U.S.-Canadian Healthcare Conversations and Our Shared Missions: On to Vancouver!

Sept. 16, 2015
At this week’s Health IT Summit in Vancouver, expect complex, nuanced discussions of the common challenges facing U.S. and Canadian healthcare leaders in a time of accelerating change—and demands on providers

In the run-up to the Health IT Summit in Vancouver, being held later this week at the Rosewood Hotel Georgia in downtown Vancouver, I’ve been having delightful conversations with some of the panelists who will be participating in discussions that I’ll be moderating. What’s fantastic is to continue to have “cross-border” discussions with Canadian healthcare colleagues in particular, as we discuss some of the differences and some of the commonalities around the challenge of the emerging healthcare in both Canada and the United States.

Of course, whole books have, appropriately, been written about differences between the healthcare systems of the United States and Canada, and at the Health IT Summit, sessions will stay away from broad, sweeping generalizations and the abstract, academic splitting of hairs. Instead, a wide selection of sessions will address such crucial topics as “Transforming Healthcare Outcomes and Delivery with Data & Analytics,” “Improving Quality & Patient Safety with EHRs,” “Securing the 21st Century Data Repository—Best Practices for Solidifying Defensive Measures,” and “Transforming Care Delivery with Telehealth & mHealth.”

What’s fascinating is how the commonalities and differences between the policy and operational landscapes of the two countries’ health systems

As Christina Von Schindler, chief privacy officer of the Winnipeg Regional Health Authority, noted in an interview with me, she leads a team of specialists who protect the privacy of patient information across a broad swath of a huge, sparsely populated Canadian province. Indeed, the Winnipeg Regional Health Authority serves residents of the city of Winnipeg as well as the northern community of Churchill, and the rural municipalities of East and West St. Paul, representing a total population of over 700,000. The Region also provides health-care support and specialty referral services to nearly half a million Manitobans who live beyond these boundaries, as well as residents of northwestern Ontario and Nunavut, who often require the services and expertise available within the Region. And though the vastness of Manitoba’s rural spaces and the fact of the Winnipeg Regional Health Authority’s data security governance over most of a province, are different from what might be the case in the U.S., Von Schindler herself sees similarities. On the one hand, she says, “My role is to write policy and procedure that govern those activities for our 28,000 employees with regards to privacy as well as to provide advisement when needed. And that can be quite complicated for an organization as vast as ours.”

On the other hand, she opines, “The challenges we face are very similar to those in the U.S. It’s always a balance between ensuring that there is real-time availability of accurate health information to the persons providing patient care, while preventing breaches, whether intentional or inadvertent. It’s always a balancing act in that regard.”

So even though the levels of governmental control and oversight are located at different levels of the Canadian healthcare system, the core issues around patient privacy and data security are essentially the same, clearly; how and where the issues manifest are just somewhat different.

Another area of mixed similarities and differences has to do with how healthcare entities in the two countries are leveraging data to improve patient safety and outcomes quality.

Among those who will participate on a discussion panel I will lead on the topic, “Transforming Healthcare Outcomes and Delivery with Data & Analytics,” will be Alex Mair, director of health system use in the Emerging Technology Group at Canada Health Infoway. As Mair told me recently, he and his colleagues have been strategizing to invest in leading-edge analytics for the Canadian health system, including via investments in primary care initiatives that have extracted data from electronic health records and are being used to try to predict the incidence of diabetes, and predict the most effective treatments for that chronic illness. Again, the locus of activity is different from where it is in the United States, but the core tasks and strategies are similar.

Meanwhile, I am very much looking forward to conversing with Leanne Heppell, R.N., vice president of patience experience for acute programs and chief of professional practice at nursing, at the Vancouver-based Providence health system. Heppell will be one of the participants in our session, “Improving Quality and Patient Safety with EHRs.” As she told me recently, her team is helping leaders at three different but affiliated patient care organizations in British Columbia to work through processes that will allow for the standardization of clinical practices and the leveraging of technology for outcomes improvement. And, she noted to me, cultural change will be the biggest challenge in working through those processes. Again, some of the locus of activity is different in the Canadian context from the American one, but the underlying issues are far more universal.

I’ve had the privilege and the pleasure of writing about healthcare in a number of different countries, and it is always fascinating to look at what the “universals” are or might be, and to make comparisons between the differences in all the different national healthcare systems. What is particularly interesting right now is the fact that every national healthcare system in the developed world is reaching a similar inflection point around cost, quality, and value, as all of our societies are overwhelmed by the ever-accelerating costs of providing healthcare to vast populations, as national populations age, chronic illness explodes, and clinical technology makes a spectrum of patient care innovations more and more possible.

So the fact is that we all really can learn from one another. And healthcare leaders in the United States and Canada already know that there are enough similarities in their two healthcare systems in order for us to learn a great deal from cross-border discussions.

So I very much look forward to all the discussions we will be having later this week in Vancouver. There has never been a better time, in terms of the policy imperatives driving change, and the information technologies and other technologies available to healthcare leaders in both countries, to have in-depth, complex, nuanced discussions about the challenges facing all of us going forward, and the possible learnings we can share with one another across organizations and across whole healthcare systems. I look forward to seeing my colleagues in Vancouver later this week, and to engaging in the conversations that might help us all move forward together, on both sides of our peaceful border. On to Vancouver!

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