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Foundations (Conditional Grants)


Canadian Institute for Health Information (CIHI)
Start Date: April 1, 2007 End Date: March 31, 2012 Total Funding: 404.49 million
Description: CIHI is an independent, not-for-profit organization supported by federal/provincial/territorial (F/P/T) governments that provides essential data and analysis on Canada's health system and the health of Canadians. CIHI was created in 1991 by the F/P/T Ministers of Health to address significant gaps in health information. CIHI's data and its reports inform health policies, support the effective delivery of health services and raise awareness among Canadians about the factors that contribute to good health.

Since 1999, the federal government has provided funding to CIHI through a series of grants and conditional grants, known as the "Roadmap Initiatives". More recently, CIHI's funding has been consolidated through the Health Information Initiative.

CIHI was provided with approximately 260 million between 1999 and 2005 through the Roadmap Initiatives (I, II and II+). Budget 2005 allocated an additional 110 million over five years (2005-06 to 2009-10) to CIHI through Roadmap III. This funding has allowed CIHI to provide quality and timely health information, including the delivery of data on a variety of important health indicators and other health publications to support health sector decision-making and improve accountability.

Beginning in 2007-08, the Health Information Initiative will provide ongoing conditional grant funding to CIHI replacing the previous Roadmap II, II+, and III funding and will also provide additional funds for new initiatives. This funding will allow CIHI to continue important work under the Roadmap Initiatives and to further enhance the coverage of health data systems. This will allow Canadians to obtain information about their health care system, including information on wait times, and it will support the development of comparable health indicators. The funding will also enable CIHI to respond effectively to emerging priorities. CIHI is currently in the process of completing national stakeholder consultations to renew their strategic directions and priorities. The results of the consultations will be factored into future corporate plans and directions. Under this initiative, up to 404.49 million will be delivered to CIHI over five years (2007-08 to 2011-12).
Strategic Outcome: Accessible and sustainable health system responsive to the health needs of Canadians
Summary of Annual Plans of Recipient: The 2008-09 Operational Plan and Budget will be presented for approval to the Board of Directors at a March 2008 meeting, and subsequently submitted to the Minister of Health. At this time, the key projects and initiatives will be confirmed.

A preliminary overview of key projects and initiatives includes:
  • increasing pan-Canadian coverage of new databases (e.g., National Prescription Utilization Information System, National Ambulatory Care Reporting System for Emergency and Day Surgery, Home Care Reporting System, Continuing Care Reporting System);
  • working with stakeholders to identify and address challenges/barriers to implementing national reporting systems;
  • building the capacity of stakeholders to use and understand information through the implementation of rapid response analysis for topical issues, training and workshops;
  • continuing knowledge exchange/transfer activities such as helping clients better understand/use CIHI data, reports and tools;
  • improving the website to improve accessibility of data and information;
  • building new data sources (e.g., primary health care, long term care, community mental health);
  • continuing development of health human resources databases and population of new workforce databases for medical laboratory and radiation technologists;
  • continuing development of a new database of hospital medication incidents - Canadian Medication Incident Prevention and Reporting System;
  • continuing to expand and develop indicators to report on quality and access of care, patient safety, health outcomes, and system efficiency across health sectors;
  • continuing to strengthen relationships with researchers and expand data access;
  • establishing infrastructure to support data linkage between databases in a privacy-sensitive manner;
  • expanding data in the areas of costs and productivity;
  • continuing implementation of Long Range Analytical Plan;
  • continuing efforts to improve data quality, with a special focus on timeliness of data;
  • increasing the organization's flexibility and responsiveness to address local/regional needs;
  • continuing development and increased uptake of CIHI Portal;
  • continuing examination of potential impacts on health system, and secondarily, potential uses of electronic health record data; and
  • releasing Health Care in Canada 2008 and other annual publications.
Planned Evaluations: A third-party evaluation of the first phase of the Roadmap Initiative was previously completed and CIHI was found to have met its objectives.

An evaluation of the second phase was recently undertaken and the final results will soon be submitted to Health Canada.

