October 8, 1996
New Centre for Health Information
A new Centre for Health Information will bring various
existing health information systems together to establish an
integrated and comprehensive information technology (IT) system
for health and social services, Health Minister Lloyd Matthews
and Social Services Minister Joan Marie Aylward announced today.
The Newfoundland and Labrador Centre for Health Information
(NLCHI) follows final recommendations made by the Health System
Information Task Force; established jointly by government and the
Newfoundland and Labrador Health Care Association in 1993. The
NLCHI will implement other recommendations of the task force as
part of its mandate.
The new centre will be established within the Health Care
Corporation of St. John's, to be reviewed after two years. The
centre will have responsibility for coordinating, monitoring and
analysing data province-wide. "At the present time, various
information systems exist separately from one another," said
the minister. "Bringing these systems together will have a
positive impact on the future of health services in Newfoundland
and Labrador. Coordinating health information and databases will
assist government, health providers, consumers and special
interest groups in making more informed decisions about health
Mr. Matthews says the new centre is an essential step in
health reform initiatives, enabling government to identify where
health resources can most effectively be placed, based upon
timely, accurate and reliable information. "The data
collected will facilitate government's ability to make sound
financial decisions based on proven health outcomes, ensure
effective utilization of health services, and carry out sound
financial and human resource planning. This is important in this
province where we are challenged by our vast georgraphy and
population, especially at a time when we are striving to enhance
the quality of health services within our limited financial
The future vision for health information incorporates a person
centred approach, whereby each individual in the province is
assigned a code or number so that all medical procedures, doctor
visits and prescription medication can be accurately monitored.
Essentially, this means health providers will be in a better
position to meet individual health needs based upon that person's
health history. Drug interactions, allergies and other adverse
reactions, for example, can be minimized. As well, with this kind
of information available to health professionals on a provincial
basis, inappropriate use of the health system such as multiple
doctor visits and prescriptions can be signigicantly reduced. Mr.
Matthews said privacy and confidentiality will be assured in
creating a new, secure information system.
In addition to health data, the new information system will
incorporate statistics from the Department of Social Services.
Joan Marie Aylward, Social Services Minister says improving the
health of the population involves more than tracking hospital
data. "There is a link between the health of an individual
and that person's social, economic and educational background.
For example we know that income, employment, and social support
networks among others, are determinants of health. Incorporating
data related to these social conditions can help government gain
a better understanding of this link and set out a plan of action
that will prove beneficial to the people of the province."
Ms. Aylward said the new system will prove beneficial to her
department and to the overall operation of government. "It
is more efficient and sensible to collaborate with other
departments and agencies than to develop separate but similar
systems for a client base which has obvious overlapping,"
said the minister. "We will be looking at areas where
partnering will be beneficial to quality service delivery."
Ms. Aylward added that because the departments of Health and
Social Services serve many of the same clients, an integrated
approach will enhance policy development and program delivery.
She said that by eliminating the cost of two separate systems, it
will also allow government to better meet the increasing demand
Operational funding and human resources for the centre will be
achieved primarily through existing allocations from information
systems in health boards and other health and social agencies.
Mr. Matthews added the new centre would work closely with the
local information technology sector in the development of a
health information system for the province. "Public/private
partnering in this initiative is a positive step in enhancing
local industry in the province and ensuring Newfoundland
companies are key players in developing an information
system," said Mr. Matthews.
The next step in establishing the Centre for Health
Information will be to appoint a board of management to carry out
the mandate of the new centre. The board will have representation
from the following partners; the Department of Health, the
Newfoundland and Labrador Medical Association, the Association of
Registered Nurses of Newfoundland, the Medical School, MCP,
Regional Health Boards through the Newfoundland and Labrador
Health Care Association, the Department of Social Services, the
Department of Industry, Trade and Technology, Treasury Board,
other health and social agencies, consumers and the business
community. The board will be appointed by the Health Care
Corporation of St. John's.
Contact: Jill Sooley, Department of Health, (709) 729-1377 or
Glenn Bruce, Department of Social Services, (709) 729-4062.
THE NEWFOUNDLAND AND LABRADOR CENTRE FOR HEALTH INFORMATION
- 1993, the Health System Information Task Force was
established by the Department of Health, Treasury Board
and the Newfoundland and Labrador Health Care Association
(formerly Newfoundland Hospital and Nursing Home
- The Task Force was charged with developing a vision for
the future of a health information technology system in
- In 1995, the Task Force submitted the final report with
26 recommendations (list attached), including the
creation of a Newfoundland and Labrador Centre for Health
- The NLCHI will be mandated to carry out the other
recommendations of the Task Force.
- The NLCHI will be located in the offices of the Health
Care Corporation of St. John's. The Health Care
Corporation will oversee the new Centre.
