A Perspective on Canadian Initiatives in Health Care Quality HL7 Clinical Quality Work Group June 26,

Agenda Overview of health care in Canada Key players in Canada’s health system information and performance reporting landscape Overview of CIHI’s mandate and work Some of CIHI’s key initiatives 2

Canada’s Health Care System Responsibilities –Federal government –Provincial/territorial governments Canada Health Act – conditions for receiving federal funds for delivery of health care services –Publicly administered –Comprehensive –Universal –Portable –Accessible 3

Health Status of Canadians 4 Source yourhealthsystem.cihi.ca/inbrief yourhealthsystem.cihi.ca/inbrief

Health Status of Canadians 5 Source Vital Statistics, Statistics Canada as reported in yourhealthsystem.cihi.ca/inbriefyourhealthsystem.cihi.ca/inbrief Avoidable Deaths per 100, through

Canada’s per person spending is just more than half of what is spent on health care in the U.S. but higher than the OECD average 6 Note * Data for Source OECD Health Statistics 2014 (June edition), Organisation for Economic Co-operation and Development (OECD).

The share of health spending funded by the public sector in Canada is less than the OECD average 7 Note * Data for Source OECD Health Statistics 2014 (June edition), OECD.

Canada’s Health System and Performance Improvement Landscape Federal departments and agencies –Health Canada – regulatory role, delivers care to First Nations &Inuit –Public Health Agency of Canada – health promotion & disease prevention, infectious diseases, public health emergencies –Statistics Canada – Canada’s national statistical agency Source of information on population health status 8

Canada’s Health System and Performance Improvement Landscape National organizations –Includes CIHI –Examples: Canadian Patient Safety Institute Canadian Partnership Against Cancer Canadian Foundation for Healthcare Improvement 9

Canada’s Health System and Performance Improvement Landscape Provincial health quality councils –Often mandated to report on provincial performance –Often lead quality improvement within the jurisdiction Other data/information shops –Institute for Clinical and Evaluative Sciences –Manitoba Centre for Health Policy –Newfoundland and Labrador Centre for Health Information 10

CIHI’s mandate and role 11 Our Vision Better data. Better decisions. Healthier Canadians. Our Mandate To lead the development and maintenance of comprehensive and integrated health information that enables sound policy and effective health system management that improve health and health care. Our Values Respect, Integrity, Collaboration, Excellence, Innovation

CIHI’s Data Holdings Acute care – inpatient admissions, ED visits, Financial – macro and facility level Rehabilitation Acute mental health Health human resources Prescription drugs Home care and long-term care Registries – joint replacement, organ replacement, multiple sclerosis Wait times Patient experiences Gaps 12

What we do with the data holdings Develop standards Collect data from stakeholders Manage data holdings –Data quality assessments and reporting Disseminate –Through standard annual reports –E-tools –Research requests Enrich –Case Mix Grouper (CMG) –Population Risk Adjustment Grouper (PRAG) 13

CIHI’s Products – how we use our data holdings Public reporting of health system performance –yourhealthsystem.cihi.ca – In Brief and In Depthyourhealthsystem.cihi.ca –Wait times –International comparisons Analytical reports and indicator development, e.g., –Level and determinants of health system efficiency –Weekend admissions and in-hospital mortality –High users of health care –Patient harm –In-hospital infections 14

Your Health System: In Depth performance indicators covering: Population health, long-term care, acute care Focus on regional and facility results Benchmarking and visualization tools

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Health System Performance Initiative Phase 2 Focus on benchmarking Focus on more and more powerful analytics 19