Good morning, everyone.
Thank you for the opportunity to appear before you today with my colleagues from Health Canada and Canada Health Infoway on the important topic of breast implant safety in Canada.
My organization, the Canadian Institute for Health Information, or CIHI, is an independent, not-for-profit organization created by provinces, territories and the federal government almost 30 years ago. Our core mandate is to deliver comparable and actionable information to accelerate improvements in health care, health system performance and population health in Canada.
We have over 30 data holdings, and our collection of personal health information is limited to the purposes of our mandate, which is around health system performance measurement and reporting.
Some examples of our work include reporting on wait times for priority surgeries, annual health spending in Canada, health workforce information and the impact of COVID-19 on health systems across the country. Ultimately, we work to provide information to help improve health care systems and the health of Canadians.
To the subject of today, first and foremost, CIHI recognizes the importance of breast implant safety for Canadians, and we hope our experience in managing a medical device registry can help inform this discussion.
CIHI manages several clinical registries, including the Canadian joint replacement registry for hip and knee joint replacements, with over 137,000 surgeries performed every year across Canada. The registry collects information on devices such as artificial hips and knees that were implanted in each patient.
The registry was established in 2001 from a collaboration between CIHI and the Canadian Orthopaedic Association. It started out with voluntary participation from orthopaedic surgeons and evolved over time as several provinces mandated the submission of data directly from health facilities.
Of note, this joint replacement registry is not a safety recall registry. CIHI as an organization is not set up or provided with the mandate to perform such care-related functions. The goal of our joint replacement registry is to support evaluation of the costs and outcomes of the medical devices and to inform clinical best practices and service delivery for these surgeries.
From our experience in managing several registries at CIHI, we think there are several key considerations in establishing a new breast implant registry.
Number one, it would be very important to establish clear objectives and intended purposes for the registry. Tracking and tracing implants to facilitate safety recall notices versus measuring health service activities and outcomes are two very distinct objectives, with very different implementation pathways and considerations.
Number two, understanding how data can flow from private surgeons' offices all the way to patient notification is also important. We know that about 85% of breast implant procedures in Canada are performed in private settings. The willingness from both the providers and the patients to participate in this registry would be necessary for it to be effective in achieving its traceability goals. Also, data collection and flows from private clinics do not readily exist today in Canada and will require substantial foundational work to explore a legislative framework and the infrastructure required.
With that, I thank the committee for the interest in CIHI and for the opportunity to be here today. I'll be happy to answer your questions.
Thank you.