ARCHIVED - 2004 GOL Public Report- Making the Government On-Line Vision a Reality at Health Canada [Health Canada, 2004]
Making the Government On-Line Vision a Reality at Health Canada
Table of Contents
- Introduction
- Health Canada's e-Government Strategy and Vision
- Health Canada Advances the GOL Agenda
- 'In-line' with the 'On-Line' Objectives
- Centre for Surveillance Coordination
- First Nations and Inuit Health Information System
- Telehealth
- Remote Community Connections
- Canada Health Infostructure Partnerships Program
- Pest Management Regulatory Agency - E-Registration and Approval
- Canadian Institutes of Health Research - ResearchNet
- Human Pathogens Import Permit Tracking System
- Global Public Health Intelligence Network
- Identifying Client Needs
- Contact GOL at Health Canada
1. Introduction
Health Canada's Mission and Vision
Health Canada is responsible for helping the people of Canada maintain and improve their health. Health Canada strives to improve the health of all Canadians, while respecting individual choices and circumstances, and therefore seeks to put Canada among the countries with the healthiest people in the world. (www.hc-sc.gc.ca)
What We Do
In partnership with provincial and territorial governments, Health Canada provides national leadership to develop health policy, enforce health regulations, promote disease prevention and enhance healthy living for all Canadians. Health Canada ensures that health services are available and accessible to First Nations and Inuit communities. It also works closely with other federal departments, agencies and health stakeholders to reduce health and safety risks to Canadians.
Departmental Relationships
Health Canada's roles in all aspects of its work are anchored in a pair of key realities. First, a large number of social, behavioural, physical and economic determinants interact to affect the health of Canadians. Therefore, the Department uses a wide and strategic range of policies and actions to "maintain and improve the health of Canadians".
Second, progress on Canada's health priorities requires collaboration and coordination among many partners. For example, the Department works with the provinces and territories to ensure the long-term sustainability of Canada's health system, while safeguarding the principles of the Canada Health Act. Through its First Nations and Inuit Health Branch, the Department works with the Indian and Northern Affairs Canada, the First Nations communities themselves, and the provinces and territories to provide quality health services to First Nations and Inuit in Canada. In developing a spectrum of departmental policies and activities, the Department works with the voluntary and community sector, health professionals, the private sector, and individual Canadians.
2. Health Canada e-Government Strategy and Vision
The vision for Health Canada in the area of e-Government is:
"Health Canada will be front- and-centre in the advancement of timely and trusted electronic health information and service delivery."
Health Canada will achieve this vision by:
- transforming information and services for on-line delivery;
- integrating information and service delivery methods (e.g. Internet, telephone, in-person);
- providing national leadership in the advancement of e-government concepts within the health community;
- ensuring a continued trusted relationship with Canadians by providing appropriate levels of protection for their personal information;
- confirming that the information and services being provided are those that are needed by Canadians; and
- working cooperatively with its federal/provincial/territorial partners and private sector stakeholders.
Steps are being undertaken in all areas of the Department to move Health Canada closer to achieving this e-vision. Since its May 2000 inception, the Department's Government On-Line (GOL) Division coordinates and champions GOL activities.
3. Health Canada Advances the GOL Agenda
Health Canada is working to support the Government of Canada's service strategy goals of delivery of key services on-line and to integrate service delivery across channels. The Department is working to be in a position to provide trusted and authoritative health information by whichever method Canadians choose, be it in person, by fax, phone or via the Internet or e-mail.
As more federal and provincial jurisdictions become collaborators in the delivery of information and services on-line, and as Canadians continue to move on-line and away from other service channels, Health Canada will be in a position to support on-line goals. The Department is committed to the use of information and communication technology to improve access to client-centred and integrated services.
Health Canada is focused on a service delivery vision that includes:
- rethinking delivery of information and services;
- encouraging up-take of electronic offerings;
- increasing e-enablers and common business processes;
- achieving sustainability for on-line service offerings and integrated Web sites;
- engaging partners on service and policy fronts;
- creating new governance and accountability models; and
- building a flexible, adaptable workforce.
Health Canada is involved in a number of initiatives in support of the Government of Canada's Government On-Line objectives. These initiatives include:
Canada Health Portal
As part of Government On-Line initiative, the Canada Health Portal was conceived to provide on-line access to health information, and eventually services, through a client-centric, single-window approach. Led by Health Canada, the Canada Health Portal was launched May 31, 2002 and is one of the largest of the 17 Canada Site subject portals.
