Health Information System (HIS), The

Aboriginal Nurse, The, May 1999

(Health Canada, Medical Services Branch)

If Health Canada is to achieve its vision of "maintaining and improving the health of all Canadians", directions taken must be based on comprehensive evidence. Unfortunately, our current health information and surveillance systems tend to exclude or simply do not relevant to First Nations and Inuit populations. In example, the National Population Health Survey excluded First Nations people living on reserve; provincial and national communicable disease surveillance systems, as a rule, do not include an ethnicity variable. As Health Canada moves into a Population Health approach, this significant gap in health information must be addressed to better target its programs.

In 1998, an assessment of health-related data for the First Nations population in Ontario Region revealed many inconsistencies in data collection practices. This assessment highlighted the need to develop a comprehensive Health Information System (HIS) that would standardize data collection practices and improve the reliability the data available for case management, program planning and evaluation, and surveillance. The HIS is a unique, community-based computerized system which was recently adopted by the Medical Services Branch as its standard health information and surveillance system.

The following four objectives have and continue to guide all HIS activities: provide to First Nations and Inuit communities a leading edge health information system that will enhance the program management and surveillance at community, tribal council, regional and national levels; build capacity among all levels of First Nations government, to manage health information and program surveillance; facilitate the eventual development of a comprehensive First Nations health surveillance system; through the telecommunication linkages established via the distribution of the HIS, introduce First Nations and Inuit communities to the Health Information Highway.

The HIS currently comprises the following 12 systems: Client Core information, Immunization, Reportable Diseases, Maternal Health, Abuse Profile, Test/Exam, Medication, Medication Allergy/Adverse Reactions, Public Health Education and Client Mortality Information. Data for all subsystems are collected according to standard clinical and public health practice.

Now that the development of the HIS has been completed, the primary focus is shifting from development activities to implementation activities in 500 to 600 First Nations communities across Canada. As end of February 1999, over 100 health facilities across all provinces are accessing the HIS system via a network of dial-up facilities and the Health Canada router based network. It is the intention of the Medical Services Branch, coordinator of all implementation activities, to implement the HIS via WEB-based technologies. All implementation activities are funded via the Health Information Highway initiative and should mostly conclude by March 2000.