As health reforms gain momentum in Canada, a critical need has been identified for the development of standardized health information across the continuum of health services. Although vast amounts of data are collected, deficiencies and gaps in current information systems seriously limit its effective use. As provinces and territories move toward more integrated health services systems, the necessity for a comprehensive and systematic analysis of health information requirements, and the development of requisite standards has never been greater. To begin addressing this need, the Canadian Institute for Health Information (CIHI) established a number of interrelated projects in 1995. This paper describes the goals of these projects, as well as the approach used to assess information needs across health services and to develop required standards.
The BC Cancer Agency sees 128,172 patients per year, of which 2,186 are referred to the Patient Symptom Management/Palliative Care (PSMPC) clinics for tertiary symptom management. Other than at the PSMPC clinics, screening for symptom distress is extremely variable because there is no systematic assessment protocol. In a recent audit of patients coming to the Cancer Agency, approximately 64% of patients reported experiencing a moderate to severe level of symptom distress. Of the total patients in the audit (n = 1,147), only 18 were seen by the PSMPC teams and it is unclear whether or not the remaining patients had their symptoms attended to by a health professional at the BCCA.The tool which the BCCA has chosen for screening and assessment is the Edmonton Symptom Assessment System (ESAS), which was developed by Dr. Eduardo Bruera. ESAS is a nine-item, self-reporting, visual analogue instrument used to measure pain and other symptoms using numeric ratings. Cancer Care Ontario (CCO) has developed an electronic means whereby patients' ESAS scores are entered and housed in an electronic health record and then used for triage. BCCA is in partnership with CCO to adapt this system for use in BC.
Several health databases contain information on blindness and visual impairment in Canada. Such databases may permit studies of the outcomes, predictors, economic costs and meta-analysis of ocular health problems and visual disability. In this paper we summarize the existing public health information on blindness and visual impairment in Canada.
A systematic search was performed to find the information in three areas: health administrative databases, health surveys and registries. Both literature searching and Internet searching were performed. The institutions were notified by email or telephone that information pertaining to vision and blindness was desired. When necessary, we visited the institution to obtain the information.
Health administrative databases contain information on a wide cross-section of diagnoses but are usually limited in detail and seldom provide longitudinal information. Health surveys have a limited amount of systematic information on vision-related questions and rely exclusively on self-reporting. Registries exist on a wide range of visual topics. The Canadian National Institute for the Blind (CNIB) has the most comprehensive registry.
This is the first attempt at summarizing all the public health information on blindness and visual impairment in Canada. The present population-based ocular information has numerous shortcomings. More comprehensive validation of large registries, such as that of the CNIB, is needed to provide the foundation for a longitudinal ocular surveillance system. Such a system could guide research on risk factors and the effect of treatment, economic analyses, and public policy for ocular research and service allocation.
Comment In: Can J Ophthalmol. 2001 Jun;36(4):171-211428525
The article presents an approach to the development of information technology for management of epidemics and risk ranking to increase the efficacy of struggle with HIV/AIDS in Ukraine, minimize incidence rate, maximize the quality of health care, and augment the reliability of a long-term forecasting of epidemiological situation in Ukraine and its separate regions.
The aims of this study were to assess organizational readiness for e-health among the staff of an out-patient rehabilitation centre and to identify the personal characteristics of potential users that may have influenced readiness.
A cross-sectional study was conducted with 137 clinicians, 28 managers, and 47 nonclinical staff in a rehabilitation centre in Montreal, Quebec, Canada. All participants completed a self-administered questionnaire assessing organizational readiness for e-health. The measure contained three subscales: Individual, Organizational and Technological. Data were also collected on the users' profile, use of technologies and typical response to new information.
Generally, participants considered themselves ready to adopt e-health in their work (X?=?73.8%, SD?=?8.5) and they also had a favorable view of the technologies in place (X?73.8%, SD?=?7.2). However, they perceived the center as being only moderately ready (X?66.6%, SD?=?9.8) for e-health changes. Perceived workload and position/duties in the organization were found to have an impact on readiness for e-health.
These results underscore the importance of addressing organizational readiness for change as a multidimensional concept. Based on these results, implementation strategies tailored to the specific profile of a rehabilitation organization were identified.