Making intelligent connections on the Iway [CMAJ

Making intelligent connections on the Iway

CMAJ 1998;158:862-3

New information technology has enormous potential for health care reform, but how can it be translated into action? The federal government has been grappling with this issue since 1993, when it created a not-for-profit corporation, the Canadian Network for the Advancement of Research, Industry and Education (CANARIE), to promote networking technologies by improving research and development and other capabilities (613 660-3634; www.canarie.ca). By 1999 it will have spent about $105 million in federal money and overseen the spending of another $300 million from private sources.

CANARIE has targeted the health sector as one of its priorities, and that should come as no surprise because CANARIE's board chair — and the chair of its Advisory Committee on Health Information Infrastructure — is Dr. Mamoru Watanabe, a former dean of medicine at the University of Calgary who currently chairs the CMA's Committee on Physician Resources. He was also a member of the National Forum on Health. He coauthored a recent report, Towards a Canadian Health Iway: Vision, Opportunities and Future Steps, which was written by representatives from CANARIE and 2 federal departments, including Health Canada. The authors wanted to articulate a vision of an integrated "national health Iway" or information highway. By promoting this vision, they hoped the report would also stimulate the next generation of products and applications to support a wide range of health-related services.

At the recent conference of the Canadian Association of Paediatric Hospitals, Watanabe explained that a "national health Iway" would be a "network of networks" created and used by communities and individuals across Canada that would respond to the health-information needs of the public and serve as an agent of change for the health system.

Watanabe insists that this high-tech network must be seen within the context of an evolving health care sector. "The health care system is increasingly preoccupied with health rather than disease, and it is moving away from its traditional emphasis on acute care to an approach that connects hospitals to long-term-care institutions, community care and home care, and across the full spectrum of health care providers."

A new health Iway has a vital role to play in this evolution because it will allow give people access to quality, easy-to-use information, primarily through Web sites. However, for the Iway to do this people like Watanabe must ensure that its content is valid and up-to-date, and Canadians must become technology literate.

In Ottawa there is every sign that the government recognizes the urgency of the issues and the up-front costs for payers and providers. The federal government also knows that the Iway can have a significant impact on the promotion of health-information technology and at the same time on the federal role in health care. Last year's budget included several initiatives supporting information systems. A $50 million Canada Health Information system was announced, as was a $150 million Health Transition Fund and a $850 million Canada Innovation Foundation to support the infrastructure requirements of universities and research hospitals.

Several funding opportunities are available for researchers working on health information technology projects, including CANARIE's Technology and Application Development Competition. "We simply have to make intelligent connections," said Watanabe.

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