ARCHIVED - Health Canada - Supplementary Tables

Name of Recipient: Rick Hansen Man in Motion Foundation

Start Date: April 1, 2007

End Date: March 31, 2012

Total Funding: $30M

Description:

The Rick Hansen Man in Motion Foundation (RHF) is an independent, not-for-profit organization founded by Rick Hansen in 1988 to create solutions to improve the lives of Canadians with spinal cord injury (SCI) and to drive advances in SCI research.

Funding is used to implement a Strategy being carried out by the Rick Hansen Institute (RHI). The Strategy has the following objectives:

1. reduce the incidence and severity of permanent paralysis resulting from SCI;
2. increase the recovery of function following SCI;
3. reduce the incidence and severity of secondary complications associated with SCI;
4. increase the level of satisfaction with quality of life among Canadians with SCI;
5. enhance the customized response to the priority unmet needs of Canadians with SCI; and,
6. establish a world class Canadian SCI registry and data management platform.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient: Key accomplishments of the RHI include:

• The development and expansion of the Rick Hansen Spinal Cord Injury Registry to promote collaborative national research and the collection of longitudinal clinical data of people with traumatic SCI across the health care continuum.
• Partnering with Accreditation Canada to develop comprehensive, evidence-based standards for SCI service delivery in Canada.
• Sponsorship of the ReJoyce (Rehabilitation Joystick for Computerized Exercise) system clinical trial. ReJoyce is a hand and arm rehabilitation system that is now a commercial product being sold in North America and Europe and waiting approval for sale in Asia.
• Creation and dissemination of "Actionable Nuggets" on best practices in SCI care to family physicians in Canada.
• Creation and dissemination of SCI Physical Activity Guidelines.
• Support of translational research (24 projects in 2010-11).

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$0	$0	$0	$0	$0	$0

Comments on Variance(s): None noted for 2010-2011 (the full $30M was provided to the recipient upon signing of the agreement in 2007).

Significant Evaluation findings by the recipient during the reporting year and future plan:

The RHI conducted an Independent Mid-Point Review to measure its overall performance in achieving the strategic plan as outlined in the funding agreement with Health Canada. The Mid-Point Review, submitted to Health Canada June 18, 2010, confirmed the underlying rationale for HC funding and the need for the continued work of the RHI. Generally, good progress was reported in creating the infrastructure to engage SCI clinicians and researchers, create and manage the translational research program, and expand the Rick Hansen SCI Registry.

Some methodological issues and limitations were noted with the Review and the data collected. In addition, opportunities were identified for improved communication and transparency, establishing linkages with other funding agencies (such as the Canadian Institutes of Health Research), and improving the research grants administration process. The RHF and RHI are working closely with Health Canada to implement improvements outlined in their management response to the Mid-Point Review.

A summative performance evaluation for the RHI is scheduled to be submitted to Health Canada by July 31, 2012.

Significant Audit findings by the recipient during the reporting year and future plan:

As outlined in the funding agreement, the RHI must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2009-2010 annual audit showed no major concerns. The 2010-2011 audited financial statements have now been completed and were submitted to Health Canada July 29, 2011.

The RHI is also required to engage an independent auditor to conduct a performance audit. The performance audit is scheduled to be submitted to Health Canada by March 31, 2012. The performance audit will assess the efficiency, economy and effectiveness with which Health Canada's funds have been used.

Name of Recipient: Canadian Health Services Research Foundation (CHSRF)

Start Date: 1996-1997

End Date: N/A

Total Funding: $151.5M

Description:

1996 - $66.5 M endowment (received over five years) to establish the CHSRF;

1999 - $25 M one-time grant to support a ten-year program to develop capacity for research on nursing recruitment, retention, management, leadership and the issues emerging from health system restructuring (Nursing Research Fund or NRF); and a $35 M one-time grant to support the CHSRF's participation in the Canadian Institutes of Health Research (CIHR); and

2003 - $25 M one-time grant to develop a program to equip health service professionals and their organizations with the skills to find, assess, interpret and use research to better manage the Canadian health care system (Executive Training for Research Application or EXTRA) over a thirteen-year period.

CHSRF's mission is to improve the health of Canadians by:

• Capturing the best evidence about how healthcare and other services can do more to improve the health of Canadians;
• Filling critical gaps in evidence about how to improve the health of Canadians, by funding research and evaluation; and
• Supporting policy makers and managers to develop the skills needed to apply the best evidence about services to improve the health of Canadians.