- The NLCHI will also incorporate data related to the
Department of Social Services in recognition of the
determinants of health such as income, employment, social
- Operational funding and staffing of the new centre will
be realized through existing budgets. Health facilities
and agencies already have monies allocated for
information systems, some of which will be transferred to
the new Centre. It is estimated Government spends $9.4
million in information technology in the health system
(includes MCP, the Department of Health, the drug program
and the regional health boards). Staff from the
Department of Health will also be transferred to work in
- The new Centre will work closely with the local
information technology industry so that Newfoundland
companies are key players in developing a new health
- The next step in this process is for the Health Care
Corporation to appoint a Board of Management. Membership
will be from the Department of Health, the Newfoundland
and Labrador Medical Association, the Association of
Registered Nurses of Newfoundland, the Medical School, MCP, Regional Health Boards through the Newfoundland and
Labrador Health Care Association, the Department of
Social Services, the Department of Industry, Trade and
Technology, Treasury Board, other health and social
agencies, consumers and the business community.
- An approximate expenditure of $50 million in health
information systems is anticipated over the next several
- A review of the NLCHI will be carried out after two
RECOMMENDATIONS OF THE HEALTH SYSTEM
INFORMATION TASK FORCE
- That a population health baseline be updated annually and
maintained on an ongoing basis.
- That government promote historical, descriptive and
- That a mechanism be established to create linkages
between the health information system and other sectors.
- The Task Force endorses several initiatives currently
underway with regard to strengthening quality information
such as; a qualifications survey of health record
technicians/administrators; a Clinical Issues Committee
tasked with standardizing clinical coding practices in
hospitals; and a province-wide reabstraction study
attempting to measure the extent of variation in clinical
coding practices in provincial health facilities.
- That initiatives be undertaken to identify and develop
the elements of a person-oriented information system and
that these initiatives include broad representation of
- Given the emergence of person-oriented information as a
national issue, it is recommended that a formal liaison
mechanism be established with the Canadian Institute for
Health Information (CIHI) to facilitate collaboration on
standardization in the development of person-oriented
- That the province create a Provincial Health Number to
uniquely identify each person as per the Report on a
Unique Identifier for Newfoundland and Labrador - An
Analysis of Options and Implementation Strategies. The
new card will be called the Newfoundland and Labrador
- That the use of the new health card be a requirement for
all provincial residents for access to all health care
interventions and the Provincial Health Number be
required on all documents related to health.
- That a central registry for maintaining the Provincial
Health Number be established and be accessible 24 hours a
day, seven days a week.
- That the Newfoundland Medical Care Commission and other
agencies be encouraged to use the new unique identifier.
- That forums and community meetings be held to encourage
input, obtain advice and provide information for those
affected by the proposed changes.
- That the health information system be designed with
standard definitions developed using a consensus building
- That in addition to the MIS Guidelines, other national
information system standards be implemented throughout
the provincial health system, as appropriate.
- That the Report of the Focus Group on Human Resource
Management Information Systems be used as the conceptual
basis to develop data requirements for a comprehensive
Health Human Resource Management Information System to be
implemented across the health system.
- That the recommendations of the Ad Hoc Committee on
Standard Residence Codes be implemented.
- That an Information Technology Plan be developed as part
of the larger Health Information System Strategic Plan
and be based on the concepts of open systems architecture
and the distributed information database.
- That the memorandum of understanding between the health
system and the information technology community in
Newfoundland and Labrador, and any subsequent follow-up
agreements, be supported by all stakeholders.
- That provincial standards be developed and maintained
regarding collection, retention, security,
confidentiality, access and dissemination of information.
Established standards at the national and provincial
levels be used to guide development of these standards
(e.g., professional codes of ethics, CHRA position
statements, and CIHI policies), especially where client
and employee information are involved. In particular, the
issues of confidentiality and data ownership must be
addressed to safeguard the client's health information,
while at the same time, providing access to information
necessary for research and administrative purposes.
- That provincial standards be established and maintained
to document and measure outcomes of health interventions
in a consistent manner to support appropriate analysis
and evaluation across the continuum.
- That provincial guidelines be established defining what
information may be accessed for research and by whom.
These guidelines should clearly identify how information
may be used while protecting the individual's right to
- That a comprehensive education strategy for all users be
developed, targeting the public and health professionals,
with the objectives of raising awareness of the
importance of quality health information and educating
users on how to use the health information system.
- That personnel whose primary responsibility is with
information (e.g., health records, information
technology) be appropriately trained and certified.
- That a comprehensive human and financial resource plan be
developed that identifies the required resources as well
as strategies for obtaining same in a manner that is
acceptable to health system stakeholders. Such a plan
must include a consideration of existing services already
being provided by agencies/organizations.
- That health informatics be identified as a priority
strategy for the Provincial Economic Recovery Plan.
- That a Newfoundland and Labrador Centre for Health
Information (NLCHI) be established and governed by
representation from major stakeholders to oversee the
continuation of the Health System Information Task
- That the NLCHI develop an Information System Strategic
Plan, based on the province's Strategic Health Plan,
incorporating the strategic directions identified by the
Health System Information Task Force.