The Canada Health Portal provides Canadians single-window access to trusted and authoritative health information. The Portal includes information for specific groups of the public such as seniors, youth, children, Aboriginal peoples, health-care workers, veterans and the international traveler.
In addition to incorporating Health Canada subject matter, the Canada Health Portal provides access to health information and services from several other federal government Departments, the Canadian Health Network, provincial and territorial governments, municipalities, Canadian non-government agencies and major health-related bodies such as the World Health Organization and the U.S. Centres for Disease Control.
With the Canada Health Portal, Canadians will find it easier to locate federal, provincial and territorial government health information. The portal is a window to previously inaccessible or difficult-to-find information and services for those living in urban, rural, remote or foreign locations. Access the Canada Health Portal directly at www.chp-pcs.gc.ca or through the Canada Site.
Service Transformation
Health Canada supports the Government of Canada Service Strategy Vision that identifies the need to set a federal service delivery vision for citizens and clients that is client-centred and integrated across the whole of government and across service delivery channels. The Department recognizes that there are significant opportunities to capitalize upon new service delivery capabilities to meet raised client expectations for access to service and information. Successful exploitation of these opportunities and the development of a departmental service delivery vision should allow for citizens to have a choice of devices and channels which allows for pervasive access to health service and information at home, at work, on the move or in the community.
Health Canada is undertaking the development of a new Service Delivery Vision and Strategy that will set out the strategic direction for the Department to plan and shape the future development of service and information delivery over a spectrum of service channels.
Service Improvement Initiative
Treasury Board's Service Improvement Initiative applies to Departments with significant direct service delivery to Canadians. The Service Improvement Initiative is designed to achieve significant, measurable and sustainable improvement in Canadians' satisfaction with the quality of service provided by federal government Departments and Agencies. With the goal of improving Health Canada's information-based services to Canadians, six key information services have become the initial focus for departmental service improvement: Canadian Health Network, "It's Your Health" publications, Pest Management 1-800 Information System, Non-Insured Health Benefits Drug Exception Centre, Health Canada's General Enquiries Lines, and the 24/7 Emergency Call Management System.
To-date, client satisfaction surveys have been completed and satisfaction baselines established for four of the six identified services. Suggestions for improving services obtained from the surveys have been implemented and reported back to the client. The results of these surveys form the basis for annual service improvement plans, including setting service improvement targets. The remaining two services will establish client satisfaction baselines by the end of 2004.
Building upon the successes of these initiatives, Health Canada will continue to identify and plan for continuous client satisfaction improvement in other areas of the department that provide client-facing services.
HC Online Web Site
Health Canada has an extensive online presence. The Health Canada Web site contains a vast amount of information and on average receives more than 80,000 unique visits per month. In the first half of 2003 the HC Web site received approximately two million visitors per month. In addition to providing information, publications and links supporting the delivery of the Department's mandate, the site offers forms that can be downloaded, access points for client feedback and interactive services.
To support the Government of Canada's focus on on-line information delivery, Health Canada has undertaken a renovation of the Department's Web site. The primary goal is to organize departmental Web information to be accessible to Canadians in a logical and consistent manner. Information will be organized by subject rather than by organizational structure. This will allow content created by the various areas of the Department to be grouped together on the Web site, thus ensuring that the Department's clients have ready access to the full spectrum of Web content on a particular subject.
This client-centric approach increases the accessibility of departmental information and improves the distribution of information. This enhanced organization and management of the Health Canada Web site will also solidify the connection between Web content and the experts and professionals in the program delivery areas of the Department, ensuring that the content of the departmental Web site is always current, relevant and accurate.
Privacy and Security
The health care field is an information-intensive sector. As such, Health Canada finds itself, at times, in the role of a custodian of sensitive and personal health information. The Department takes this 'public trust' role seriously, especially as it is helping expand the range of e-health services to the public. To ensure a continued, trusted relationship with Canadians regarding the handling of their personal information, the Department is updating its' privacy policies, procedures and training of staff. New privacy processes and tools, such as Privacy Impact Assessments are being used to identify privacy risks and related solutions.
4. 'In-line' with the 'On-Line' Objectives
Health Canada has been at the forefront of providing Canadians with on-line health information. The Department is well established on the "information super highway" with its extensive public presence on the World Wide Web, as well as its collaborations with key health stakeholders and multi-jurisdictional partnerships with initiatives such as the Canada Health Portal, the Canadian Health Network and the First Nations and Inuit Health Information System.