CHSRF's work contributes to Health Canada's aim of strengthening the knowledge base to address health and healthcare priorities. More specifically, CHSRF's programs further the development of health human resources, provide health managers with tools to improve primary and continuing care, and support nursing research from a health system perspective.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient:

Effective Governance for Quality and Patient Safety

• The effective governance program (for citizens on healthcare boards) was delivered as a pilot in three Manitoba regional health authorities, and to 15 health organizations in the Hamilton-Niagara-Haldimand-Brant region.
• Following the official launch of the program where 19 health organizations participated, one regional health authority and the Saskatchewan Cancer Agency took part in the program, followed by a session for eight health organizations in Saskatoon.
• After the Manitoba pilot, Manitoba Health, the Regional Health Association of Manitoba and the Manitoba Institute for Patient Safety jointly requested training for the remaining regional health authorities in 2011.
• In Fall 2010, the Ontario Ministry of Health and Long-Term Care and the Ontario Hospital Association entered into discussions around the delivery of effective governance programs across Ontario in 2011.

Patient Engagement

• A call for proposals attracted 74 applications; 11 patient engagement projects (PEP) were selected.
• Twenty-five team members, including representatives from all selected projects met for a learning workshop, following which all PEP teams submitted their project implementation and evaluation plans.

Accelerating Evidence-Informed Change

• Launched new conference series, Picking Up the Pace (PUP), a biennial event showcasing innovation in key areas of the health system. Approximately 300 senior policy-makers, healthcare managers and clinicians participated. Forty-seven effective innovations in primary care from across Canada were featured.

Executive Training for Research Application (EXTRA)

• Ongoing cohort management (fellows participate in four residency sessions over two years during which they study six curriculum modules)
• Twenty-four new fellows were accepted through competition into EXTRA

CEO Forum

• The theme of the 2010 forum was Metrics for Healthcare Quality: The Leader's Role, and focused on ways to measure healthcare in order to support efforts to improve quality and performance. More than 120 CEOs attended.
• CHSRF launched a new, annual survey of leaders' perspectives on the challenges facing the healthcare system to inform the CEO Forum, establish a channel for CHSRF to engage with organizations that are leading improvements and contribute to renewal of the EXTRA curriculum.

Northern Initiatives

• CHSRF and the Northwest Territories Department of Health and Social Services hosted the first of four workshops aimed at developing a model for chronic disease management in the territory.
• Awarded a two-year grant to the Institute for Circumpolar Health Research and the Yellowknife Health and Social Services Authority to explore the use of information technology to improve physician support services in the Northwest Territories.
• Capacity for Applied and Developmental Research in Evaluation in Health Sciences and Nursing (CADRE)
• Much of the effort in 2010 was focused on wind-down, fulfilling accountability and reporting requirements, and evaluation. The formal evaluation, to be completed in 2011 and released in 2012, will assess the extent to which CADRE has influenced health system decision-making and academia.

Nursing

• Published "Clinical Nurse Specialists and Nurse Practitioners in Canada: A decision support synthesis." Based on the recommendations of the report, CHSRF, the Canadian Nurses Association and Health Canada's Office of Nursing Policy are providing direction on a forum on advanced practice nursing to be held in 2011. CHSRF also funded a special issue of the Journal of Nursing Leadership, which will be released in 2011.

Healthcare financing, innovation and transformation

• Five research papers on cost drivers, a paper on healthcare financing, and a policy options paper on hospital funding were completed (for release in 2011). Health Canada contributed $500K in contribution funding to this work.
• Partnered with policy research groups on events across Canada including: the Invitational Symposium on Healthcare Renewal, a healthcare roundtable to discuss the recommendations of the healthcare chapter of the Organisation for Economic Co-operation and Development's Economic Survey of Canada 2010; and a national forum on high-quality, sustainable funding models with the Canadian Institute for Health Information and the Institute of Health Economics.

Planning for the aging population

• Hosted a national and five regional roundtables as part of its series, Better with Age: Health systems planning for the aging population, which brought together more than 200 policy-makers, healthcare executives, researchers and citizens from across Canada. Analysis of the themes that emerged--including integrated care, ageism, choice, patient-centred care and health human resource availability--is underway and CHSRF will release six roundtable reports and one synthesis report in 2011.

