Thank you, Madam Chair. We thank you for this opportunity to present the results of our audit on Canada Health Infoway Inc., which were included in our November 2009 report. As you mentioned, I'm accompanied today by Neil Maxwell, assistant auditor general, and Louise Dubé, principal, who were responsible for this audit.
Infoway was created in 2001 as a not-for-profit corporation at arm's length from the government. It describes its role as that of a strategic investor that works with the provinces and territories to foster and accelerate the development and adoption of electronic health records, EHRs, across Canada.
Electronic health records are intended to offer solutions to a number of persistent problems in Canada's health system, some of which can be attributed to the use of paper-based health records. With EHRs, it is expected that health care professionals would be better able to share patient information.
It is anticipated that this could result in reduced costs, improved quality of care, and lives saved. As of 31 March 2009, Infoway had spent close to $615 million and had committed another $615 million on electronic health records, for a total of $1.2 billion.
But it is still in its early days. Some experts have estimated the total cost of implementing EHRs Canada-wide at over $10 billion. We examined how Infoway manages the funds from the federal government to achieve its goal of making compatible electronic health records available across Canada.
Concurrent with our audit, six provincial audit offices audited how electronic health records funded by Infoway and/or provincial governments are being implemented in their respective provinces. The provincial audit offices are each reporting separately and we will table a summary of the federal and provincial audits next spring.
Overall, we found that Infoway has accomplished a lot since its inception and that it manages well the $1.2 billion in funds granted by the federal government to achieve its goal. There is good oversight of the corporation by the board of directors and Health Canada, the sponsoring department. Infoway has set the national direction for the implementation of electronic health records by developing an approach, as well as the key requirements and components of an electronic health record. It developed a blueprint, or architecture, for the design of the systems, and it developed strategic plans and a risk management strategy. Infoway worked collaboratively with, and obtained buy-in from, its partners and stakeholders, which is critical to the success of the initiative.
We also found that Infoway approves projects, which it cost shares with the provinces and territories, that are designed to comply with standards and align with the blueprint. We noted that Infoway adequately monitors the implementation of projects by provinces and territories.
We reported that Infoway needs to improve in certain areas. Infoway's 2010 goal is for 50% of Canadians to have electronic health records available to their health care professionals. We found that Infoway needs to report more information on results, in particular information on progress achieved toward its 2010 goal. To date, it only reports if systems are completed, not whether the systems are actually being used by health care professionals or whether completed systems meet the requirements for compatibility. This information on systems usage and compatibility would help Parliament and Canadians better understand progress to date.
We also found that Infoway approves projects, which it cost shares with the provinces and territories, that are designed to comply with standards and align with the Blueprint. We noted that Infoway adequately monitors the implementation of projects by provinces and territories. We noted that Infoway's controls over executive pay, travel, and hospitality are basically sound, although it could improve its contracting policy. Infoway has made a significant contribution to the development and implementation of EHRs, but important challenges remain. Reaching the goal of 50% of Canadians having an EHR available to their health care professionals by 2010 will be very challenging because they are only at 17% now.
Other challenges include upgrading legacy systems to ensure compatibility, ensuring that electronic medical records are used by primary care doctors, ensuring the compatibility of systems designed to allow patients direct access and control over their personal health information, and ensuring the privacy and security of personal health information. These challenges also need to be addressed by the provinces and territories.
Madam Chair, we are pleased that Infoway agreed with our recommendations and that it is developing an action plan. It has committed to clarifying its goal, to reporting additional information on progress achieved, and to revising its contracting policy. Because significant funds are spent on this initiative to implement electronic health records across Canada, and because the potential benefits offered by electronic health records are important to Canadians, this committee may wish to devote continued attention to the initiative by following up on progress achieved against the goal and against Infoway's action plan.
Madam Chair, this concludes my opening statement. My colleagues and I would be pleased to answer any questions that committee members may have.