The issue is that we have a complex health care system with provincial and federal partners in everything that we do. Historically, the provinces received health care dollars, most of which they use for providing health care. The information collection that is done is done very variably. Some institutions do it themselves. Some provinces have registries, and many don't. Smaller provinces don't have registries at all. Larger provinces, for instance Ontario, have core health, so they have a registry.
But what they're measuring in Ontario is not the same as what they're registering in British Columbia with Cardiac Services BC versus what they're measuring in Nova Scotia, which is only three different, small quality indicators. Many provinces don't have a registry. We have CIHI. They measure administrative data, but up until we started working with them with medical expert stakeholders, they were providing administrative data like number of bed days, which is meaningless to doctors.
What we want to know is our death rate, our complication rate. I need to be able to compare what I'm doing in Nova Scotia to what's happening in Saskatchewan or Ontario, because I may think I'm doing a fabulous job. Maybe my length of stay is four days for treating a heart attack patient. I think that's good, but I might find out that in Ontario they can have people home in two days, and when I see that, I wonder what Ontario is doing differently. Right now we don't have a pan-Canadian process.
We did it with our demonstration report in one small area on transcatheter aortic valve replacement, which is a very expensive new innovation. We had 100% participation from all institutions across the entire country, including Quebec. We did a demonstration report with that in 2016. Just getting the data back to the operators led to immediate changes in practice when they saw their own data compared to others, and it helped inform how they built their new programs in Saskatchewan and other places.
The difference is providing stakeholders, medical experts who are engaged into collecting what's really important to us, pulling together what's already been done, adding what's missing, and then giving the toolkits back to the operators—the doctors, the practitioners—not just publishing in some Excel spreadsheet someplace. We have our annual congress where all the cardiovascular specialists come together. We have workshops where we show the data for the whole country and show them how they're doing it differently. From that we can start to build best practices and share them.