Primary healthcare innovation

• Provided funding for and worked with a pan-Canadian primary healthcare working group to help plan the Canadian Institutes of Health Research's primary healthcare summit (+500 attendees in January).
• Published three reports on primary healthcare improvement; released Clinical Nurse Specialists and Nurse Practitioners in Canada: A decision support synthesis; supported five Research, Exchange and Impact for System Support (REISS) projects focusing on the interface between primary healthcare and public health; and provided a one-time grant of $50,000 to the C.T. Lamont Primary Healthcare Research Centre at the University of Ottawa for an economic analysis of the consequences of achieving a high-quality primary healthcare system in Canada.

Publications and programs

• 5 Researcher on Call webinars
• 3 Mythbusters articles
• 2 editions of Pass it on!
• Published Quality of Healthcare in Canada: A Chartbook, undertaken with the Canadian Institute for Health Information, the Canadian Patient Safety Institute and Statistics Canada.

Recognition and capacity development

• Excellence through Evidence Award and Health Services Research Advancement Award Mythbusters Award
• Canadian Harkness Fellowships in Health Care Policy and Practice (worked with The Commonwealth Fund to support the annual selection of up to two Canadian fellows, and hosted the annual Canadian Health Policy Briefing tour)

Additional information is available in CHSRF's 2010 Annual Performance Report which was submitted to Health Canada on 30 May 2010 (available online at www.chsrf.ca).

Program Activity:
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$0	$0	$0	$0	$0	$0

Comments on Variance(s): Conditional grants to CHSRF (see list in section 5 above) were all issued prior to the 10-11 reporting period.

Significant Evaluation findings by the recipient during the reporting year and future plan:

• Instituted a new organization-wide Program Performance Management (PPM) evaluation system based on the "outcome mapping" methodology
• Initiated several major evaluations including: a review of the Executive Training for Research Application program; a review of the Capacity for Applied and Developmental Research and Evaluation in Health Services and Nursing program (in wind-down); and an evaluation, in collaboration with Health Canada, of the Listening for Direction national consultation exercise

Significant Audit findings by the recipient during the reporting year and future plan:

The 2010 external financial and pension plan audits showed no major concerns, with the auditors reporting clean audits with no evidence of fraud or illegal acts.

The 2010 internal controls review examined the operational area of investments, insurance and commodity taxes functions. The recommendations from the internal controls review will be implemented in 2011.

Name of Recipient: Canada Health Infoway (Infoway)

Start Date: March 9, 2001

End Date: N/A

Total Funding: $2.1B*
*Infoway received $1.2 B as lump-sum grants between 2001 and 2004. The $400M allocated in 2007 was subject to new conditions - these funds flow to Infoway on an as-needed basis. An additional $500M for Infoway was announced in Budget 2009 and confirmed in Budget 2010. In March 2010, Health Canada and Infoway signed a related funding agreement. The $500M funds will flow to Infoway on an as-needed basis.

Description:

Canada Health Infoway Inc. (Infoway) is an independent, not-for-profit corporation established in 2001 to accelerate the development of health information and communication technologies such as electronic health records, telehealth and public health surveillance systems on a pan-Canadian basis. Its Corporate Members are the 14 federal, provincial and territorial Deputy Ministers of Health.

Since 2001, the federal government has committed the following funding allocations: $500 million in 2001 in support of the September 2000 First Ministers' Action Plan for Health System Renewal to strengthen a Canada-wide health infostructure (with the electronic health record - EHR - as a priority); $600 million in the First Ministers' Health Accord of February 2003, to accelerate implementation of the EHR and Telehealth; $100 million as part of Budget 2004 to support development of a pan-Canadian health surveillance system; and $400 million as part of Budget 2007 to support continued work on EHRs and wait times reductions. Also, as part of the Economic Action Plan, and as indicated in Budget 2009, the Government of Canada announced an additional investment of $500 million in Infoway, to support continued implementation of EHRs, implementation of electronic medical records in physicians' offices, and integration of points of service with the EHR system. Following a due diligence process, Budget 2010 announced the government's intention to move forward with the transfer of the funds. In March 2010, Health Canada and Infoway signed a related funding agreement, which includes enhanced accountability provisions.

