Canada Health IT

Melissa Boufaida , Robert Boyd, Rudy Gracia, Sara Peche

Why Canada IT?

• Differences and similarities in approaches to implementing EHR’s

• Payment systems

• Government involvement

• Views of organizational change

Differences and Similarities in Implementation Approaches

• United States• ARRA enforced incentives and penalties• $35-40 billion invested in HIT• Nationwide interoperability not yet

achieved• Canada• Canada Health Infoway• $1.5 billion invested in HIT• Emphasis on interoperability between

territories

Payment Systems

• United States• Multi-payer system; Both

private and federally funded• Providers and hospitals pay

for EHR systems.• Canada• One-payer system• Canada Healthcare Infoway

pays for 75% of EHR system.

Views of Organizational Change

• United States• Poor workflow and project management

have slowed implementation• Physicians reluctant to implement EHR’s

• Canada• Viewed as a business transformation• Learning about EHR’s incorporated into

medical schools

Government Involvment

• United States• Physicians who do not receive federal

funds have limited incentives• Government can only penalize

physicians who take federal payments• Canada• Government beginning to require

implementation• Goal: 100% implementation by 2016

• Provide support for practices and hospitals

Shortcomings and Benefits of Further Study

• Canada’s original goal was 50% implementation by 2010, only got to 17% by 2009. Why?

• Limited research in barriers to adoption in Canada.

• Effectiveness of EHR education in medical schools

• Privacy and Security Policies in Canada.

Conclusions

• United States could model interoperability principles around Canada’s HIT structure

• Having a global budget does not necessarily mean standardization of adoption

• Views of organizational change must improve in the United States for widespread implementation to occur.

References

• http://ehrwatch.com/blog/no-ehr-yet-thats-it-i’m-moving-canada

• http://www.ncbi.nlm.nih.gov/pubmed/14728312

• http://emruser.typepad.com/• http://

www.infoway-inforoute.ca/lang-en/about-infoway/approach

• http://www.sciencedirect.com.ezproxy.lib.utexas.edu/science?_ob=ArticleURL&_udi=B6T7S-4T3TR2Y-1&_user=108429&_coverDate=06/30/2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor&view=c&_acct=C000059713&_version=1&_urlVersion=0&_userid=108429&md5=845423e9bf503c7c960c215ec1283793

Questions or comments ?