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The COVID-19 pandemic has prompted a re-examination of Canada’s health system and the ways in which it delivers care. Specifically, the virtualization of care has heightened the need for safe and efficient electronic communication, collaboration and sharing of information across the circle of care. Continuing to improve Canada’s health system will necessitate work in interoperability: the ability for information to flow seamlessly between different health systems and solutions.
The National Interoperability Effort
Increasing use of digital health tools has created renewed impetus to address key interoperability challenges to enable better coordination and continuity of care. In support of the provinces and territories, Infoway is facilitating a national collaborative effort to advance interoperability.
While there are many interoperability-related challenges, the following two have been identified as priorities based on extensive consultations:
- Sharing of patient summaries across different solutions to support transitions of care and cross-jurisdictional patient flows
- Secure messaging between solutions to enable safer and more efficient collaboration across the circle of care
Infoway has been facilitating collaboration among stakeholders to begin addressing these two interoperability challenges.
Benefits and Impacts
Public and private sector implementers agree on the benefit of a standard set of flexible specifications endorsed by all jurisdictions, in contrast to the current fragmented approach, which is costly and inefficient. The collaborative development of implementable interoperability standards, supported by Infoway, will add value across the health ecosystem:
Canadian health system has faced unprecedented strain during the global pandemic, which exacerbated existing systemic challenges and issues. Consequently, there has been accelerated urgency to alleviate underlying pain points to continue to build a health system that is connected, equitable and sustainable. Numerous issues continue to challenge our health system, including inequitable access to care; insatiable demand across the system, most acutely at emergency departments; the ongoing health human resources crisis and the notable exodus of many health care professionals along with a shortage of information technology/informatics/interoperability experts. It is more imperative than ever that we build a more efficient health system within the resources available to us.
There is growing recognition that timely exchange and access to consistent and reliable health information can significantly improve care and drive positive health outcomes. While there has been immense digitization of health information over the past two decades, the pandemic further catalyzed the adoption of virtual care solutions. We are at a critical inflection point to ensure a sustainable health system, in which we must focus our efforts on creating the world-class interoperable system that Canadians deserve— one which puts them in control of how they receive care and empowers them to access and use their health record as they deem appropriate. The quintessential characteristic of an interoperable health system is person-centric care, in which standardized data can follow the patient across all care settings and geographies to enable more informed care provision, leading to better health outcomes.
As we look ahead, we must continue to modernize our health system through the premise of, “Connected Care to Enable a Healthier Canada,” whereby all care sectors, organizations and providers are linked through health technology and standardized data. Digital health systems need to interact with each other across all care settings so that Canadians’ health information moves with them through the system, ensuring no patients fall through the cracks. For clinicians and care providers, technology must support effective and efficient communications, and improve care delivery and the patient experience. Beyond accessing information for the provision of care, health systems need to be able to access and analyze large data sets to inform health system planning and performance, analytics, research and population health management to protect and optimize a learning health system for the generations to come. Similarly, health data needs to continue to support Canada’s reputation of world-class research (e.g., biotechnology), medical breakthroughs (e.g., genomics) and innovation.
Canada Health Infoway (Infoway) is committed to achieving a more connected health system and will leverage more than two decades of progress and experience to guide this journey. Infoway’s commitment means assuming roles from convenor to standards developer to strategic investor in order to effectively support all stakeholders across the health system in making this goal a reality. To bring this goal to reality, Infoway is developing a pan-Canadian interoperability roadmap that will leverage related work that has been planned or already initiated within Canadian jurisdictions, unlock value and address immediate pain points.
Stay tuned for the upcoming release of the Shared Pan-Canadian Interoperability Roadmap.
Understanding Interoperability
Interoperability, within the context of the digital health, refers to the secure and timely exchange of health information between systems (e.g., health technology solutions, devices, consumer apps) and the common interpretation of that information devoid of additional action from users. While this sounds straightforward, there are many moving pieces that must fall into place across the health technology ecosystem for interoperability to be achieved. These pieces can range from consensus on the technical execution of sending, processing and rendering information; to the development, interpretation and representation of the policies and frameworks that allow these actions to take place.
Interoperability pertains to a wide array of data types, formats and uses. While we traditionally think about interoperability in the context of an individual’s care, it applies to a much broader array of use cases, which will only continue to expand as technology advances. For instance, as the availability of consumer-generated data (geolocation data, wearables data, etc.) continues to grow, interoperability will be required to enable use of the data effectively for care provisioning and secondary use (e.g., population health, research).
The Significance of Interoperability
When different parts of the health system are interoperable, they “speak the same language.” Effective information flow improves continuity of care and communication between health care providers and facilitates patient access to their health information.
Connection, collaboration and communication have never been more important for the health system. Increased use of virtual care has highlighted the need for secure and efficient electronic sharing of information across the circle of care. Continuing to improve Canadian health care will require sustained focus — connected systems are healthier systems.
How Interoperability Benefits Patients, Providers, Industry and the Health System
Patients Benefits
Improved access and information flow from interoperability can:
Improve access to their health information, including their ability to manage and share it
Reduce time to diagnosis and treatment
Reduce medication errors that might lead to patient harm
Result in fewer emergency visits and shorter hospital stays (e.g., through more efficient and timely information and communication)
Facilitate better transitions of care
Industry Benefits
Faster time to market by building to a single pan-Canadian, service-oriented Reference Architecture representing building blocks that support programs and data exchange(e.g., PS-CA, CA:FeX, eReferral and eConsult)
More rapid entrance for new market participants through clear and defined technology requirements that enable compliance with variation in legislative requirements across the country
Time and expense savings through the requirement to build to a single codebase for implementation across multiple jurisdictions
Diminished frustration as vendors seek to understand and respond to variable requirements, and the ability for more resource effort to be allocated to innovation, rather than base compliance
Provider Benefits
Time savings as a result of having the ability to access more complete and comprehensive information in one place
Improve communication with care teams across the health system
Improve confidence in decision-making
Increase available time that can be spent with patients and their families (e.g., on direct care)
Health System Benefits
Increase system capacity and productivity (e.g., by reducing duplication of work, streamlining care pathways)
More effective systems planning and evaluation by leveraging data
Improve morale of health workers by reducing frustrations caused by inefficient workflows and lack of information
Cost savings and greater value for money
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