Provinces across Canada have agreed to facilitate the sharing of health information as part of receiving additional federal transfers. This commitment has potential benefits, but it also raises concerns.
On February 13th, the provinces accepted $196 billion in transfers from the federal government, with $46 billion being new money. To access the funds, the Canadian government requires provinces and territories to “commit to improving how health information is collected, shared, used, and reported…to promote greater transparency on results, and to help manage public health emergencies”, according to a statement issued by the Prime Minister on February 7th.
Herb Emery, a political science professor from the University of New Brunswick and former program director of health policy at the University of Calgary’s School of Public Policy, believes that a greater role for federal health care, including sharing more data, won’t bring the change the health system needs. He states that “the same basic flaws exist in an arrangement that is open-ended payment for services with no mechanisms to allocate [or] re-allocate resources when shifts are needed”.
The federal government first announced the Canada Health Infoway in 2000 to facilitate “a more connected and collaborative health system”. However, Emery explains that the enormity of the challenge is what has caused delays in its implementation. He states that “health data has its own privacy and security challenges at the level of province that are not minor issues with respect to data-sharing, even with a trusted federal government”.
Susan Martinuk, a policy fellow with the Frontier Centre for Public Policy and author of “Patients at Risk: Exposing Canada’s Health-care Crisis”, believes that the Canadian Institute for Health Information (CIHI) already collects enough data to help Ottawa steer towards service targets.
Jason Woywada, executive director of the BC Freedom of Information and Privacy Association, does not have any major concerns about the federal plans. He believes that “standardized key performance indicators in health metrics” would help “improve patient service and monitor the system”. His primary attention is on limiting information-sharing abroad.
Martinuk, however, believes that the new platform would be a big target for hackers and increase vulnerabilities for personal information.
Health Canada Senior Media Relations Adviser Anne Genier pointed to 30 years of federal-provincial participation sharing information with CIHI while preserving privacy. She states that “all provinces and territories disclose health data to CIHI in accordance with applicable privacy legislation and under the terms of data sharing agreements”.
The federal government must negotiate agreements on a province-by-province basis. Prior to the agreement, Saskatchewan Premier Scott Moe and Alberta Premier Danielle Smith had both said they would not share personal medical information with the federal government.
A bid for a federal contractor to build a “digital health tech platform” closed on January 3rd. A Digital Transformation Branch within Health Canada will guide standards and solutions for “pan-Canadian initiatives”, including “proof of vaccination credentials” as well as “immunization international interoperability”. The contract also had a statement of work that called for a digital health credential such as a “medical qualification, competence, health status, record” by a relevant authority.
Conservative Leader Pierre Poilievre pledged at a recent campaign stop in Windsor, Ontario that he would not implement a digital ID if he became Prime Minister.
Martinuk believes that it will happen eventually. She states that “it’s going to happen anyway, no matter what. That’s the kind of society that we’re moving towards rapidly”.