Evidence of meeting #18 for Public Accounts in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was infoway.
A recording is available from Parliament.
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
I will continue in the same vein.
What measures have you implemented to follow other performance indicators? Aside from indicators on buy-in among professionals, what measures have you implemented to ensure the system is compatible from one province to the next?
Are you monitoring progress on this point?
President and Chief Executive Officer, Canada Health Infoway
Actually, that's a twofold question. The first answer is that in the new reporting, we are going to be reporting not only aspects of availability, but also aspects of adoption. In the report that's coming out, I don't believe we will be reporting on use, mainly because I'm not competent in those numbers and won't publish any data until I get some confidence in the numbers that have been given to me by—
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
In fact, I would like to know whether the systems that have been developed by the provinces and territories, the 14 jurisdictions, will be compatible?
Have they used the same development standards? Who determines these standards?
President and Chief Executive Officer, Canada Health Infoway
That's actually the second part of the question I was getting to. A core business of Infoway is standards development around an architecture and a blueprint. It's very simple in our world. If we're going to fund a project, you have to use the standards. If you don't use the standards, we won't fund the project. Even so, there are going to be some variances, because the business requirements change from jurisdiction to jurisdiction. That's number one.
Number two, there are some IT legacy systems that we haven't funded and that have old standards. As these come up for redevelopment, we will ensure that the new standards are adopted. Think about your experience as a patient. You go to your GP, to your emergency room, to clinics, or to labs. Typically, we don't do that from Toronto to Whistler; we do that in the area we live in. It's important to get those data operating around the traffic patterns of the individual. When I talk about adoption, if there's not interoperability between these systems, we wouldn't pay and they wouldn't get a take-up rate. Certainly, the aim of this is that when you travel from Toronto to Whistler or wherever, you should be able to access your record in a compatible way. Over time, I believe this will happen.
Meili Faille Bloc Vaudreuil—Soulanges, QC
I have a question on the various contracts. Enormous amounts have been granted. Various departments are now turning to fairness monitors for the awarding of contracts and the purchase of technology.
Do you have an individual who is designated to ensure fairness during the procurement process? Has the report been drawn up? Have opposing views been expressed regarding your extending contracts as you have done?
President and Chief Executive Officer, Canada Health Infoway
I'll answer the second part of the question first. The answer is no, there have been no objections. We've never had any contract disputes.
As to the first part of your question, no, we do not have a fairness commissioner for contracts. We do have a board. We have board procedures. If I'm out of bounds on board procedures, I have to go to the board and express that to them. We have a rigid procurement regime based on board policies, which we are bound to follow. We have a variety of audits every year, from compliance audits based on the funding agreement to financial audits that look at a variety of these things.
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
That said, you have received nothing. You have not heard any opposite views, from consultants or in studies which you may have conducted internally, suggesting that you should not proceed in the way in that you did. Did Treasury Board Secretariat support your way of doing things?
President and Chief Executive Officer, Canada Health Infoway
To my knowledge, we haven't received any....
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
I will give you some time to check, and you can send us some information in writing if you want.
President and Chief Executive Officer, Canada Health Infoway
I have definite information that when vendors don't win contracts, they're somewhat disappointed.
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
This has nothing to do with suppliers. I want to know whether, internally, when you made the decision to proceed in this way for procurement, you received contrary advice. Did you seek advice to find out whether proceeding in this way held any risks?
President and Chief Executive Officer, Canada Health Infoway
The answer to both of those questions is no, we didn't receive any contrary or contentious arguments. This was brought to our attention, and we have amended those procedures now to make sure, right up front, we're transparent in saying that these contracts could get renewed.
Bloc
Meili Faille Bloc Vaudreuil—Soulanges, QC
On page 5 of the Auditor General's report, the eligibility criteria for projects are discussed, as well as the established architecture, the total funding granted for the Infoway, which is definitively determined when projects are approved. We also hear that the provinces and the territories must assume all risks of cost overruns.
Ms. Fraser, as far as I understand, the provinces are dependent on the federal government. For some time now, the Auditor General of Quebec has been pursuing a development project that is called the Dossier de santé du Québec. Have you had an opportunity to get acquainted with the report of the Auditor General?
