The institute that compiles Canada’s health care indicators is part of a countrywide effort to standardize patients’ records in electronic format, which it says will address current data gaps in critical areas such as hospital emergency services.
The Canadian Institute for Health Information (CIHI) is an independent clearinghouse for millions of records documenting how the country’s health care system performs. However, it has to rely on provinces and territories to contribute their data.
A Globe and Mail report on Saturday underlined that one of CIHI’s biggest datasets, the National Ambulatory Care Reporting System, has information for more than 85 per cent of emergency department visits in the country but has no metrics for New Brunswick and Newfoundland and Labrador. The system has only partial coverage for Prince Edward Island, Nova Scotia, Manitoba, Saskatchewan and British Columbia.
Data collected in The Globe and Mail’s report highlighted how emergency services still have not returned to pre-pandemic levels.
In an interview, CIHI executive Brent Diverty said the institute is working with provinces, territories, software vendors and the federally funded not-for-profit Canada Health Infoway to develop a guideline for standardized electronic patient-record summaries.
The summaries, known by the abbreviation PS-CA, would be consistent across provinces and internationally, following a template used in other countries such as Australia or the United States. The summaries would also make it easier for provinces to contribute their performance indicators to CIHI.
The PS-CA patient summary guidelines are part of bilateral deals that Ottawa has been signing with individual provinces since Prime Minister Justin Trudeau announced $46.2-billion in new health care spending last year. In return for the federal money, provinces commit to tracking their performance via benchmarks being developed by CIHI.
Last July, New Brunswick Health Department announced it was rolling out a patient-summary system compatible with the PS-CA.
“We have the potential for that standardized data to come to CIHI in the future in a faster and more affordable way than maybe some of the ways that it’s being done today,” said Mr. Diverty, CIHI’s vice-president of data strategies and statistics.
He could not provide a precise deadline for when the patient summaries would be in place across the country, but said it would be “a multiyear journey.”
Since its creation in 1992, CIHI has had to deal with the fact that Canada has 13 provinces and territories managing 13 separate health care systems. Provinces don’t contribute evenly to all of CIHI’s datasets.
“Gathering this data can be quite expensive and can be quite manual. This is literally pulling information out of patient charts and putting it into another format and sending it to us. And so, for smaller provinces and territories, this can be a big leap,” Mr. Diverty said.
Moreover, even though hospitals are computerized now, their systems are not necessarily in line with other jurisdictions or with CIHI. “We have a highly digitized health care system but not standardized in terms of what’s captured, how it’s captured and how it’s summarized.”
Health officials in New Brunswick and Newfoundland have not responded to Globe and Mail queries about their provinces’ absence from CIHI’s emergency services data.
Elsewhere, the data gathered by The Globe illustrated the dire state of the country’s hospital emergency departments.
At the start of this year, only one in 10 Ontario hospitals met the provincial target waiting time for patients with serious conditions, compared with 25 per cent before the pandemic. At the Montreal General Hospital, emergency patients spent, on average, a whole day on stretchers, 10 more hours than in 2020. At the Saskatoon City Hospital, people who needed to be admitted from the emergency room to an in-patient bed typically had to wait more than two days last winter.
CIHI says it is up to provinces and territories to determine what statistics they share with the institute. “We’re a carrot organization, not a stick organization,” Mr. Diverty said. “We don’t have a stick.”
He said the institute is focusing on improving the standardization of statistics for hospitals and long-term care. Those two areas of health care are CIHI priorities because of their importance to health care users, he said.
“We have good momentum towards greater participation from a number of provinces in those systems,” he said.
“I think a fair bit of progress has been made over many years to assemble and provide pan-Canadian health system data, but there’s lots of work still to do.”
