Patient safety, care quality, interoperability: Canadian healthcare report

Toronto, ON – September 18, 2019 – Amid the ongoing debate about the role of technology in transforming Canadian healthcare, a new report uncovers a top challenge facing the Canadian system – interoperability. Healthcare interoperability is something long identified as a major issue preventing global health systems from overcoming fragmentation of care delivery and resulting in poor health outcomes.

Specifically, interoperability is defined by Healthcare Information and Management Systems Society (HIMSS) as “the ability of diverse information systems, devices or applications to connect, exchange and cooperatively use data amongst stakeholders, to optimize the health of individuals and populations.”

The report, entitled: The Health of Interoperability in Canada, was commissioned by Orion Health and conducted by MAVERICK and Angus Reid – with digital health professionals provided by Orion Health. It takes the pulse of Canada’s top digital health experts on achieving an integrated health system and shares their views on the progress and challenges they face.

More effective care and improved patient safety
The survey found two major benefits achieved today through the use of healthcare interoperability are more effective care (60%) and improved patient safety (52%). Improved accuracy of medication information came in next (46%) followed by reduced duplication of lab tests (41%); reduced duplication of radiology tests (34%); and reduced duplication of medication prescriptions (32%).

“While Canada’s healthcare system is set to explode with innovations in genomics, AI and Big Data, the biggest innovation needed is still the ability to break down information silos while protecting existing core investments made by different jurisdictions,” said Dr. Chris Hobson, a family physician and Chief Medical Officer at Orion Health. “Interoperability will allow healthcare providers and patients to have access to complete information and a streamlined, coordinated healthcare system.”

Barriers in the system
The findings also uncover a number of barriers limiting information exchange:

  • Financial barriers, including the cost of development and a need for better payment models for physicians – models that specifically reward improved health outcomes.
  • Technical barriers, including poor end user experience, lack of agreement on standards and poor data quality.
  • Trust or legal barriers including privacy issues and data blocking.

Privacy is greatest legal barrier
Privacy and data security are of utmost importance throughout the digital health innovation discussion – especially as patients demand greater access and control with respect to their health information.

In terms of safeguarding data, six-in-10 digital health experts consider privacy to be the greatest legal barrier for interoperability; while one-third cited data blocking by other organizations.

Government support for interoperability
Nine-in-10 respondents feel that additional government support would improve interoperability in their jurisdiction. When asked to rank which government initiatives would be most effective, legislation to improve interoperability led (33%), followed closely by mandates for specific standards and architectures (27%), support for population-based funding or value-based care initiatives (23%) and  well-publicized support for a uniform technical approach across Canada (17%).

EHRs and connected data
Six-in-10 healthcare organizations exchange data with their relevant provincial electronic health record (EHR), a number that varies by province as each jurisdiction has its own model for its health technology architecture.

When asked which of the following data types were being exchanged electronically, two-thirds of respondents answered laboratory results and another two-thirds listed patient demographics. Next up were clinical documents such as referrals and discharges; radiology reports; and medication data, including opioids.

Open healthcare and APIs
Application programming interfaces (APIs) are often viewed as the ‘Holy Grail’ of healthcare interoperability. As in other sectors of modern society (government, finance, transportation), there is growing support in health care for the use of modern data exchange methods, specifically APIs. To that end, three-in-10 organizations are already using Fast Healthcare Interoperability Resources (FHIR) as their interoperability standard.

Healthcare innovation drivers
As healthcare executives turn their attention to meeting the demands and challenges of a new era of healthcare, investment in technology is critical. The top drivers for interoperability investment are: care coordination, provincial government mandates, clinician demand, patient benefits, and a desire to connect community care with primary and acute care.

The full results of the study can be found here, and a supporting infographic can be downloaded here.

To learn more about the results of the study, join Dr. Chris Hobson on Digital Health Canada’s Webinar on Wednesday, September 25 at 12:00 p.m. EST.