Evidence of meeting #7 for Public Safety and National Security in the 40th Parliament, 3rd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was system.
A recording is available from Parliament.
Conservative
Conservative
The Chair Conservative Garry Breitkreuz
Shall we suspend for half an hour, then? Will there be no presentation?
Bloc
Maria Mourani Bloc Ahuntsic, QC
Since it is not in both official languages, I suggest that the witness make the presentation by simply looking at his laptop rather than using the projector. We will be able to understand what he is saying.
Conservative
Bruce Penner General Manager, Canadian Operations, Momentum Healthware
I do understand the request, and I came prepared to deal with this presentation in that way, if that's the wish of the committee.
Conservative
The Chair Conservative Garry Breitkreuz
Okay. Everything you say will be translated.
Go ahead. We have a very short time here, so go ahead.
Conservative
The Chair Conservative Garry Breitkreuz
The order for questions in this round will be first to you, Mr. Holland, and then the Conservatives and then the Bloc. The NDP won't get a turn this time.
Go ahead, Mr. Penner.
General Manager, Canadian Operations, Momentum Healthware
I'll try to be efficient with my comments, but I would be remiss if I didn't begin by saying thank you to this committee for the privilege of coming to Ottawa from Manitoba to address my government.
You have had just a brief moment to see an untranslated picture of my family, and you would have seen that four of our children are Ethiopian, first-generation Canadians, and they're very proud of this country and the privilege that I have today to serve in some small way.
The reason I'm here today--and that brings me to my second thank you--is that Shelly Glover was in our offices a few weeks ago to present to Momentum Healthware a certificate recognizing Momentum Healthware as an innovation leader in Canada. That certificate also came with the recognition that you, our government, have invested in Momentum Healthware over the last number of years. Most recently you have spent $111,000 of National Research Council money to invest in the development of a mental health module for Momentum Healthware's health IT solution. That was recognized at a press conference. I want to thank you for that investment in our research and development and I want to give you at least some feedback on the effectiveness of that investment. We are now already moving into the pilot stage in Manitoba with our community mental health module. We've had expressions of interest from a number of other provinces, as well as New Zealand, for possible deployment of that module as well. So I think it speaks for itself that the National Research Council has invested well.
Canada is a country that has many jurisdictions in it. I recognize, as a health IT executive, that my job is in fact a very, very simple job compared to the role that you have and that the executives who sat in these chairs before me have, in terms of forming policy and respecting the incredibly complementary but sometimes conflicting values that come from the different jurisdictions we are made up of. As an IT solution provider, I have often found in my experience in the health IT sector that as I come into different sectors of health care--Momentum Healthware's solutions span long-term care, home care, community care, community mental health, palliative care--in each of these sectors of care and each of these forums of care, the health care providers use a different language to describe their activities. They use different processes to provide care to their clients. One of the things that we've done with the software solutions is we've really focused on trying to abstract that or reduce that down to what things are common across the different health care sectors, and create a solution that is highly translatable. It's translatable among sectors of health care and it's also translatable among different languages in order to be able to provide a single repository for health information to the multiple health care providers.
As a citizen of Canada, it's something I'm very conscious of. At the same time, I'm also a citizen of Manitoba. In my early years as a child growing up, I was educated on the God's River First Nation, so I also have both an allegiance and interest in the first nations communities of Canada. Each of those communities will treat me as a stakeholder to some extent. The work that you're doing with Corrections Canada also deals with, again, those same citizens. For them, you also represent an important stakeholder in their health care.
What we try to do with the software solutions that we've developed--and I want to really treat this as general information available to you--is really highlight the fact that information technology is a determinant of health care. There are so many different things that you have the opportunity to review as determinants of health care, and I would submit to you that this information is perhaps one of the greatest determinants of health care.
If you were to ask health care providers in any sector of care whether they would appreciate or benefit from or whether the care of their clients would benefit from the knowledge of the other health care providers in the continuum of care, whether they are federal or provincial or whether they work for an aboriginal healing centre or within a correctional facility or a parole centre, every health care provider would understand that the care they provide would be better, more informed, and more effective if they were able to have access to the information that was provided by the other health care providers who are caring for that same client.
I'm reminded of an Indian fable--and in this case I mean Indian as in India--a story about six blind men who discover an elephant and seek to define it. One of them defines it as being very much like a tree because he has come across the leg of the elephant. One of them describes it as being very much like a wall because he has come across the side of the elephant. One of them describes it as a spear because he has a tusk in his hand. One of them describes it as a rope because he has encountered the tail. They then get into heated debates about what exactly an elephant is. Is it more like a spear or more like a tree? None of them is capable of seeing the whole elephant, and it blunts their ability to have an effective discussion about elephants.
I want to offer my services to you this afternoon to inform your discussion about how health information technology could serve to bridge the gap between federal correctional institutions and community mental health.
We have developed a software solution that has the capacity to model the health care delivery system in any form of care. I did go through the effort to develop some slides for you that demonstrate the ability to deliver care within a correctional facility. It's not necessary for the purposes of the discussion to simply understand that the same client can be seen in different forms of care and can be treated by different teams of providers. He or she can have selective information appropriately shared through the privacy and the security you define--or negotiate with the other health-care-providing constituents--to deliver the most effective care and to be able to most effectively understand what the elephant is that you're trying to understand in each individual case.
