Evidence of meeting #29 for Health in the 45th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was infoway.
A recording is available from Parliament.
Director General, Health Care Strategies Directorate, Department of Health
In 2001, it was their goal to enable electronic health records. There were no standards at the time, and now their goal is interoperability.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Thank you.
When did self-sustainability become a goal of the PrescribeIT program?
Director General, Health Care Strategies Directorate, Department of Health
It has been from the outset.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Ms. Voisin, you described a vision. It was a national vision. Health care is complicated. Every province and territory has its own needs in different regions.
Would you say, at this point, that the vision is impossible?
Senior Assistant Deputy Minister, Health Policy Branch, Department of Health
I would say that we had very good results in the early days of PrescribeIT. There was a lot of enrolment among pharmacies and physicians. It wasn't until later that we saw how adoption rates, based on that enrolment, were not meeting expectations.
The provinces and territories are very engaged. As we noted, there are several of them on the Infoway board of directors. They are engaged through the conference of deputy ministers and the FPT health ministers' discussions. They also have evolving health systems and evolving ways they're deploying health information in their health systems.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
A grand national project was undertaken, and it wasn't possible. You're not able to tell me that somebody could have done something different to make it possible. It wasn't possible in 2017 for this project to succeed and be self-sustainable. It is not possible today, hence the pivot.
Senior Assistant Deputy Minister, Health Policy Branch, Department of Health
I think we learned from this. We set the foundation for e-prescribing in Canada. Canada Health Infoway proved that the technology is possible and does exist, and it set the foundation for e-prescribing use.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
This is my last question: You said that some period of time was taken for users to transition. Dr. Bolzon is a family doctor in St. Thomas, Ontario. He's been on the CBC saying that he has not been transitioned. A friend of mine in Kawartha Lakes is a family doctor. He says that he has no idea what is going to happen with his prescriptions a month from now.
Are you aware of this? The users—the physicians—don't feel they've transitioned in any way.
Senior Assistant Deputy Minister, Health Policy Branch, Department of Health
Canada Health Infoway is working with the provinces and territories to support the transition.
Conservative
Matt Strauss Conservative Kitchener South—Hespeler, ON
Thank you.
I'd like to give my remaining time to Mr. Mazier.
Conservative
Dan Mazier Conservative Riding Mountain, MB
Thank you.
With that, I would like to present a motion.
It's in light of what we found out here today. There are still lots of unanswered questions. This is a list of what we seek for documents.
I move:
That the committee order the production of the following documents, unredacted, for the period from 2016 to the present:
a. Contribution agreements concluded with Canada Health Infoway relating to PrescribeIT.
b. A record of intellectual property developed under PrescribeIT, including the entity that holds the rights and the general terms of use, licensing or transfer.
c. Annual adoption data, broken down by province.
d. The total revenue generated from the $0.20 per-prescription fee.
e. Viability analyses and program evaluations.
f. Documents that led to the decision to terminate the program, including recommendations and analyses provided to Health Canada and to the Minister, where applicable.
g. A list of the principal vendors involved in the program, including the amounts paid to each.
h. Documents and analyses related to the cost of terminating the program, including contractual obligations, penalties, and transition costs.
That these documents be provided by Health Canada and Canada Health Infoway, in accordance with their respective responsibilities, and deposited with the Clerk of the Committee within one week of adoption of this motion.
That any redactions be limited to commercially confidential information and that a summary of redacted content and the reasons for such redactions be provided.
Liberal
The Chair Liberal Hedy Fry
We now have a motion on the floor.
Is there discussion on the motion?
Go ahead, Ms. Sidhu.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Madam Chair, can we suspend to discuss? We want to discuss it.
Liberal
The Chair Liberal Hedy Fry
I'm going to resume the meeting.
We have a motion on the table. Is there discussion?
Go ahead, Mr. Eyolfson.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Thank you, Chair.
We reviewed it. This is a long, wordy motion. We believe there are elements in it that we can support, but to give unanimous consent at this point, without more time to review it in detail....
We are wondering if we can have consent to move this motion to Thursday and discuss it fully on Thursday, once we've had time, because this has just landed on our desks. To ask us to give unanimous consent on a motion that has just appeared in front of us is a very difficult proposition. We want to make sure we're making a responsible decision.
Liberal
The Chair Liberal Hedy Fry
Obviously, I don't have to ask for unanimous consent. You don't have it, Mr. Mazier.
Is there anyone else to speak on this? Is there a response?
Do the Liberals have the time they're asking for?
Yes, go ahead, Maxime.
Bloc
Maxime Blanchette-Joncas Bloc Rimouski—La Matapédia, QC
Madam Chair, I think that the situation is fairly straightforward. Do they want transparency regarding a failure that cost $250 million, or do they just want to buy time to put things off? It's as simple as that.
We don't have answers to our questions. We have evaluations, and we're asking for written answers. If the government had been transparent from the start, we wouldn't be in this position today.
That's why we're moving this motion today. We just want to get to the bottom of where taxpayers' money is going. That's all.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Thank you, Chair.
Thank you, Mr. Blanchette-Joncas.
The point is very well taken, and wanting this information is very reasonable.
This is a long, complex motion. There is a lot to review. We want to make sure that we make a responsible decision. We might have amendments, on further reflection, that are acceptable to all parties. It would be irresponsible, with committee time and with committee business, to make a premature decision on something that I think we all agree is very important. We all want to make good decisions, the right decisions, in this place. This is why I'm asking to move it to Thursday.
If you see what we're trying to accomplish and what we're transitioning to, we can go forward with a better review of this. We're talking about the interoperability of health systems, how we can improve it and what lessons we can learn from the past. This is about how we can take the information, apply it to our deliberations on this bill and decide if we will take it at its face value, or if we will suggest amendments that the opposition may find acceptable. It's the responsibility of this committee to make the right decisions.
We're dealing with issues of medical technology and medical information. It ultimately comes down to patient safety. We owe patients safety, accuracy and efficiency. We want the efficiency of not repeating the same mistakes.
We know there are problems with medical record-keeping, as we have a myriad of systems. I've worked in some regions in which, within one city, there were different medical record systems. The hospital I recently worked in, within the last year, still has its own paper charts on the floor. We're not quite there yet. We need a lot more development and a lot more time, if we're going to make the right decisions. It is in the best interests of all Canadians, for their safety, that we make the right decisions in all motions regarding this.
Canada is failing in the interoperability of medical records, medical record-keeping and the transfer of information, and we need to improve. PrescribeIT helped illustrate a lot of gaps in our system. It showed that there are unique provincial systems, and they have their own reasons for thinking this is how it should be done there.
We have medical practitioners in different environments, and we don't know how much they were consulted in this. We will not have progress unless we make sure that all facts are properly reviewed, and we can then make those decisions properly and safely.
We talked about using fax machines in 2026. I did my last clinical shift in October. We were still faxing handwritten requisitions to the X-ray department. This is still how we order X-rays. It's not a minor inconvenience; it's a structural failure in our medical technology system. This goes back to the reason for making the correct decisions in all issues with this, including these motions.
From the testimony on this, we know things were done without enough consultation. A lot of health care providers obviously weren't asked the right questions, and decisions were made without enough information, which speaks to this motion.
If we are being asked to make the decision on this, having just seen it, and to accept it at face value without a fulsome review, then we are compounding the mistakes we have made before and we are no further ahead.
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
I'll thank the member not to interrupt me while I have the floor.
Conservative
Liberal
Doug Eyolfson Liberal Winnipeg West, MB
Madam Chair, Mr. Mazier is interrupting and he needs to stop.