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Most of the health care story in Canada has been told on paper, in the form of patient records.

That’s changing, however, in part because Canada Health Infoway Inc. has become a storyteller too – digitally speaking.

Infoway is an independent, not-for-profit corporation created by the federal, provincial and territorial governments that has been tasked with establishing the foundation for interoperable electronic health record (EHR) solutions over the next 12 to 18 months. The long-term goal is to have the main components in place within five to seven years. This system would allow health care providers to have access to a patient’s complete medical history, regardless of where he or she received treatment in the past.

The government’s commitment to establishing EHR solutions was reflected in a recent recommendation by the House of Commons Standing Committee on Social Affairs, Science and Technology, which called for Infoway to receive $400 million a year over the next five years so that the corporation could develop a national EHR system.

“We are delighted that the…com-mittee recognizes electronic health records are a key building block to improved quality and timeliness in health care delivery,” said Linda Lizotte-MacPherson, president and CEO of Infoway. “This is the first step in gathering health-related information that will allow for evidence-based decision making throughout the whole health care system. Moving paper records to electronic records is essential to modernizing and transforming the health care system.”

However, an interoperable EHR solution for national use will depend on the development of technologies that allow health information to be communicated securely among health care providers. These technologies will have to cross a number of jurisdictions and networks, including provincial and territorial governments, local and regional health delivery systems and health providers. In addition, even though each environment may have its own networks, hardware and software, and employ applications from different vendors in different versions and for different purposes, they will all have to work together for a complete EHR solution.

The integration and communication of information among health care providers will also require collaborative data collection and effective information management. Infoway plans to help create standards for data definition, collection and communication. Technology standards based on best practices and innovation will also have to be developed.

In order to ensure that the national system becomes a reality, Infoway is creating a national registry to document – on an organizational, regional, provincial and national level – the status of EHR developments. The registry will be updated regularly as additional systems are created to develop the overall infrastructure. The registry will also incorporate existing data collected by the provinces and others about current infrastructure and capacity. Surveys will determine what information is available and should be included in the registry.

With all the work that is to be completed before a national EHR solution can be reached, Lizotte-MacPherson says the recommendation to invest in such a system is timely.

“We are playing catch-up,” she said. “Whereas in the U.S., health care spending on IT is around 5.5 per cent of operating budgets, in Canada we invest only 1.8 per cent of health care operating budgets for IT. The gap is even wider when we compare the health care industry with other information-sensitive sectors such as banking and government where IT spending ranges from 9 to 13 per cent of operating budgets.”

Lizotte-MacPherson said an investment in a national EHR strategy will result in significant cost savings.

“Our analysis shows that if jurisdictions were to implement EHR in isolation, the estimated one-time costs climb to $3.8 billion. However, with Infoway’s collaborative approach, the cost is estimated at $2.2 billion.”

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