Question Period Note: Health data and digital health

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• Improving Canada’s health data is a key priority to drive health system transformation, particularly with respect to health outcomes.
• Canada has not harnessed the power of digital health and data, and this has impeded our ability to respond to public health emergencies, to move the system toward more responsive and patient-centred care, and to provide people with the tools to better understand and manage their own health.
• In Canada, there is a weak foundation for data collection, sharing, and use – resulting in a highly fragmented system.
• Building on what we learned during the pandemic, the Government is committed to working with Provinces and Territories to fill data gaps to ensure that our health care system is underpinned by health data that will support health care system improvements, transparency, and Canadians’ access to their own personal health records. Canadians expect to interact with the health care system in the same way that they do with banking and other sectors of the economy. To modernize our health system, we need to responsibly harness the power of health data and digital health tools.
• Improving access and sharing of health data will help drive progress in improving access to care. What is measured matters.
• When data is accessible and linked, decision-makers and researchers will have the data they need to improve health outcomes and manage public health crises like the COVID-19 pandemic.
• Individual Canadians should have access to their own personal health records, allowing them to more actively manage their own care.
• The pandemic helped us recognize the importance of timely health data and pushed us all to innovate in this area through better access to virtual care services and digital tools.
• We will continue to work with provinces, territories and other partners to build on momentum and deliver tangible results for Canadians.

IF PRESSED ON DATA PRIVACY AND SECURITY
• Canadians expect that their personal health information will be adequately protected when used and exchanged.
o Privacy protection and cyber security remain key considerations in advancing digital health and health data initiatives.
• To increase transparency when Canadians’ personal information is handled by organizations and to give Canadians the freedom to move their information from one source to another, the Government of Canada tabled the Digital Charter Implementation Act.
o The act will help to strengthen Canadians control over their own personal information.
• The federal government will engage Canadians on digital health and health data, working with provinces and territories.

IF PRESSED ON EQUITABLE ACCESS TO CARE
• The Government of Canada is committed to working with provinces, territories and other partners to promote effective and appropriate ways to use digital health services and health data to meet the needs of underserved populations in Canada.
• Recognizing the critical need for respectful partnerships with Indigenous peoples in this area, we are committed to engaging Indigenous leaders and organizations to ensure their specific viewpoints, cultural sensitivities, rights and autonomy are respected and upheld.
• The Government of Canada will collaborate with the provinces and territories on approaches to data and digital literacy to ensure all Canadians stand to benefit from digital health.

