Panel recommends folding Infoway into new agency

OTTAWA – Three federal agencies, including Canada Health Infoway, should be merged into a new organization, called the Healthcare Innovation Agency of Canada, to spur the modernization of healthcare across the country. That’s one of the main recommendations of the federal government’s Advisory Panel on Healthcare Innovation, which was delivered last week.

Chaired by former University of Toronto president Dr. David Naylor (pictured), the panel also recommends establishing a healthcare innovation fund as early as next year. The innovation fund would be managed by the Healthcare Innovation Agency, and would be given a 10-year mandate to invest in projects that have demonstrated the ability to dramatically improve healthcare delivery, and it should have an annual budget of $1 billion by 2020.

The advisory panel recommended merging Infoway with the Canadian Foundation for Healthcare Improvement and the Canadian Patient Safety Institute. The merger would “reduce duplication, provide some economies of scale for the federal government, and streamline a crowded pan-Canadian health organization field.”

The report from the Advisory Panel on Healthcare Innovation urges more active participation from the federal government to break down the barriers preventing the dissemination and adoption of innovations.

According to the report, “the bad news is that our performance is slipping in international league tables. Substantial numbers of Canadians are concerned about the state of healthcare in their respective jurisdictions. We are paying a lot for a relatively narrow bundle of publicly-insured services. Although there are many great ideas in circulation and extraordinary pockets of innovative activity across the country, Canada has not been successful in mobilizing large scale change at the system level.”

Panel members lamented the inability of Canadians to share innovations: “The panel members were taken aback by the extent to which stakeholders focused on small differences between jurisdictions, regions and institutions. Whereas leaders of high-performing healthcare systems are open to adopting or adapting well-proven innovations from anywhere, some Canadian leaders seemed stricken with the “Not Invented Here syndrome.”

“The panel’s conclusion was that positive changes in Canadian healthcare systems could be accelerated by mechanisms that challenge our propensity to reinvent the healthcare wheel, city by city, and region by region … Canada is too short on both time and money to continue indulging in healthcare parochialism.”

As a prime method of fostering collaboration and meaningful expansion of innovation, the panel proposed the creation of the Healthcare Innovation Agency and the $1 billion investment fund.

The idea, Dr. Naylor said, is that the agency would act as an “Innovation Switzerland,” helping to bring together coalitions of two or three provinces or stakeholders at a time to scale up innovative ideas that are already working well on a smaller level.

“The degree of politicization, we believe, would be reduced,” Dr. Naylor said.

The panel avoided recommending changes to federal health transfers to the provinces, which the Conservative government, beginning in 2017-18, plans to reduce to 3-per-cent annual growth or the growth rate of gross domestic product, whichever is larger.

Despite the fanfare with which the panel was first introduced about one year ago, its $700,000, 164-page report was released quietly by Health Canada on a Friday in July when Parliament is not in session.

“When you release a report on a Friday afternoon in the middle of the summer, one can draw certain inferences from that,” Murray Rankin, health critic for the NDP, told the Globe and Mail. “Maybe this panel is taking positions that the government of Canada doesn’t share.”

Health Minister Ambrose declined an interview request. “We will review that panel’s report,” her office said by e-mail. “To date, our government has increased healthcare transfers to the provinces to record levels.”

The report has other recommendations, as well. They include initiatives in person-centred care, technology-driven improvements, and precision medicine:

•  Develop and implement a strategy to promote patient and family-centred care in partnership with governments, patients, providers and others. Elements of this strategy would include: Developing and implementing information tools that patients need, and creating incentives for greater patient engagement at the organizational and system level, with the goal of improving models of care and system design.
•  Sourcing and supporting mobile and digital health solutions that meet needed common standards and interoperability requirements. Adopting and deploying best practices in the development and use of patient portals, including best practices internationally.
•  Through Infoway initially and then through the Healthcare Innovation Agency of Canada, accelerate the deployment of interoperable electronic health records across points of care, including efforts to assist providers and payers in meaningful use and prioritizing the creation of online portals where patients have mobile access to their own records.
•  Ensure future investments in health information technologies are standardized, interoperable, linked across multiple sites, and available to third parties for assessment of performance.
•  With support from the Healthcare Innovation Fund, and building on current efforts by organizations such as CIHI, provide greater transparency about healthcare in Canada, by enabling more accessible and user-friendly information on areas including patient satisfaction, quality, safety, efficiency, effectiveness and health outcomes.