1.
15 years of eHealth in
Canada: Observations
on the challenge of
balancing Innovation
and Central
Coordination
Will Falk
@willfalk, @PwCHealth
Consulting
22 April 2015

2.
PwC
22 April 2015
Canada Health Infoway was started at the beginning of
the millennium. At a time when the PC was dominant
and there was minimal existing digital infrastructure
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination
• Created in 2001
• $2.1 billion in federal funding
• Independent, not-for-profit corporation
• Accountable to 14 federal/provincial/territorial
governments
Mission:
Fostering and accelerating the development and adoption of
electronic health information systems with compatible standards
and communications technologies on a pan-Canadian basis with
tangible benefits to Canadians. Infoway will build on existing
initiatives and pursue collaborative relationships
in pursuit of its mission.

3.
PwC
22 April 2015
Canada Health Infoway started over a decade ago…
3
Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

4.
PwC
22 April 2015
• Common architecture
including privacy and
security
• Infoway Standards
Collaborative:
• Standards
development
• Architecture and
standards freely
available
Standards and Interoperability
EHR Blueprint: https://www.infoway-inforoute.ca/en/component/edocman/resources/technical-documents/391-ehrs-blueprint-v2-full
4
Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

5.
PwC
22 April 2015
The first decade saw a build out of core systems…
Good success in most areas; mixed results in drug
systems
5
Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

6.
PwC
22 April 2015
Physician desktops were added by provinces first
and then nationally in 2010…
6
Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

7.
PwC
22 April 2015
Interoperability Challenges
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination
700+
36,000
315,000
29,000
26,000
2,500
hospitals
general practitioners
nurses
specialists
pharmacists
long-term care facilities
Homecare
Emergency
Services
Pharmacy
Laboratory
DiagnosticHospital
Emergency
Specialist
Clinic
Clinic
(for more information see also accelerating clinical interoperability: https://www.youtube.com/watch?v=vutjMHmvTC4 )

8.
PwC
22 April 2015
HIAL – Enables Regional Interoperability
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

9.
PwC
22 April 2015
Benefits Evaluation
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination
Use
• Use Behavior/Pattern
• Self Reported Use
• Intention to Use
User Satisfaction
• Competency
• User Satisfaction
• Ease of Use
NET BENEFITS
Quality
• Patient safety
• Appropriateness/effectiveness
• Health outcomes
Access
• Ability of patients/providers to
access services
• Patient and caregiver
• Participation
Productivity
• Efficiency
• Care coordination
• Net cost
System quality
• Functionality
• Performance
• Security
Information quality
• Content
• Availability
Service quality
• Responsiveness

10.
PwC
22 April 2015
As the Digital Health industry has grown, there has
been a struggle to find a balance between central
planning and allowing innovation to flourish…
10
Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination
Central
Control Innovation
Central
Control
Innovation

11.
PwC
22 April 2015
Infoway has responded with Innovation Programs
and by using @Infoway
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

12.
PwC
22 April 2015
Infoway’s Path Forward to 2019
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

13.
PwC
22 April 2015
1. In 2001 it was all PC’s. Smartphones (2007), then Tablets
(2010) and now Wearables (2012) are growing fast. Watch
(2015) is coming
2. Re-Focusing on “Frequent Flyers” and chronic disease
management
3. The challenge of improving core hospital systems
4. The rise of “off the grid” data systems
5. New players entering healthcare: The Rise of New Health
Entrants
6. Virtual Care: mHealth and the Quantified Self
eHealth landscape rapidly is evolving – Six things to
consider
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination

14.
PwC
22 April 2015
Will Falk
Managing Partner, Health Industries
416.317.9232
william.f.falk@ca.pwc.com
Twitter: @willfalk
Thank you!
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Successful organization and governance of eHealth - International trends and lessons to be learnt • Torsten Håkansta & Will Falk
Section 1 – 15 years of eHealth in Canada: Observations on the challenge of balancing Innovation and Central Coordination