Curiously enough, he is interested in the same matters as you are, at this time. He's criticizing the fact that the system is far from yielding the expected results. Have you any suggestions or expectations regarding the Infoway, so as to ensure a certain degree of leadership or so as to review, together with the provinces, the monitoring of various projects? We can see that the projects have been approved, but for some reason or other, the risks have not been correctly assessed.
Auditor General of Canada, Office of the Auditor General of Canada
Mr. Chair, I think it is important to clarify the fact that the responsibility belongs to the provinces. The provinces submit certain projects to the Infoway, but these are not entire projects. The Infoway participates in funding certain projects, based on certain admissible costs. On the other hand, the planning, the follow-up and the rest are really the responsibility of the provinces.
In the report that we prepared with some of our provincial colleagues, we noted in several cases that strategic planning was not done properly and that planning as a whole was defective. Telling the provinces what to do is not really the Infoway's responsibility. Of course, the Infoway can help us to establish certain strategies, such as the program's architecture. Nevertheless, the responsibility belongs to the provinces.
Bloc
NDP
David Christopherson NDP Hamilton Centre, ON
Thank you very much, Mr. Chair.
Thank you all for your attendance today.
I have to say, Mr. Alvarez, I agree with Mr. Dion that this is a pretty good audit, as they go. You made a big statement in your closing remarks, so I just want to put that to the test. I do think it's a pretty good audit, but you went on to say:
We believe that we have responded to the recommendations in a timely, efficient and effective manner and have addressed the issues and concerns raised in the OAG's audit report.
Would you stand by that statement, Auditor General?
Auditor General of Canada, Office of the Auditor General of Canada
We looked at the action plan that Infoway had prepared to address the recommendations, and we were satisfied that, if implemented, it would address our recommendations. We have not gone back to do a follow-up audit to see how it was implemented, but we were satisfied with the action plan.
Auditor General of Canada, Office of the Auditor General of Canada
Well, the second audit will be the test.
NDP
David Christopherson NDP Hamilton Centre, ON
You have to watch for the pauses in between. But that's okay. Around here, living for one day at a time is a win.
I was curious that you have what you call a “gated funding model”, which means that as certain compliance standards or objectives are met, that triggers the money to be released.
I'm taking note of what the Auditor General just said about it not being the job of Infoway to tell provinces what to do. But I'm trying to understand the difference between the provinces being allowed to do what they think is appropriate, versus your monitoring what they're doing and only funding when they hit certain trigger points. I'm curious as to how a strategic plan wouldn't be a major point that had to be reached before you would free up any money.
Can you help me understand that a bit, please?
President and Chief Executive Officer, Canada Health Infoway
Sure, and thank you for that question.
Basically, we put in place a safeguard mechanism: if there is no take-up or the take-up from clinicians is taking a while, then we hold back that money until they meet that goal. So we have a gated funding approach.
If provinces delay their project, it's going to cost more. But guess what? With our agreement with them, with federal funds, we limit what we're going to pay. Once we sign that deal and they want to take as long as they can, it's on their coin, not on ours.
With all of that said, if they fail, we fail. So we go over and beyond that by trying to put to them from time to time other options and other plans. In fact, if you see the auditor's report in Quebec that came out the other day, it basically said that Infoway put plans to the government in terms of how it can move forward; the government at this stage hasn't moved on those plans. But clearly it's a failure for us to sit here with federal funds and not be able to execute on them, because those projects are taking so long. At the same time, we don't want to waste those moneys if in fact we're not getting results.
NDP
David Christopherson NDP Hamilton Centre, ON
No, I understand, but I'm sorry, I still didn't hear a clear answer to my question. And I accept it could be just me, that maybe I didn't get it.
Again, you only give money once they've achieved certain things. I'm just curious as to how they could continue to get funding when they haven't done something like a strategic plan, which is so important and needs to be up front in the process. There are some jurisdictions that haven't.
I'm probably not using the right terminology, but there's a checklist of things they have to do. Is a strategic plan not one of them?
President and Chief Executive Officer, Canada Health Infoway
I wouldn't go as far as saying a strategic plan.... We basically fund project by project. Each of the projects is subject to a contractual arrangement, and the contractual arrangement is worked on a statement of work. A statement of work basically has the milestones and the checkpoints as to what the deliverables are supposed to be.
Now, is it a strategic plan for the entire province? No, it isn't. It's a strategic plan for that set of priorities and that particular contract, and that's what we basically monitor to.
