Result at a Glance – Evaluation of the eHealth Infostructure Program 2011-2012 to 2015-2016

Introduction

• The Program works towards the modernization, transformation, improvement and sustainment of health care services in First Nations communities by supporting and funding a combination of eHealth information, applications, technology and people.
• This evaluation assessed the Program's relevance and performance from April 2011 to March 2016.

Background

• Health Canada has invested in eHealth Infostructure Program (eHIP) for over a decade.
• Program expenditures were $124 million from 2011-2012 to 2015-2016.

What the evaluation found

• The Program continues to address a fundamental, demonstrable need and is responding to the needs of First Nations.
• The Program has met or exceeded most key targets in 2015-2016 (e.g., reported 84 communities with Public Health Information Systems versus a target of 24 communities by 2015-2016, and 10,389 telehealth clinical sessions versus a target of 8,160 sessions by 2016-2017).
• Access to and quality of health care services, and the planning, surveillance and reporting of health data have improved for First Nations communities over the past five years as a result of eHealth. The Program was assessed as efficient and economical.  Cost avoidance as a result of all telehealth clinical session delivered in four regions in 2015-2016 alone was approximately $11.7 million.

Recommendations and responses

1. Enhance partnership, collaboration and integration with partners and stakeholders to continue to improve Internet connectivity to provide equitable access to underserved First Nations communities.

Response:  FNIHB will work with partners through the Connectivity for First Nation Health Facilities project to obtain a clear understanding of connectivity needs for on-reserve health facilities in six regions by developing site profiles and a connectivity gap analysis.

2. Advance work with partners, to address IT- and health facility-related issues to enable health care practitioners (nurses) to integrate eHealth tools into primary and public health care delivery.

Response:  eHIP is working with partners in the IT Support for FNIHB Nurses Working Group to incrementally address IT infrastructure and support for nurses working in remote and isolated locations.

3. Work closely with provincial governments, federal partners, (e.g., Infoway), First Nations regional organizations and communities to further integrate approaches to render electronic records and Public Health Information Systems interoperable, effective and efficient by removing jurisdictional, legislative and logistical hurdles.

Response: FNIHB is working with provincial partners to develop joint action plans to address privacy issues.  eHIP is working with First Nations partners and stakeholders to identify community-driven priorities and approaches to implement digital health technologies.

4. Continue to engage First Nations communities to enhance knowledge, capacity and control over their health care service delivery and use of health data for evidence-based decision making.

Response: eHIP will engage with First Nations partners and stakeholders to revise a project readiness assessment tool and develop a national marketing plan for eHealth.

5. Improve performance data collection and analysis across regions and over time on key performance indicators by setting up a Program performance measurement system that takes into consideration the capacity on the ground.

Response:  eHIP will explore the use of tools for annual reporting to improve data collection.

6. Develop a long-term plan that is sufficiently flexible to accommodate technology innovation and a commensurate funding strategy for eHIP.

Response:  eHIP will develop a five-year plan to build on and sustain First Nations digital health infrastructure.

About this evaluation

This evaluation was completed by the Office of Audit and Evaluation in March 2017.  Data collection methods included: literature and document reviews; analysis of administrative, financial and performance measurement data; key informant interviews; case studies; and, a review and analysis of international eHealth approaches.