The next evaluation will be conducted after the completion of the Health Information Initiative in 2010.
Planned Audit: An audit was recently completed by Health Canada internal auditors on the Health Information Contribution Program. Auditors concluded that, in general, the internal controls in place at CIHI to manage the Contribution Agreement were sufficient to meet the terms and conditions of the Agreement with minor exceptions. Risk exposure was not serious.
URL of Recipient Site: http://secure.cihi.ca/cihiweb/splash.html
The Canadian Institute for Health Information (CIHI)
Canada Health Infoway (Infoway)
Start Date: March 9, 2001 End Date: Not applicable Total Funding: 1.6 billion
Description: Canada Health Infoway is a federally-funded, independent, not-for-profit corporation with a mandate to accelerate the development and adoption of electronic health information systems with compatible standards and communications technologies on a pan-Canadian basis. Health information and communications technologies such as electronic health records (EHRs), telehealth and public health surveillance systems will significantly improve access to health care services, patient safety, quality of care and productivity.

Infoway collaborates with F/P/T governments towards a common goal of modernizing Canada's health information systems. This collaborative approach reduces overall costs by coordinating efforts, avoiding duplication, taking advantage of economies of scale, replicating successful initiatives across the country, and sharing best practices. For example, Infoway's EHR Blueprint architecture has been adopted by jurisdictions and vendors across Canada, saving time, effort and money, and helping to ensure systems are interoperable. As well, some jurisdictions have saved both time and money by acquiring vendor solutions together, rather than individually.

Infoway is a strategic investor, providing a portion of system development costs and project oversight. Provincial and territorial (P/T) partners are responsible for the actual system development, implementation and overall funding, including ongoing operational costs.
Strategic Outcome: Accessible and sustainable health system responsive to the health needs of Canadians
Summary of Annual Plans of Recipient: In its Corporate Business Plan 2007-08, entitled Electronic Health Records: Transforming health care, improving lives, Canada Health Infoway indicated the following action plans, which will continue into 2008-09 and build upon Infoway's existing business strategies:

1. Participation in Healthcare Renewal: Infoway will continue to support national, jurisdictional and local initiatives to strengthen health care in Canada through a focus on improving patient access (wait times projects with P/Ts). Infoway will continue to participate in committees dealing with patient safety, heart health, cancer, mental health, primary health care, health indicators and reporting.

2. Collaboration with Partners: Infoway will continue to work with public and private sector partners to implement the pan-Canadian health infostructure. Infoway also continues to work with provinces and territories to help align their three-year plans with Infoway investments for EHRs, telehealth, public health surveillance and patient access (wait times) solutions. Infoway will continue to discuss the opportunities and challenges of EHR solutions with stakeholders, including health delivery organizations and clinician groups.

3. Targeting the Investments: As of December 31, 2007, Infoway had approved over 1.3 billion to support more than 240 projects across the country. Over the next one to two years, Infoway will focus on: continued work on EHR development and surveillance, updating of the telehealth program, implementation of the new patient access to quality care program (wait times), and adjustments to the gated funding model to help P/Ts meet their cash flow requirements for larger projects. Infoway intends to deliver 110-150 million in new project approvals by the end of March 2008.

4. Supporting Solution Deployment: Infoway will continue to provide expertise to support its partners as they successfully implement secure electronic health information solutions and will monitor projects to ensure cost and risk are well-managed. This work includes: standard development, EHR Blueprint, national solution agreements (such as pricing agreements), and collaboration with jurisdictions on risk and quality assessments and privacy. Infoway recently established a Privacy Forum where F/P/T Privacy Officers and representatives from F/P/T health departments discuss privacy governance matters as they relate to electronic health information management.