Since the onset of the pandemic there has been ongoing federal, provincial, and territorial (FPT) collaboration in digital health that has been supported by notable virtual care investments by the Government of Canada in May 2020. On May 3, 2020, the Prime Minister announced $240.5M to support virtual care and digital tools for Canadians.
Of this, funding of $150M is flowing to provinces and territories through bilateral agreements for enhancements to virtual services focused on secure messaging and file transfer, secure videoconferencing, remote patient monitoring, patient online access to test results, and back-end supports to integrate these tools within existing digital systems. In addition, Canada Health Infoway (Infoway) received $50M to develop pan-Canadian standards on secure messaging and videoconferencing and support Provinces and Territories as they implement new initiatives pursuant to the bilateral agreements. To date, Infoway has led consultations on standards with all jurisdictions and is actively supporting jurisdictions with implementation of virtual care initiatives.
Health Canada will continue to collaborate closely with Provinces and Territories on the advancement of standards to support interoperability, as there is extensive FPT collaboration in this space and PTs are prioritizing the advancement of approaches to support interoperability. For example, ON has recently passed ‘digital health information exchange’ regulations within its existing personal health information law, which requires IT vendors to use specific technical standards to ensure data can be exchanged between IT systems and points of care. Likewise, Quebec has tabled Bill-19, which enshrines the right to access health data and requirements for IT vendors to use specific standards.
FPT governments are continuing to build on the initial momentum of digital health and virtual care during the pandemic, consistently promoting the spread and adoption of pan-Canadian virtual care and digital health approaches that can support the Canadian health systems. In June 2021, a FPT Virtual Care and Digital Health Table hosted a multi-stakeholder Virtual Care Summit to discuss the policy enablers underpinning virtual care and digital health, and identify key considerations for a pan-Canadian action plan to maintain the unprecedented momentum spurred by the pandemic in the delivery of virtual care services. The final report is available online and continues to inform FPT dialogue on digital health and health data.
Recognizing the critical importance of timely access to health data in supporting public health response efforts, FPT Governments have been collaborating on a pan-Canadian Health Data Strategy, that seeks to strengthen Canada’s health data foundation by putting forward a vision aimed at modernizing health data collection, sharing and interoperability, while streamlining approaches to access, collection and use of health data for the benefit of all Canadians.
In addition, an external Expert Advisory Group (EAG) comprised of national health data experts (chaired by Dr. Vivek Goel, President of the University of Waterloo), is advising on the development of the strategy and has produced three reports, most recently in May 2022. The final report reaches several conclusions that highlight a need for a collaborative culture, public trust, and significant FPT investment to support needed improvements in health data policies, interoperability, and literacy. The EAG’s advice and recommendations are critical for informing FPT efforts as it provides strategic direction for the use of health system, population, and public health data to improve the health of Canada and Canadians, as well as a principles to guide the creation, collection, storage, and use of data;
Going forward, Budget 2022 reaffirmed the Government’s commitment to working with provinces and territories on strategies to better use health data to support health care system improvements and Canadians’ access to their personal health records. It also speaks to the importance of increasing virtual care for all Canadians. Further, Budget 2022 also reaffirmed the Government of Canada’s commitment to supporting health innovation, including adoption and procurement. For example, Budget 2022 provides $30 million investment over four years, starting in 2022-23, to build upon the success of the Coordinated Accessible National (CAN) Health Network and expand it nationally to Quebec, the territories, and Indigenous communities.
These investments build on broader efforts to support health innovation, for example, Budget 2021 provides $443M over 10-years for the Canadian Institute for Advanced Research (CIFAR) to continue advancing a pan-Canadian Artificial Intelligence (AI) strategy, which seeks to bridge world-class talent and cutting edge research capacity with commercialization and adoption to ensure that Canadian ideas and knowledge are mobilized at home. The first phase of the Pan-Canadian AI strategy was launched in 2017, and includes an ‘AI for Health Task Force’ that produced a 2020 report with recommendations for Governments to help support the advancement of AI innovations within Canadian health systems.
Recognizing the potential benefits of a pan-Canadian approach to interoperable e-prescribing, previously, the federal government has also provided Infoway with funding in Budget 2016 and Budget 2017 to design, pilot, and grow PrescribeIT. PrescribeIT is a national, interoperable e-prescribing service that provides safer and more efficient medication management by connecting community-based prescribers (such as physicians and nurse practitioners) to community retail pharmacies, enabling the digital transmission of prescriptions. The platform builds off Infoway's role in supporting interoperability by enabling prescribers to electronically transmit a prescription directly from an electronic medical record to the pharmacy management system of a patient’s pharmacy of choice.

• Canada lags behind when it comes to providing citizens’ with access and control of their own electronic health information.
o Today, only 32% of surveyed Canadians report ever electronically accessing their personal health information, despite 79% of the same Canadians reporting that they want access to be provided.
o On top of that, only 35% of surveyed Canadian primary care physicians can share patient information outside of their practice.
• As a result, health care providers are left with incomplete information about their patients’ medical history, creating risks to patient safety and ultimately minimizing the potential to use data for research and innovation.
• The pandemic revealed just how critical timely data is, with crucial public health decisions being made on uncoordinated, incomplete information, and vaccination data unable to link with primary or acute care data, ultimately negatively impacting the health outcomes of Canadians.
• That is why in Budget 2022, the Government of Canada made a commitment to strengthen our public health care by advancing the priorities of Canadians, including a focus on the effective use of high-quality data and digital systems in Canada.
o This echoed the five priorities for health announced by the Minister of Health in March 2022, which included using modern health data and digital health more effectively in Canada.