Centre for Surveillance Coordination
The Centre for Surveillance Coordination, formerly the National Health Surveillance Infostructure, collaborates with public health stakeholders on the development, maintenance and use of health surveillance information, tools and skills that strengthen Canada's capacity for timely and informed decision-making. It is another initiative of the Canada Health Infostructure.
The Centre has made significant progress in transitioning from a number of pilot projects (which proves the concepts of networks and information management as applied to surveillance) to an infostructure, which supports advances in health surveillance systems undertaken by partners at the federal, provincial and local levels.
With their partners, the Centre for Surveillance Coordination is involved in promoting several surveillance tools and projects, and provides training programs to support these activities. Some of their activities include:
- Canadian Integrated Public Health Surveillance (CIPHS) Project: provides a model for the long-term standardization of public health data management which has organized the national public health community to a degree that has never been achieved before. The project is comprised of a number of computer and database applications, including the Laboratory Data Management System (LDMS) and a public health case management system entitled Public Health Information System (i-PHIS). Through the CIPHS Collaborative, Health Canada has been working in cooperation with its Federal, Provincial, Territorial, and Local (F/P/T/L) partners to further enhance these products.
- Geographic Information Systems Infrastructure: the infrastructure for linking data from different surveillance and public health information systems enabling public health workers to visualize and analyze in spatial format. One such project is the Web-based Public Health Map Generator Service that provides public health practitioners the ability to login and use data to generate maps to aid in the detection of health events in populations. They can also upload personal data to generate customized maps.
- Injury Surveillance Project: a prototype system for collecting injury surveillance data from emergency rooms on both unintentional and intentional injuries for all ages and involves 10 hospitals in British Columbia and the British Columbia Ministry of Health Services. Injury continues to be a major source of sickness, disability and death in many age groups even though much of it is considered preventable. This BC project has developed a comprehensive approach to injury surveillance that did not exist before.
- MotherNet: a system for collecting and analyzing data on the effects of drugs and other exposures on pregnant and breast-feeding women. MotherNet is being developed in collaboration with the Motherisk Clinic at the Hospital for Sick Children, Toronto and the IMAGe Clinic at Hôpital Ste Justine, Montreal. MotherNet will give front-line counsellors and care providers a state-of-the-art patient management tool. In addition, MotherNet will enable the secure, confidential use of the accumulated data for research into evaluating treatments and identifying emerging threats.
- Skills Enhancement for Health Surveillance: an Internet-based training initiative for health professionals in local public health departments and regional health authorities across Canada. The need for a cost-effective method to train and upgrade the skills of public health practitioners has been widely recognized for years. To address this pressing issue, this project is working with front-line public health and academic collaborators to combine a thorough knowledge of the requirements of the professions with the latest developments in Web-based learning technologies and techniques.
The First Nations and Inuit Health Information System (FNIHIS)
The First Nations and Inuit Health Information System (FNIHIS) is a community-based electronic health information system used to support delivery of health programs in First Nations and Inuit communities. It provides timely access to health information for case management, program planning and health assessment.
The system has been developed by Health Canada's First Nations and Inuit Health Branch (FNIHB) in partnership with First Nation and Inuit communities and is a Canada Health Infostructure and Electronic Health Care Services System initiative. It is currently operational in 359 sites serving 427 communities. Full deployment to all 566 communities is targeted for 2005. The current version of FNIHIS comprises 12 subsystems including client core information, immunization, tests, medication and chronic disease. The tool allows for informed decisions about patients by health professionals providing care in on-reserve health facilities. A component providing additional functionality in diabetes and home and community care will pilot in the spring of 2004. The administrative tool for Home and Community Care the Service Delivery Reporting Template (e-SDRT) was deployed in autumn 2003.
The longer-term vision of FNIHB is to expand the FNIHS to integrate information captured in other care settings, such as the home, physicians' offices and provincial/territorial health facilities into the system. This integration will in essence, create a primary care Electronic Health Record that is linked with provincial/territorial health records and responds to information needs in priority health areas. The primary benefit of using electronic records over paper records is that access to information is limited to authorized and authenticated users on a "need to know" basis. Electronic Health Records will allow providers to access a patient's health information from a variety of locations and to share that information more easily with other potential users such as specialists. Electronic Health Records is viewed internationally as one of several methods to improve health care delivery and potentially reduce the cost of care.
