ARCHIVED - 2005 GOL Public Report - Strengthening On-Line Results at Health Canada [Health Canada, 2005]

Strengthening On-Line Results at Health Canada

Table of Contents

1. Introduction
   • Health Canada's Mission and Vision
   • What We Do
   • Departmental Relationships
2. Health Canada e-Government Strategy and Vision
3. Health Canada Advances the GOL Agenda
   • Canada Health Portal
   • Service Transformation
   • Service Improvement Initiative
   • Health Canada Online Web Site
   • Privacy
4. Meeting On-Line Objectives
   • Centre for Surveillance Coordination
   • Telehealth and First Nations and Inuit Communities
   • Program Delivery Applications for First Nations and Inuit
   • Remote Community Connections
   • Canada Health Infostructure Partnership Program (CHIPP)
   • Pest Management Regulatory Agency - E-Regulatory System
   • Canadian Institutes of Health Research - ResearchNet
   • Global Public Health Intelligence Network
5. Identifying Client Needs
6. Contact GOL at Health Canada

1. Introduction

Health Canada's Mission and Vision

Health Canada is responsible for helping the people of Canada maintain and improve their health. The Department respects individual choices and circumstances, and seeks to put Canada among the countries with the healthiest people in the world.

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. The Department 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, since a large number of social, behavioural, physical and economic determinants interact to affect the health of individuals, 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 and Inuit in Canada. In developing a spectrum of departmental policies and activities, the Department works with the voluntary and community sectors, 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 states:

Health Canada will achieve this vision by:

1. transforming information and services for on-line delivery;
2. integrating information and service delivery methods (e.g. Internet, telephone, in-person);
3. providing national leadership in the advancement of e-government concepts within the health community;
4. ensuring a continued trusted relationship with Canadians by providing appropriate levels of protection for their personal information;
5. confirming that the information and services being provided are those that are needed by Canadians;
6. 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 vision. Since its May 2000 inception, the Department's Government On-Line (GOL) Division has coordinated and been the champion for GOL activities. As the GOL initiative terminates at the end of December 2005, the new focus for this group will be the Government of Canada's Service Vision for Canadians that makes citizens the centre of business transformation activities.

3. Health Canada Advances the GOL Agenda

Health Canada continues to support Canada's service strategy goals of delivering key on-line services and integrating service delivery across channels. The Department is strategically aligned 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 have become collaborators in on-line delivery of information and services, and as Canadians have continued to move on line and away from other service channels, Health Canada has become better positioned to support on-line goals. The Department remains committed to the use of information and communication technologies to improve access to client-centred and integrated services.

Health Canada is focussed on a service delivery vision that includes:

1. rethinking delivery of information and services;
2. encouraging up-take of electronic offerings;
3. increasing e-enablers and common business processes;
4. achieving sustainability for on-line service offerings and integrated Web sites;
5. engaging partners on service and policy fronts;
6. creating new governance and accountability models;
7. building a flexible, adaptable workforce.

Health Canada is involved in a number of initiatives in support of the on-line objectives of the Government of Canada (GoC). These initiatives include those described below.

Canada Health Portal

The Canada Health Portal provides Canadians today with single-window, on-line access to trusted and authoritative health information, and will eventually offer on line services. The Portal includes information for specific groups of the public such as seniors, youth, children, Aboriginal peoples, veterans and the international traveller.

In addition to incorporating Health Canada subject matter, the Canada Health Portal provides access to health information and services from several other federal government departments, the Canadian Health Network, provincial and territorial governments, municipalities, Canadian non-government agencies and major health-related bodies such as the World Health Organization and the U.S. Centres for Disease Control.

The Canada Health Portal regularly consults Canadians in a continuing effort to enhance the site in terms of their needs and preferences. In response to this client feedback, additional features were recently introduced, including Healthy Living Tools, Newsroom, On-Line forms and Services.

Visits to the Canada Health Portal have increased by 38% over the past year.
Access the Canada Health Portal directly or through the Canada Site.

Service Transformation

Health Canada supports the GoC 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. The Department recognizes that there are significant opportunities to capitalize upon new service delivery capabilities to meet raised client expectations for access to service and information. Successful exploitation of these opportunities and the development of a departmental service delivery vision should allow for citizens to have a choice of devices and channels for pervasive access to health service and information at home, at work, on the move or in the community.

Health Canada is undertaking the development of a new Service Delivery Vision and Strategy that will set out the strategic direction to plan and shape the future development of service and information delivery over all service channels.

Service Improvement Initiative

Treasury Board's Service Improvement Initiative applies to Departments with significant direct service delivery to Canadians. This initiative is designed to achieve significant, measurable and sustainable improvement in Canadians' satisfaction with the quality of service provided by federal government departments and agencies.