It is anticipated that Infoway's approach, where federal, provincial and territorial (F/P/T) governments participate as equals, toward a goal of modernizing the health information system, will reduce costs and improve the quality of health care and patient safety through coordination of effort and avoidance of duplication.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians.

Summary of Results Achieved by the Recipient:

Investment Strategy - Infoway is a strategic investor, with a funding formula covering up to 100% of territorial and 75% of provincial project development and implementation costs. Infoway provides a portion of system development costs and supports project oversight while P/T partners are responsible for actual system development, implementation and overall funding, including ongoing operational costs. In 2010-2011, Infoway approved $390.5 million in new projects (21 projects), bringing its cumulative allocation of investments to $2.007 billion (315 projects since Infoway's inception).

Electronic Health Records (EHRs) - Infoway's goal for EHRs, endorsed by all jurisdictions is that: "by 2010, every province and territory and the populations they serve will benefit from new health information systems that will help transform their health care delivery system. Further, by 2010, the electronic health records of 50 per cent of Canadians and by 2016, those of 100 per cent of Canadians, will be available to their authorized health care professionals." The first part of this goal has been achieved; as of March 31, 2011, the core components of an EHR were in place for 50.1% of Canadians.

In 2010-2011, Infoway and the P/Ts continued to make significant progress on the various components of the EHR - client and provider registries, laboratory information and diagnostic imaging systems, drug information systems and clinical reports. For example, the following results were achieved in 2010-2011.

Drug Information Systems (DIS): It is estimated that 30,000 health care professionals are using second generation drug information systems. As an example, British Columbia's PharmaNet DIS captures every prescription dispensed in the province's pharmacies and provides alerts to pharmacists. In 2010, more than 60 million prescriptions were reviewed via PharmaNet, resulting in the identification of 32 million potential drug interactions.

Diagnostic Imaging Systems (DI Systems): As of March 2011 an estimated 43,000 health care professionals are using diagnostic imaging system technology. This has improved the turnaround time of receiving the results of these tests by 30-40%, patients are able to get their results faster and start treatment earlier. Infoway's DI system program is available in several provinces.

Telehealth - Infoway is working to implement solutions that facilitate the delivery of health information and services between patients and providers over distance, with a focus on Aboriginal, official language minority, northern and remote communities. Strategic telehealth plans are in place in most jurisdictions.

In 2010, Infoway commissioned an independent pan-Canadian study to describe telehealth use in Canada and the benefits achieved to date. The report was released in May 2011. This report, Telehealth Benefits and Adoption: Connecting People and Providers Across Canada, describes how telehealth has delivered a number of benefits for clinicians, patients and the health care system. The report highlights that telehealth is:

• Growing and on its way to becoming a mainstream way of delivering care
• Reducing travel by patients, families and health care providers
• Making it easier for Canadians in rural and remote areas to access specialized care that they need

Electronic Medical Records (EMR) - As a result of the new funding in 2010, Infoway has allocated funds toward investment in EMR systems in community based practices and outpatient settings. Investments will be used toward clinical peer support networks, innovation projects and consumer health solutions.

In 2010-2011, Infoway worked with jurisdictions and vendors to develop user guides and a set of software solutions to accelerate the interoperability of EHRs, especially with point of service systems such as physicians' office EMRs, hospital information systems and community pharmacy systems.

Consumer Health Solutions - As an emerging area of interest and investment for Infoway, this program will educate and empower Canadians by providing electronic access to their medical record. For example, Infoway is funding Alberta's MyHealth.Alberta.ca initiative. Once complete, Alberta's personal health portal --- the first in Canada -- will provide Albertans secure access to their personal health information through the province's electronic health record system. Patients will be able to track their own personal health data such as blood pressure readings, insulin levels, weight, and immunizations. The portal was launched in May, 2011.

Innovation and Adoption - In the past fiscal year, Infoway launched new investment programs focused on accelerating the extent to which clinicians and Canadians receive tangible value from the use of information and communications technology. Investment is being made in Clinician Peer Support Networks, training and other initiatives to foster innovation in eHealth.

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$122.9	$64.49	$91.84	$91.84	$91.84	$0

Comments on Variance(s): N/A

Significant Evaluation findings by the recipient during the reporting year and future plan:

In March 2011, Infoway released an independent evaluation of its performance in achieving the objectives of the 2003 funding agreement with the Government of Canada. The report concluded that Infoway has met or made progress on the outcomes specified in the 2003 funding agreement, despite the existing challenges. The evaluation found that the appropriate strategies are in place to achieve the outcomes specified in the funding agreement and projects are managed in a cost effective manner and are achieving the intended results.