I'll limit my comments to that and make myself available to any questions.
Conservative
The Chair Conservative Garry Breitkreuz
Thank you very much.
We're in five-minute rounds now.
Mr. Kennedy.
Liberal
Gerard Kennedy Liberal Parkdale—High Park, ON
Thank you.
Mr. Penner, welcome.
I was born and raised in The Pas, Manitoba, so it's good to see a fellow Manitoban here.
I understand you're a health information services provider. Have you formed any opinions about the availability of information, the degree to which integration is available within federal corrections? You said you had some slides, but we didn't see them.
Some of the preceding witnesses were talking about aspects of the problem, and the specific thing we're looking at is addictions and mental health, to what degree there is knowledge of the problems, to what degree there is action about it, obviously what is effective and what isn't, specifically methadone and other drug treatments. There are also public safety concerns as well as individual concerns. I think there seem to be some missing pieces.
Have you been able to come to any understanding about what goes on in corrections in terms of the work you have done on your own software?
General Manager, Canadian Operations, Momentum Healthware
Certainly.
I was paying rapt attention to the previous witnesses and took some statistics from their conversation, like the statistic that 24% of the women in their particular form of care had significant mental health issues. I recognize that the 24% of that population are likely or ultimately going to be released back into the community or into residential care facilities within the community.
I certainly have done no assessment of the quality of information systems within the correctional system. In terms of my assessment, I am aware, again from the previous witnesses, that they have developed standardized assessments and are finding them to be very effective when women are being taken into the process. Obviously information technology is just a tool, but it is a great tool for taking standardized assessments, collecting information in a way that can easily be shared where appropriate, and then informing future decisions as you start to try to understand the impact of assessment, recovery planning, and outcomes.
I'm not well informed in the area of how much information technology has taken hold in the correction system. Anecdotally, it seems to be limited, but I haven't researched it.
Liberal
Gerard Kennedy Liberal Parkdale—High Park, ON
Okay.
There was a pledge in the 2008 budget of about $500 million to develop the Health Infoway, which I'm sure you're versed in and at least somewhat oriented to, whether provincially or nationally. That money has yet to flow, for a variety of reasons.
What can you tell us about the development within Manitoba? Because provincial health systems often make their own decisions independently of that federal funding. Is there an idea about what the plan looks like? Have you heard nationally how that fits with Manitoba's system? Again, I'm not trying to pigeonhole you just because you're from Manitoba, but it may be a health system you're more familiar with. Nonetheless, from whatever purview, what is that federal money going to be used for? How effective can it be? Can it help us with the problem we're looking at today? You touched on that in a general way.
In the private sector, in the community helping to develop these various potential solutions, what is the anticipation and knowledge of where that $500 million—a fair bit of money—needs to be, and when will it be available?
General Manager, Canadian Operations, Momentum Healthware
There are a few answers to that question. First, to the degree that I am conversant with where Manitoba is planning to target that funding, I do understand it has been targeted significantly to primary health care. I think there's a real sense that it has to be targeted in significant blocks of funding to deal with significant issues that need to be dealt with so that you're not spraying it all over the place.
There are two components to the Health Infoway funding block that are of potential specific interest to this topic. There's an innovation component and an interoperability component, both of which might well be tapped to enhance innovation and sponsor or fund the interoperability of health care systems between the different forms of care. I don't know to what extent Health Infoway funding is applicable to the Correctional Service of Canada, but that does seem like a very useful place to look at potentially fostering interoperability between systems.
Liberal
Gerard Kennedy Liberal Parkdale—High Park, ON
Do you have faith in the system coming together? Because outside observers have been working on health information systems for a long time, and we have this big delay with the $500 million. Can it come together? Do you have faith that there can be a system that has interoperability and really does enhance the existing system?
General Manager, Canadian Operations, Momentum Healthware
My sense is that Health Infoway is funding the big blocks of repositories and electronic health records, which can draw the national eHealth population health records together. What it has not done and what at this point I do not see it focusing on yet are some of the grassroots systems that will form the record of care delivery at the grassroots level. I think this primary care investment is a beginning in that direction.
Conservative
Shelly Glover Conservative Saint Boniface, MB
I want to welcome you here today, Mr. Penner. Thank you very much for taking part in these discussions. I was quite impressed with the presentation. I actually got to see the presentation, which brought to my mind what's been repeated in this study continually, and that is continuum of care.
To me it was significant to have been able to see the slides showing that not only can you capture, retain, and track the health treatments and the proposals that have been made by different health officials, and what's worked and hasn't worked, but also to have been able to see that we can track information from places like the correctional service, the police, and other inter-agencies that will be functioning in tandem because they care about the individual suffering from mental illness.
I believe in trying to find solutions to problems. We've heard a number of times here from witnesses that they're still using paper files. Of course, in corrections, it's very difficult to get a paper file from one jurisdiction to another or to track someone effectively and quickly. That's why I believe that electronic records are something that ought to be considered so we can quickly get that information, which might lead to our better serving someone who is suffering from mental illness.
We just heard one of the deputy commissioners indicate that they must do an assessment in the prison system, which can be time-consuming. In your system, I believe that will reduce the time taken, because you're going to have access to previous treatment, what did and didn't work, and the diagnosis, of course, which will obviously help them treat that person more quickly.
Am I assessing your program correctly?
