Health Bulletins

Open letter to Ed Clark

October 7, 2016

Further to our discussions, I am writing to seek your expert advice based on your experience in valuing public and private assets with respect to Ontario's digital health strategy.

As you know, over the last eight years, Ontario's health care system partners have worked steadily to establish a connected health information network with leadership from eHealth Ontario. eHealth was established in 2008 with a mandate to facilitate the establishment and maintenance of electronic health records for all of Ontario's residents. While the agency has encountered some setbacks and challenges, significant progress toward this goal has been achieved. Nearly all residents of Ontario who have interacted with the health system now have health records that are electronic. Most family physicians in our province have electronic medical records in their practices. In addition, nearly all hospital-based diagnostic imaging is now digital and key lab results are now available through a provincial information system

These systems have generated significant value for Ontario. In its 2015-16 annual report, Canada Health Infoway – the federal/provincial body charged with overseeing the use of innovative digital health solutions to improve Canadians' health – estimated that since 2007, digital health systems have produced an estimated $16 billion in benefits nationally . It is acknowledged that Ontario's share of the national benefits is substantial. In fact, a report prepared by CHI looking specifically at Ontario health technology accomplishments shows that the province is leading the country in several key areas.

Today, I am writing to you as the Premier's Business Advisor and Chair of the Advisory Council on Government Assets to assess and validate the value these systems have created for Ontario and to recommend ways to take them to the next level. Specifically, I am asking you to consider advising the government on two key issues with support from experts in digital health, as appropriate. First, I would ask you to provide the government with a value assessment of Ontario's digital health assets and all related intellectual property and infrastructure. Secondly, please provide us with recommendations related to how to maximize the value of these assets for Ontarians by improving how care is delivered, the patient experience in interacting with the health care system and, indirectly, through the economic value that is created for Ontario's economy. To inform the valuation, I would ask that you engage an international expert in digital health, such as Dr. John Halamka. In addition, please seek advice from the Information and Privacy Commissioner's Office of Ontario to ensure the protection of personal health information in all recommendations.

I believe there is growing opportunity in moving to a digital health care system. Consistent with the government's Digital Government plan, as announced in the 2016 Budget, our focus is shifting from providers to patients. We already have the infrastructure in place to connect and equip physicians, hospitals and other health care providers. Now, we need to focus on patient and consumer-focused tools and services that enable direct access to health information and improved care, such as accessing an individual's own health records, booking physician appointments online, keeping track of medicines, renewing prescriptions electronically, accessing services and advice remotely, and more. This is the direction that will serve emerging public and patient needs.

As the mandate of eHealth Ontario nears expiry at the end of December 2017, I feel now is the opportunity to renew our vision for digital health as part of our work to transform our health-care system into one that is truly patient-centred. Shortly, my ministry will be consulting with patients, health stakeholders and digital health experts about a new digital health strategy. But the full extent and value of our existing digital health assets must be fully understood if we are to move forward with a new vision.

I want to be absolutely clear that in the course of your work on digital health and your resulting recommendation(s), the protection of personal health information is paramount. Enormous energy, resources and intellectual effort have been dedicated to ensuring the integrity and privacy of people's personal health information. The purpose of this work is to better understand the value of our digital assets to help guide, in combination with the advice of other experts, Ontario's future digital health strategy.

I hope you will accept my request to lead this work, and would welcome your advice before the end of December 2016 so that we can assess this information in advance of the final year of the agency's current mandate.

Signed,
Dr. Eric Hoskins
Minister of Health and Long-Term Care

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