Executive Summary



July 1995

The Health System Information Task Force was established by the Department of Health, the Newfoundland Hospital & Nursing Home Association, and Treasury Board to examine Newfoundland & Labrador’s health information system, develop a vision of what this system should become, and make recommendations on how the vision can be realized. The work of the Task Force was guided by the belief that the health of the Province’s people and communities can be improved through improved health information flow and the utilization of it.

The scope of this report has addressed the areas of health information specific to the traditional health system. Task Force members have recognized that a health information system for the province must also include information from other sectors such as Social Services, Education and Justice.

The Task Force developed a health system information framework depicting the development of quality information in an efficient and effective health system. Based upon this model, a vision statement was drafted. It identified the need to redevelop Newfoundland & Labrador’s health information system with a focus on the individual. A key step in this direction is the creation of a unique identifier - a number assigned to each person to track all interventions with the health system.

To realize a quality health information system, we must implement and adhere to standards - definitions and terminology, information systems, and information technology. Education of both consumers and health professionals in the use of information is central to realizing the vision. People need to learn the importance of quality health information, as well as, how to make use of it.

The demand for better health information is growing. Quality information is not only important for improving the health of the population, it has become a commodity. As such, opportunities for economic development and wealth creation are possible through the development of products and expertise in this field.

The Task Force strongly believes that a leadership group is essential to take its recommendations and make the strategic directions identified happen. Such an organization will require system-wide support.

Although a number of the recommendations of the Task Force require further planning before they can be addressed, four priority areas are believed to require immediate attention: the introduction of a provincial health number to uniquely identify all persons; development of a province-wide health human resource management information system; continued initiatives aimed at furthering the development of quality information; and creating a provincial protocol for confidentiality of information.

Through its consultations with the broader health system that it represents, the Health System Information Task Force has raised awareness of the importance of quality information to improving the health of our people. It has also sparked an opportunity for other sectors of the provincial economy to produce wealth and create jobs by becoming partners with the health system in realizing the vision. The time is right to pursue the redevelopment of our health information system.

SUMMARY OF RECOMMENDATIONS
  1. That a population health baseline, be updated annually and maintained on an ongoing basis.
  2. That the government promote historical, descriptive and experimental research.
  3. That a mechanism be established to create linkages between the health information system and other sectors.
  4. The Task Force endorses several initiatives currently underway with regard to strengthening quality information, such as: a qualifications survey of health record technicians/mgtistrators; a Clinical Issues Committee tasked with standardizing clinical coding practices in hospitals; and a province-wide reabstraction study attempting to measure the extent of variation in clinical coding practices in provincial health facilities.
  5. That initiatives be undertaken to identify and develop the elements of a person-oriented information system and that these initiatives include broad representation of stakeholders.
  6. Given the emergence of person-oriented information as a national issue, it is recommended that a formal liaison mechanism be established with the Canadian Institute for Health Information (CIHI) to facilitate collaboration on standardization in the development of person-oriented information.
  7. That the Province create a Provincial Health Number to uniquely identify each person, to be implemented as per the Report on a Unique Lifetime Identifier for Newfoundland & Labrador - An Analysis of Options and Implementation Strategies. The new card will be called the ‘Newfoundland & Labrador Health Card’ and will be in place by August 1996.
  8. That the use of the new health card be a requirement for all provincial residents for to all health care interventions and the Provincial Health Number be required on all documents related to health.
  9. That a central registry for maintaining the Provincial Health Number be established and be accessible twenty-four hours a day, seven days a week.
  10. That the Newfoundland Medical Care Commission and other agencies be encouraged to use the new unique identifier.
  11. That forums and community meetings be held to encourage input, obtain advice and provide information for those affected by the proposed changes.
  12. That the health information system be designed with standard definitions developed using a consensus building strategy.
  13. That in addition to the MIS Guidelines, other national information system standards be implemented throughout the provincial health system, as appropriate.
  14. That the Report of the Focus Group on Human Resource Management Information Systems be used as the conceptual basis to develop data requirements for a comprehensive Health Human Resource Management Information System to be implemented across the health system by January 1997.
  15. That the recommendations of the Ad Hoc Committee on Standard Residence Codes be implemented.
  16. That an Information Technology Plan be developed as part of a larger Health Information System Strategic Plan and be based on the concepts of open systems architecture and the distributed information database.
  17. That the memorandum of understanding between the health system and the information technology community in Newfoundland & Labrador, and any subsequent follow-up agreements, be supported by all stakeholders.
  18. That provincial standards be developed and maintained regarding collection, retention, security, confidentiality, access and dissemination of information. Established standards at the national and provincial levels be used to guide development of these standards (e.g., professional codes of ethics, CHRA position statements, and CIHI policies), especially where client and employee information are involved. In particular, the issues of confidentiality and data ownership must be addressed to safeguard the client’s health information while, at the same time, providing access to information necessary for research and mgtistrative purposes.
  19. That provincial standards be established and maintained to document and measure outcomes of health interventions in a consistent manner to support appropriate analysis and evaluation across the continuum.
  20. That provincial guidelines be established defining what information may be accessed for research and by whom. These guidelines should clearly identify how information may be used while protecting the individual’s right to privacy.
  21. That a comprehensive education strategy for all users be developed, targeting the public and health professionals, with the objectives of raising awareness of the importance of quality health information and educating users on how to use the health information system.
  22. That personnel whose primary responsibility is with information (e.g., health records, information technology) be appropriately trained and certified.
  23. That a comprehensive human and financial resource plan be developed that identifies the required resources as well as strategies for obtaining same in a manner that is acceptable to health system stakeholders. Such a plan must include a consideration of existing services already being provided by agencies/organizations.
  24. That health informatics be identified as a priority strategy for the Provincial Economic Recovery Plan.
  25. That a Newfoundland & Labrador Centre for Health Information (NLCHI) be established and governed by representation from major stakeholders to oversee the continuation of the Health System Information Task Force’s work. The Centre will be accountable to the Minister of Health with its own governance structure (refer to Appendix F for detailed terms of reference).
  26. That the NLCHI develop an Information System Strategic Plan, based on the province’s Strategic Health Plan, incorporating the strategic directions identified by the Health System Information Task Force.

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