Research is Canada's major federal funding agency for health research. The research community in Canada is large, diverse and increasingly multi-disciplinary, covering areas not only of health, but also engineering, natural and social sciences. Information sharing is crucial to this community at all stages of scientific discovery and innovative information services like Internet, email and the World Wide Web offer great potential for increased collaboration and efficiencies. Even greater benefits can be gained if multiple research organizations pool their resources to create common Internet tools for the research community as a whole.
This sharing of organizational effort is the vision of ResearchNet. Through a single window, ResearchNet will allow researchers the opportunity to network and collaborate with colleagues and to share information on their research with the public. By 2005, researchers will be able to submit research, which their peers can review and government agencies can access for grants--all electronically and within a secure environment.
The first e-service launched under this vision was "The Common CV" (curriculum vitae). The goal of this project is to allow researchers to keep their CV information up-to-date in a secure, Web-based format and to easily submit this same information in the formats required by multiple agencies for funding. Launched in July 2002, over 6,000 researchers and students have placed their CVs online in the first five months of the service.
5. Identifying Client Needs
Health Canada invests in public opinion research each year. This research feeds advisory and decision support processes in communications, policy development and program management and guides the Department's strategic thinking.
In addition to subscribing to a syndicated survey dedicated to what Web users' need, almost every departmental survey has a component that probes issues related to Canadians' preferences for receiving information. Further, the Health Canada Web site also provides a feedback survey form that allows categorization of Web site users and their satisfaction levels. This survey and public opinion information is analyzed, synthesized, and feeds into the development of strategic plans for GOL.
6. Contact GOL at Health Canada
Further information may be obtained from the Health Canada Government On-Line Division:
Government On-line Division
Office of Health and the Information Highway
Health Canada
(613) 946-8000
info@hc-sc.gc.ca
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