Five key information services are the current focus for departmental service improvement: the Canadian Health Network, It's Your Health publications, Pest Management 1-800 Information System, Non-Insured Health Benefits Drug Exception Centre, and Health Canada's General Enquiries Lines.

Annual client satisfaction surveys are conducted for these initiatives and suggestions obtained from the surveys for improving services are implemented and reported to clients. The results of these surveys form the basis for annual service improvement plans, including setting service improvement targets and service standards.

Building upon the success of these initiatives, Health Canada will continue to identify and plan for continuous client satisfaction improvement in other areas of the Department that provide client-facing services.

Health Canada Online Web Site

Health Canada has an extensive on-line presence. The Health Canada Web site contains a vast amount of information and, on average, received approximately 1,000,000 unique visits per month during 2004. Besides 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 GoC directions for on-line information delivery, Health Canada has undertaken a renovation of the Department's Web site. The primary goal is to organize departmental Web information to be accessible to Canadians in a logical and consistent manner. Information 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, ensuring that the Department's clients have ready access to the full spectrum of Web content on a particular subject.

This client-centric approach improves accessibility and the distribution of departmental information. Enhanced organization and management of the 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

The health care field is an information-intensive sector. Consequently, Health Canada finds itself, at times, the custodian of sensitive and personal health information. The Department takes its role of ensuring public trust seriously, especially as it supports the development and implementation of electronic health services for the public. To maintain a trusted relationship with Canadians regarding the handling of their personal information, the Department is updating its privacy policies and guidelines and enhancing its staff training programs.
New privacy processes and tools, such as Privacy Impact Assessments, are being used to identify privacy risks and solutions.

Health Canada, in collaboration with its federal, provincial and territorial counterparts, has developed a Pan-Canadian Health Information Privacy and Confidentiality Framework. The objective of this framework is to respond to Canadians' privacy and confidentiality expectations while enabling the flow of information to support effective health care and interoperable, electronic health record systems. The framework is a valuable tool to achieve more consistent privacy provisions across jurisdictions as well as across the commercial and non-commercial sectors of health care.

4. Meeting On-Line Objectives

Health Canada is well established on the 'information super highway' with its extensive public presence on the World Wide Web and its collaborations with key health stakeholders and multi-jurisdictional partnerships for initiatives such as the Canada Health Portal, the Canadian Health Network and the First Nations and Inuit Health Information System.

Centre for Surveillance Coordination

In September 2004, the Centre for Surveillance Coordination was one of several former Health Canada organizations transferred to the new Public Health Agency of Canada. The Centre continues to support advances in health surveillance systems undertaken by partners at the federal, provincial/territorial and local levels.

With their partners, the Centre for Surveillance Coordination has been 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: This 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 composed of a number of computer and database applications, including the Laboratory Data Management System and a public health case management system, the Public Health Information System. Through the CIPHS Collaborative, Health Canada has been working in cooperation with its federal, provincial, territorial, and local partners to further enhance these products.
• Geographic Information Systems (GIS) Infrastructure: the infrastructure for linking data from different surveillance and public health information systems, enabling public health workers to visualize and analyze public health events in a spatial fashion. One such project is the Web-based Public Health Map Generator (PHMG) application that provides public health practitioners the ability to log on and use their own locally managed public health event data to generate maps of these events. The PHMG application has successfully completed a pilot deployment and will be launched in a production capacity prior to the end of fiscal year 2004-2005. Another Web-based service offered by the GIS Infrastructure is the collaborative Map and Data Exchange (MaDEx) discussion database. The MaDEx collaborative forum connects public health practitioners across the country with their colleagues and GIS specialists to address their needs for data, services and expertise in the rapidly emerging field of health geomatics.
• Injury Surveillance Project: The Injury Surveillance Pilot Project was a joint federal and provincial project that explored the feasibility of emergency department injury surveillance between December 2000 and March 2003. Feasibility was assessed through an evaluation conducted during the phases of implementation and operation. The evaluation determined that the surveillance system produced injury data that had high levels of completion, were reliable (as determined by chart audits) and were able to detect 95% of injuries treated in emergency departments; and that dissemination of the surveillance information was supported through strong ties with the user communities within hospitals and the communities of the three health regions in which the surveillance system operated. As an indicator of interest, special requests were received for analyses on falls by seniors, intentional injury, sports injuries in youth, and drowning. Additional funding, provided by the province of British Columbia, extended the project by an additional year (2003-2004). The strength of the pilot project was an emphasis on contact with user communities for the injury data provided by the surveillance system. Such an emphasis is instructive for the dissemination of injury data from emergency departments generated by the National Ambulatory Care Surveillance System from a database maintained by the Canadian Institute for Health Information.

