New pan-Canadian system a bonanza for public health

Public health – joke many involved in the sector – is the poor cousin of the overall Canadian health system.

The statement is only semi-facetious given that just two per cent of all government healthcare dollars are invested on public health.

Earlier this year, however, the federal government took several strategic steps to remedy this perceived neglect.

Firstly, in the 2004 budget announced March, it provided an additional $100 million for developing and implementing a pan-Canadian health surveillance system supporting infectious disease prevention and protection activities.

Secondly, it launched the new Public Health Agency of Canada (PHAC), which keeps on top of health issues such as infectious disease outbreaks and public health emergencies.

Thirdly, it appointed Dr. David Butler-Jones as the country’s first chief public health officer and placed him in charge of PHAC. The new agency has two main branches – in Winnipeg and Ottawa – and a network of specialized centres across the country.

Infectious disease surveillance, indentifying emerging threats, monitoring trends, and prioritizing allocation of health resources are key PHAC responsibilities. From a public health perspective, they are also provincial and territorial priorities.

But none of these tasks can be effectively accomplished without the proper infrastructure, processes and technologies in place.

That’s why the nationwide rollout of the Integrated Public Health Information System (iPHIS) is such good news for public health professionals – and all Canadians.

This Web-enabled client-management system – the very first of its kind in the country – will be used across and between jurisdictions to maintain and manage client health record and data reporting sytems, track communicable diseases, create immunization registries – and a myriad other tasks.

iPHIS is expected to dramatically enhance jurisdictions’ as well as Health Canada’s ability to anticipate, control and prevent public health risks.

“There are more than 500 discrete business functions going on within iPHIS,” said Ron Sussey, senior IT Advisor for the Canadian Integrated Public Health Surveillance (CIPHS) program.

CIPHIS — which designed and launched the iPHIS product — works with federal, provincial and territorial leaders, public health officials, IT professionals, program managers as well as medical health officers in an alliance dubbed the CIPHS Collaborative.

There is a consensus within the Collaborative that timely access to strategic information is a critical facet of the public health system.

The design and capabilities of iPHIS reflects this belief.

“The iPHIS system serves two primary functions: case management and surveillance,” said Sussey. He said case information collected on individuals is aggregated, filtered and transformed into to data that provincial ministries of health, or Health Canada can use for surveillance, outbreak detection, planning immunization coverage and a host of other activities.

So far, he said, iPHIS modules have been implemented across most of Western Canada. A few provinces are in the evaluation phase or have completed the pilot and are preparing for rollout.

“There’s great opportunity for the system to be used internationally as well,” said Sussey, adding that Bahamas has just finished the pilot and is expected to go live on the application soon.

While iPHIS was the first major venture of the CIPHS program, it certainly won’t be the last.

A couple of times a year CIPHS Collaborative members meet to set priorities. One of them is Outbreak management.

According to Sussey, it makes a lot of sense – from a cost and a technology standpoint – for jurisdictions to join the CIPHS Collaborative.

“By working together we realize significant cost savings,” he said. “New components developed for one jurisdiction can be used by others.” He cited a current project with Ontario to develop a major outbreak component to iPHIS. “That component will subsequently be made available to other jurisdictions.”

And collaboration is not the only pre-requisite for success.

“In any undertaking of this scope and so many players in the game it can get pretty crazy, pretty quick – so it’s important to have a good project management process in place as well,” said Sussey.

He said CIPHS has designed and implemented just such a process, which is being applied to the iPHIS rollout. “We’re cutting our teeth on iPHIS but we’ll use the same cookie cutter for all our subsequent projects.”

The process, he said, includes a collection and evaluation phase during which data is garnered from various sources – help desks, discussions with stakeholders, surveys at private sites, strategic planning sessions and more. ‘We have a method synthesizing all the information we gather.”

He said groups from the jurisdictions participate in the analysis process right from the start. “Based on that we do the product planning and go back to the CPHIS Collaborative with plans, costing, options and more for their approval.”



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