Performance Measurement and Reporting: The Canadian Perspective

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1 Performance Measurement and Reporting: The Canadian Perspective John Wright President and CEO, Canadian Institute for Health Information October 9,

2 Better Data Better Decisions Healthier Canadians Toronto St. John s Montreal Victoria Ottawa 2

3 Four Lines of Business Data Standards Analysis Understanding and Use 3

4 Evolution of Performance Measurement and Reporting

5 State of the Nation 1994 Financial Crunch for Jurisdictions 1994 CIHI Established 5 Databases Deplorable State of Health Data Poor Quality Non-Comparable 5

6 State of the Nation Finances Improved 2004 Three Health Accords Three Quality Councils Transparency and Accountability Wait Times Comparisons 6

7 State of the Nation Performance Reporting Taking Off HSMR Released Five Quality Councils 20 CIHI Databases notable gaps 7

8 State of the Nation S toon Indicator Chaos Conference Quality Councils Collaboration Endorsed Lots More Scorecarding CBC, Conf. Bd. EMR Unstructured and Non-Standardized 28 CIHI Databases and New Public Website 8

9 Pan Canadian Challenges Common Framework NO Consistent Accountability Agenda NO Coherent Approach to Measurement Confusion and Frustration Indicator Chaos NO YES YES 9

10 Challenges Fear of Being Compared Defence #1: Poor Data Quality Defence #2: Wrong Indicators Defence #3: We re Different 10

11 Public Reporting Challenges Understanding Wants Indicators Not Available Minimizing Complexity Data Visualization Appetite for Scorecards Cost 11

12 A Few Other Challenges Cost of Data Collection Systems Analytic Capacity and Culture 13 PTs and Ottawa Leadership 12

13 Crowded State of Affairs frasierinstitute commonwealthfund oecd cma cbc cihi uofr cna healthcouncil qualitycouncils conferenceboard 13

14 Also Opportunities Quality and Safety Agenda Western CEOs CEHQ Enormous Public Interest P4P Initiatives Practice Benchmarking 14

15 CIHI Health System Performance Five Packages of Work Measurement Frameworks Integrated Analytical Environment Public and Private Reporting Research and Analysis Capacity Building Activities 15

16 Health System Performance Framework

17 Align Performance Measurement, Reporting and Peer Learning Fewer Public Comparable indicators to support transparency Number of Measures More Regional and Provincial Authorities Points of Care (Hospitals/long-term care facilities/ primary health care centers) Benchmarking reports and tools support best practice, knowledge sharing, transparency, performance improvement and capacity building Enhanced drill-down capabilities in an integrated environment. 17

facilities/ primary health care centers) Benchmarking reports and tools support best practice, knowledge sharing,

18 Public s Areas of Interest Access Equity Responsiveness Value for money Quality Health promotion Allocation of resources People s circumstances OUTPUTS OUTCOMES OUTCOMES OUTCOMES OUTPUTS OUTPUTS INPUTS FACTORS

19 HSP Interactive Website for General Public 19

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22 CEHQ App 22

23 CIHI Indicator Library Reference Library of Indicator Metadata Available November 7 th First Release 60 Indicators Other Indicators to be Added Includes Definitions, Characteristics, Years Reported, Reporting Level, Where to Find Results 23

24 Scorecards Public Love It Blame and Shame can be Very Effective Subjective Methodologies May Increase Gaming Risk Complex Systems Evaluated by a Few Metrics? 24

25 Some Suggestions Adopt Pan Canadian Standards Focus You can t manage what you can t measure You can t compare what you don t standardize Information overload is a real threat Focus on limited, quality, actionable indicators Align Align strategy, reporting, measurement and incentives Invest In capacity building information literacy skills In culture of learning and improvement 25

26 State of the Nation Pan-Canadian Framework and Agenda Strong Capacity and Culture Structured and Standardized Data Flow from EHR, EMR and Other Sources Practice Benchmarking Widespread 40 Databases Complete, Timely, Accurate, Integrated and Reliable Data 26

27 Count what is countable Measure what is measurable And make measureable what is not so Galileo Thank You 27

Enhancing Pan-Canadian Health System Performance Reporting at CIHI

Enhancing Pan-Canadian Health System Performance Reporting at CIHI Background Enhancing Pan-Canadian Performance Reporting at CIHI Many countries are now regularly releasing public reports on the performance of their health system, with an increased emphasis on measuring