Another facet of the collaborative work of the Centre for Surveillance Coordination was the development of the Inventory of Injury Data Sources and Surveillance Activities that identifies an extensive list of major sources of injury data in Canada within a common framework. This has been made available to public health professionals both in print form and as a searchable database on the Web. This resource has been widely embraced by the target community and has been continually improved since its inception.

Telehealth and 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 of the Provincial-Federal TeleHealth Program, Alberta has the largest Aboriginal telehealth network in the world, providing high-speed connectivity to all First Nations community 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 see the value of telehealth services in bridging the gap, not only in geographic distances, but, more importantly, in providing enhanced access to health care services.

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 Internet Health Portal currently provides ubiquitous access to e-mail, discussion groups, health information, news and the Virtual Health Library - an electronic document repository providing on-line access to thousands of health related documents. Onehealth.ca had approximately 1,000 registered users during 2003-2004 and almost all users log on daily. Current statistics indicate over 2,000 Web mail accesses during a typical workweek, with almost 3,000 messages sent by users, indicating very healthy utilization. The current number of registered users is 1,460, with 644 users in Alberta and the balance in other regions.

Currently, significant portions of the AFNTP operations are directed towards the organization and scheduling of videoconference events (training, meetings, consultations and service delivery). In 2003-2004, First Nation communities participated in 731 telehealth sessions that focussed primarily around clinical/professional events. Estimates of administrative use were consistent with previous year figures of approximately 800 scheduled and ad hoc sessions. In total, approximately 2,100 (1,700 nursing) people attended telehealth clinical or professional sessions from FNIHB sites. One hundred and twenty nine clinical or professional events were presented via videoconference by FNIHB and/or the Province (Alberta Health and Wellness).

Surveys of Alberta First Nations community members have shown a strong belief that telehealth technologies have positive impacts for health and communities. In a survey conducted by the AFNTP, 80% of respondents felt that telehealth can provide access to many more specialists to help a local doctor manage a patient's care; 75% of respondents felt that telehealth can mean fewer travel-related expenses (such as gasoline, meals, overnight stays); and over 65% stated that telehealth can mean less time away from work and from home.

The AFNTP continues to build upon a strong model for telehealth that strengthens the relationships between federal stakeholders (FNIHB), provincial partners (Alberta Health and Wellness), and the First Nations of Alberta.

Program Delivery Applications for First Nations and Inuit

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 access to health information for case management, program planning and health assessments.

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. 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. An administrative tool for home and community care - the Electronic Service Delivery Reporting Template (e-SDRT) - was deployed in autumn 2003.

The longer-term vision of FNIHB is to expand 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, incorporate components of an eventual primary care Electronic Health Record that is linked with provincial/territorial health records and responds to information needs in priority health areas. One 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. The Electronic Health Record is viewed internationally as one of several methods to improve health care delivery and potentially reduce the cost of care.

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. Several provincial and territorial departments share 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 departments for connection to remote areas.

Health Canada has initiated the Remote Satellite Distribution Project, through the auspices of the e-Health Solutions Unit, to provide high-speed Internet access for health care workers in isolated and semi-isolated communities with neither current access nor near term prospects for access to community-based broadband solutions. In total, 196 remote communities have received a high-speed bi-directional satellite solution that will provide access to Internet, to e-mail and to multiple e-Health tools. Wireless LANs were deployed in 86 of these communities.

Canada Health Infostructure Partnership Program (CHIPP)

Initiated in 2000, CHIPP was an $80M cost-shared, incentive program aimed at supporting collaboration, innovation, and renewal in health care delivery through the use of information and communication technologies (ICTs). CHIPP supported the implementation of 29 e-health projects across the country in a cost-shared partnership with governments, hospitals and other stakeholders. The programs that were developed improved the accessibility, quality, and efficiency of health care service and delivery across Canada, especially in rural and remote areas.

As examples: one project used ICTs to bring diabetes screening services to Aboriginal communities in northern Alberta; another introduced telemedicine services, in more than 30 disciplines, to over 60 northern Ontario communities; CHIPP co-funded the development of a standard-based electronic health record system in British Columbia that supported the information needs of mental health service providers. While CHIPP ended March 2004, most of the 29 projects have been sustained by their provincial and territorial governments to contribute to the renewal of health care delivery to all Canadians.

Synopses of all 29 projects including contact information and their final project reports, can be found on the Health Canada Web site: Canada Health Infostructure Partnerships Program.