Telehealth for First Nations and Inuit Communities
Telehealth is the delivery of health care, through electronic means, at any distance. As a result of the initial implementation phase of the Provincial-Federal TeleHealth Program, Alberta has the largest aboriginal telehealth network in the world, providing high-speed connectivity to all First Nations community health centers/nursing stations. Telehealth programs have been deployed in 21 First Nation Communities and bi-directional satellite access provides e-mail and Internet access to health care workers in 41 First Nation communities. First Nations communities in Alberta see the value of e/telehealth services in bridging the gap, not only in geographic distances, but, more importantly, in providing enhanced access to health care service delivery.
The initial mandate of the Alberta First Nations Telehealth Program (AFNTP) was to develop the technical infrastructure to provide both videoconferencing and Internet access to Alberta First Nations health workers throughout the province. This is now complete. Part two of the overall mandate, sees the AFNTP facilitating the development of telehealth programs and maintaining a Health Portal for the benefit of health care workers in First Nations communities. This is now underway. The Internet Health Portal currently provides ubiquitous access to e-mail, discussion groups, health information, news and the Virtual Health Library (electronic document repository that provides on-line access to thousands of health related documents).
Currently, significant portions of the AFNTP operations are directed towards the organization and scheduling of videoconference events (training, meetings, consultations and service delivery). In 2002-2003, the Program provided a platform for approximately 250 videoconference / telehealth sessions totalling over 1,038 hours of use. Approximately 900 Health care professionals working in (or for) First Nation communities are now on-line with http://www.onehealth.ca.
Remote Community Connections
For remote and First Nations and Inuit communities, the ability to communicate on-line at high speeds is essential in delivery of federal government services. A number of federal, provincial and territorial departments have this requirement. Although implementation of this capability is not specifically a Health Canada responsibility, efforts are being made to co-ordinate the overall requirements of the departments for connection to remote areas.
Health Canada has initiated the Remote Satellite Distribution Project, through the auspices of the e-Health Solutions Unit, in order to provide high speed Internet access for health care workers in isolated and semi-isolated communities - communities that do not, at present or in the near future, have access to community-based broadband solutions. In total, 148 remote communities have received a high-speed bi-directional satellite solution that will provide access to Internet, the ability connect to e-mail and multiple e-Health tools. Wireless LANs were deployed in 86 communities.
Canada Health Infostructure Partnership Program (CHIPP)
Initiated in 2000, CHIPP is an $80 million cost-shared incentive program aimed at supporting collaboration, innovation and renewal in health care delivery through the use of information and communication technologies. CHIPP supports the implementation of 29 model e-health projects across the country in partnership with all jurisdictions and stakeholders to improve the accessibility, quality, and efficiency of health care services.
One CHIPP project, for example, has brought remote screening for diabetic complications for First Nations living on reserve in Alberta. Another has introduced telemedicine services in more than 30 disciplines for some 60 northern Ontario communities. CHIPP has also supported the development of a standard-based electronic health record system in British Columbia to support the information management needs of mental health service providers. CHIPP projects will complete implementation by the end of March 2004, and together they will have contributed to the renewal of health care delivery to all Canadians.
Pest Management Review Agency - E-Regulatory System
Health Canada's Pest Management Regulatory Agency (PMRA) regulates the sale and use of pest control products in Canada. It conducts science-based health, environmental and value (including efficacy) assessments of each pesticide before determining if it can be approved for use in Canada. PMRA also re-evaluates existing pesticides to ensure that they meet modern safety standards. By seeking to minimize the risks associated with pesticides, the PMRA helps protect human health, safety and the environment. The PMRA is developing on-line processes for its core businesses.
Since its creation in 1995, the Agency has been committed to improving processes and to achieving efficiency gains in the review of submissions. The PMRA has conducted business process analysis and implemented continuous process improvements including advances in electronic registration capacity. The electronic capability involves the national and international pesticide community, including industry and regulatory agencies. An intensive consultative and development process is underway to build a fully integrated electronic regulatory system. This system would facilitate submission preparation by industry, industry transmission on-line of submissions and other documents to PMRA, and evaluation, reporting, and archiving by PMRA while furthering overall regulatory transparency objectives as specified in the new Pest Control Products Act.