5. Promote Solution Adoption and Benefits Realization: Infoway will enhance its change management services, collaborate with P/Ts and health providers on knowledge dissemination to support clinician adoption and implement regional peer networks of physicians, nurses and pharmacists to champion and support EHR adoption and training strategies. This year Infoway will also communicate early results from Innovation projects launched over the past two years.
Planned Evaluations: Infoway will continue to coordinate jurisdictional benefits evaluation plans, and based on the framework and methodologies approved in 2007-08, will contract with both jurisdictional and research partners to conduct electronic health record benefits evaluations. The studies will measure outcomes related to quality, access and productivity. Baseline evaluations in several areas are underway, with early results being seen in the field of diagnostic imaging. During fiscal year 2008-09, Infoway will also have an external firm carry out an evaluation of its overall performance in achieving the outcomes identified in section 4.2 of the Addendum Agreement governing the pan-Canadian Health Surveillance System.
Planned Audits: An audit by Health Canada's Audit and Accountability Bureau, Chief Financial Officer Branch, began in December 2007. This audit has both an internal (Health Canada) and an external component, for which interviews with Canada Health Infoway officials are planned. The audit is intended to provide the Deputy Minister with assurances that an appropriate Management Control Framework is in place within the Health Policy Branch and Canada Health Infoway Inc. (Infoway) for the monitoring and administration of Transfer Payment funds; and that Infoway is using funds in compliance with the terms and conditions of the funding agreements. Since the Bureau has indicated this audit is to be completed before March 31, 2008, both Canada Health Infoway and Health Canada will respond to its recommendations in 2008-09.

In addition, during fiscal year 2008-09, Infoway's regular annual financial and compliance audits will be carried out by independent audit firms.
URL of Recipient Site: http://www.infoway-inforoute.ca/en/Home/home.aspx
Canada Health Infoway
Canadian Health Services Research Foundation (CHSRF)
Start Date: 1996-97 End Date: N/A Total Funding: 151.5 million
Description: Please note that CHSRF's programs also receive funding from other sources. Total federal funding for the CHSRF is as follows:
  • 1996 - 66.5 million endowment (received over five years) to establish the CHSRF;
  • 1999 - 25 million 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 million one-time grant to support the CHSRF's participation in the Canadian Institutes of Health Research (CIHR); and
  • 2003 - 25 million one-time grant to develop a program to equip health services 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 support evidence-informed decision-making in the organization, management and delivery of health services through funding research, building capacity and transferring knowledge.

CHSRF's work contributes to Health Canada's aim of strengthening the knowledge base to address health and health care 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: Accessible and sustainable health system responsive to the health needs of Canadians
Summary of Annual Plans of Recipient: The CHSRF will continue to pursue four strategic objectives:
  • To create high quality new research that is useful for health services managers and policy makers (especially in CHSRF's priority theme areas);
  • To increase the number and nature of applied health services and nursing researchers;
  • To get needed research into the hands of health system managers and policy makers in the right format, at the right time, through the right channels; and
  • To help health system managers, policy makers and their organizations to routinely acquire, appraise, adapt and apply relevant research in their work.

Four strategic priorities, endorsed at the October 25-26, 2007 Board of Trustees meeting, will guide the CHSRF's core programming activities: Workforce and the work environment; Quality and safety; Change management; and Values-based decision-making. This is in addition to the commitments (both from a program and a financial perspective) that already exist and which extend into the next three to four years.

CHSRF will continue to enrol 24 senior fellows annually in the two-year EXTRA Program. New in 2008, the expanded admission criteria will allow up to four additional fellows from government ministries or departments on a self-funded basis, with the organization providing funds to cover the marginal cost of adding these fellows to the cohort.

Funding for the NRF is slated to end in 2009. Therefore, in 2008, the CHSRF will begin to restrict NRF-related funding commitments for new initiatives with longer-term funding implications.

In addition, the CHSRF is developing its next three year (2008-10) strategic plan, one that will see the adoption and implementation of a new problem-based delivery model. This plan will also reflect the endorsement of the Board of Trustees for the need for the CHSRF to continue seeking financial support to exist beyond the current projected financial lifespan.

Planned Evaluations: A CHSRF-commissioned independent evaluation of the NRF will be completed in 2008.

The CHSRF conducts an annual evaluation of the EXTRA program. An extensive five-year review is planned for 2008.
Planned Audits: The CHSRF conducts an annual financial audit as well as an audit of its pension plan.

Recommendations from a 2007 audit of funded projects will be implemented in 2008.

The CHSRF will also receive recommendations from a Health Canada audit of the CHSRF, initiated in 2007-08.
URL of Recipient Site: http://chsrf.ca/
Canadian Health Services Research Foundation