In March 2013, Infoway is expected to release an independent evaluation to measure its performance in achieving the objectives of the 2010 funding agreement.

Significant Audit findings by the recipient during the reporting year and future plan:

No audit activity was undertaken in the 2010-2011 fiscal year.

In March 2013, Infoway is expected to submit an independent performance evaluation (value-for-money) audit report, relating to use of funds under all funding agreements.

Name of Recipient: Mental Health Commission of Canada -- Conditional Grant to support Research Demonstration Projects in Mental Health and Homelessness

Start Date: April 1, 2008

End Date: March 31, 2013

Total Funding: $110M

Description: As part of Budget 2008, the federal government committed $110 million in funding to the MHCC to support five research demonstration projects in mental health and homelessness over five years (2008-2013). Among the objectives, these projects will contribute to building knowledge on how to increase access to adequate housing in combination with the provision of necessary support services, and will result in the development of best practices that will support future interventions and long-term improvements to the lives of Canada's most vulnerable.

The initiative uses a 'Housing First' approach, which stresses recovery and consumer/tenant choice, and compares this with traditional care. A total of 2285 homeless people living with a mental illness will participate of which 1,325 people will be given a place to live, and will be offered services to assist them over the course of the initiative. The remaining participants will receive the regular services that are currently available in their cities. The goal is to find out which services provide the best outcomes to homeless people living with mental illness. Expected results include:

• the development of a knowledge-base accessible to all jurisdictions;
• the identification of effective approaches to integrating housing supports and the Basket of Necessary Services or other "prerequisites";
• the development of Best Practices and Lessons Learned; produce data that is reflective of mental health issues among Canada's homeless population;
• the identification of unique problems and solutions for diverse ethno-cultural groups within this population; and
• support improvements at each project site to address fragmentation through improved system integration and support.

Strategic Outcome(s): Accessible and sustainable health system responsive to the health needs of Canadians

Summary of Results Achieved by the Recipient: The project, entitled, At Home /Chez Soi (French)/Niapin (Cree), was launched in November, 2009, in Vancouver, Winnipeg, Toronto, Montreal, and Moncton. Each project focuses on a distinct group of homeless people living with mental illness such as those who also have a substance abuse problem, Aboriginal Canadians and non-English speaking new immigrants. As of May 2011, 95% of the intended participants have been enrolled in the study, of which, 900 have been provided housing. Overall, all sites are well on track in meeting their target enrolment. The initiative continues to gain national and international recognition, with interest from various stakeholders and countries including France and Australia interested in adapting the program. The Commission continues to work collaboratively with provincial and municipal levels of government, researchers, local service providers and people with lived experience of mental illness and homelessness.

Program Activity: Canadian Health System
($ millions)

2008-09 Actual Spending	2009-10 Actual Spending	2010-11 Planned Spending	2010-11 Total Authorities	2010-11 Actual Spending	Variance(s)
$110	$0	$0	$0	$0	$0

Comments on Variance(s): N/A

Significant Evaluation findings by the recipient during the reporting year and future plan: As per the terms and conditions of the funding agreement, the Commission is required to carry out an Independent Evaluation within 5 years and 180 days to measure the Commission's overall performance in achieving the purpose of the Grant funding.

The homelessness initiative was also included as part of the overall performance evaluation for the Commission that took place in FY 2010-2011. The evaluation set out to assess the Commission's progress between July 2007 and December 2010 in the areas of:

• ability to meet its mandate
• effectiveness of policy and/or programs;
• intended and unintended impacts across the mental health system; and
• alternative ways to achieve expected results.

The evaluation demonstrated the organization's positive efforts to strengthen its accountability, and performance management processes and practices, and is making progress on most of its initiatives including the Homelessness initiative. Findings were based on a review of project documents, an online survey, focus groups, and a series of interviews with key informants

Significant Audit findings by the recipient during the reporting year and future plan: As outlined in the funding agreement, the Commission must engage an independent auditor to conduct a full audit of its financial statements each Fiscal Year. The 2010-11 audited financial statements have now been completed and were presented to the Board of Directors for approval on June 14, 2011.

The Homeless project is expected to be part of the internal audit by Health Canada planned for 2011-12.