Canadian Institutes of Health Research - ResearchNet
Canadian Institutes of Health Research is Canada's major federal funding agency for health research. The research community in Canada is large, diverse and increasingly multi-disciplinary, covering areas not only of health, but also engineering, natural and social sciences. Information sharing is crucial to this community at all stages of scientific discovery and innovative information services like Internet, email and the World Wide Web offer great potential for increased collaboration and efficiencies. Even greater benefits can be gained if multiple research organizations pool their resources to create common Internet tools for the research community as a whole.
This sharing of organizational effort is the vision of ResearchNet. Through a single window, ResearchNet will allow researchers the opportunity to network and collaborate with colleagues and to share information on their research with the public. By 2005, researchers will be able to search for and identify funding opportunities, submit applications for funding, and track the status of applications throughout the competition process, all electronically and within a secure environment.
The first e-service launched under this vision was "The Common CV" (curriculum vitae). The goal of this project is to allow researchers to keep their CV information up-to-date in a secure, Web-based format and to easily submit this same information in the formats required by multiple agencies for funding. Launched in July 2002, over 18,000 researchers and students have placed their CVs on-line. The number of participating agencies has grown to eight.
In June 2003, The Canadian Research Information System (CRIS) database was created as a pilot project. Funding data from multiple Canadian agencies was merged into a single database publicly accessible over the Internet. A powerful and flexible search engine enables queries by a variety of criteria including research location, researcher name and research subject. The number of agencies contributing their data has increased from three (at the time of launch) to seven, and fifteen thousand project records are stored in this database.
Human Pathogens Import Permit Tracking System
Scheduled to be on-line in 2004, the Permit Tracking System will provide major efficiencies for research lab officials who apply for permits to import human pathogens into Canada. The on-line form will replace the existing hard copy form and a time-consuming manual process.
Canadian researchers will benefit from this on-line system as it allows for faster permit processing time. The system will screen up-front for errors, therefore eliminating the need to re-send forms with corrections. This on-line form will be easy to complete with on-line help a few keystrokes away. As only one Health Canada employee will receive and process the form, the applicant can be confident that the permit has reached the appropriate employee every time.
In the light of recent world-wide events, Canadians will benefit from the enhanced protection this system will provide. Public security will be improved, as all importations of human pathogens into the country will be traced. Security establishments such as the Royal Canadian Mounted Police will be able to quickly access the information they would require in the face of any potential bio-terrorist threat.
The system will also provide Health Canada officials with the ability to store and track permits, suppliers and lab information which will result in faster and more accurate processing and issuing of permits. With easily tracked and traced movement and location of human pathogens into the country, the system will provide greater security for Canadians.
Global Public Health Intelligence Network
The Global Public Health Intelligence Network (GPHIN) was developed by Health Canada in collaboration with the World Health Organization. GPHIN is an Internet-based, multilingual "early warning" system that monitors, gathers and provides preliminary reports of public health significance in the six World Health Organization official languages (Arabic, Chinese, English, French, Russian and Spanish) on a "real-time", 24 hours a day, seven days a week basis. This unique multilingual system monitors global media sources such as newswires and Web sites. GPHIN also tracks events such as disease outbreaks, infectious diseases, contaminated food and water, bio-terrorism, exposure to chemicals and radioactive materials, and issues related to the safety of products, drugs and medical devices. GPHIN is used by the global public health community including the WHO's Global Outbreak, Alert and Response Unit in its efforts to minimize health risks by developing appropriate risk management, control and prevention measures and responses.
Information gathered through the GPHIN is filtered for relevancy by an automated process, which is then complemented by human analysis. The output is categorized and made accessible to users. Credibility is assured through the system's subscription to global media providers and its' frequent audit of the sources from which information is retrieved.
5. Identifying Client Needs
Health Canada invests in public opinion research each year. This research feeds advisory and decision support processes in communications, policy development and program management and guides the Department's strategic thinking.
In addition to subscribing to a syndicated survey dedicated to what Web users' need, almost every departmental survey has a component that probes issues related to Canadians' preferences for receiving information. Further, the Health Canada Web site also provides a feedback survey form that allows categorization of Web site users and their satisfaction levels. This survey and public opinion information is analyzed, synthesized, and feeds into the development of strategic plans for GOL.
6. Contact GOL at Health Canada
Further information may be obtained from the Health Canada Government On-Line Division:
Government On-line Division
Office of Health and the Information Highway
Health Canada
(613) 946-8000
info@hc-sc.gc.ca
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