Pest Management Regulatory Agency - E-Regulatory System

Health Canada's 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 can be approved for use in Canada. PMRA also re-evaluates existing pesticides to ensure that they meet modern safety standards. By seeking to minimize the risks associated with pesticides, the PMRA helps protect human health, safety and the environment. To support these core businesses, PMRA delivered the PMRA Regulatory System (ePRS) in September 2004.

The ePRS is a Web-based system that links the entire submission process, from registrants to evaluators and to the public. The ePRS provides applicants, registrants and their regulatory representatives with the ability to securely conduct business with the Agency using the Internet and the GoC's Secure Channel service. The system is built around a sophisticated submissions management capacity within the PMRA to support the responsive, transparent regulatory system envisioned in the new Pest Control Products Act. The result will be a more effective service delivery channel for registrants to transact with the Agency while enabling the Agency to process and report on pesticide information in a more transparent and timely manner to the public.

The initial implementation of ePRS services will be phased in and the use of the Web-based approach will be voluntary. Enrolment is underway and participants have been offered an opportunity to prepare and pilot a specific subset of pesticide applications using the new services. The scope of full ePRS implementation will be determined once the results of the pilot phase are analyzed. The ePRS fulfils PMRA's commitments for delivering transactional services to stakeholders by 2005.

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. It not only covers health research, but also research in engineering, natural and social sciences. Information sharing is crucial to the health community at all stages of scientific discovery, and innovative information services like the Internet, e-mail and the World Wide Web offer great potential for increased collaboration and efficiency. 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 central to the CIHR eServices Strategy, and is one of the major components of ResearchNet, a portal which will function as a virtual meeting place for the research community. In a single access, researchers will be able to research funding opportunities, apply for funding, collaborate with other researchers on administrative tasks, conduct peer reviews of applications and track the status of applications throughout the competition process. All these services will be offered electronically within a secure environment.

Already, the ResearchNet vision is becoming a reality. The Canadian Common CV allows researchers to manage their curriculum vitae (CV) data in a single repository and generate CVs that meet the requirements set out by any member organization of the Canadian Common CV Network. Since its launch in 2002, approximately 30,000 researchers and students have placed their CVs on-line. The number of participating agencies has grown to 13. Similarly, The Canadian Research Information System, a database that allows the public to access funding data from multiple Canadian agencies, has a total of 7 participating agencies that have placed approximately 17,000 entries on-line.

In 2004, two ResearchNet pilot projects were undertaken: an electronic peer review system and an electronic submission system. The peer review system was launched in April and allowed for the submission and distribution of reviews to reviewers and applicants. The system received a favourable response from members of the two CIHR committees involved in the pilot; 92% of them agreed that it was easy to use and made the peer review process more efficient. The electronic submission portion of ResearchNet was launched in December of 2004. Using the system, researchers are able to attach all required forms, compile all components of their grant application and submit electronically. In the first month of operation, 160 applicants created accounts to begin work on their applications using the system.

In 2005, ResearchNet plans to launch a National Funding Opportunities database to allow researchers to query on multiple sources of research funding, expand the number of agencies using this shared service and enhance the e-submission process to provide more features to applicants seeking research funding.

Global Public Health Intelligence Network

The Global Public Health Intelligence Network (GPHIN) was developed by Health Canada in collaboration with the World Health Organization. GPHIN is an Internet-based, multilingual early warning system that monitors, gathers and provides preliminary reports of public health significance in seven languages including the World Health Organization official languages (Arabic, Simplified Chinese, Traditional Chinese, English, French, Russian and Spanish) on a real-time, 24-hours-a-day, seven-days-a-week basis. This unique multilingual system monitors global media sources such as news wires and Web sites.

GPHIN also tracks events such as disease outbreaks, infectious diseases, occurrences of contaminated food and water, bio-terrorism, exposure to chemicals and radioactive materials, and issues related to the safety of products, drugs and medical devices.

GPHIN is used by the global public health community, including the WHO's Global Outbreak, Alert and Response Unit in its efforts to minimize health risks by developing appropriate risk management, control and prevention measures and responses.

Information gathered through the GPHIN is filtered for relevancy by an automated process, which is then complemented by human analysis. The output is categorized and made accessible to users. Credibility is assured through the system's subscription to global media providers and its frequent audit of the sources from which information is retrieved.

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 strategic thinking of departmental management.

In addition to its subscription to a syndicated survey dedicated to what Web users need, Health Canada ensures almost every departmental survey has a component that probes issues related to Canadians' preferences for receiving information. Further, the Health Canada Web site 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 the development of strategic plans for GOL.

6. Contact GOL at Health Canada

Further information may be obtained from:

Government On-line Group
Service Transformation Strategies Centre
Information Management Services Directorate
Health Canada
info@hc-sc.gc.ca