Canadian Institute for Health Information (CIHI) Business Plan 2013 to 2016 March 2013
Table of Contents Introduction... 1 CIHI Overview... 2 Our Plans... 2 Goal 1: Improve the comprehensiveness, quality and availability of data... 4 Goal 2: Support population health and health system decision-making... 6 Goal 3: Deliver organizational excellence... 8 Our Resources... 9 Our People... 9 Our Financing... 10 Measuring Our Progress... 11 Appendix 1: CIHI s Strategic Goals, Priorities, Initiatives and, 2013 2014 to 2015 2016... 12 Appendix 2: Performance Measurement Framework and Indicators, 2013 to 2016... 20
Introduction The Canadian Institute for Health Information (CIHI) is pleased to present its business plan for 2013 to 2016, the second in a series of rolling three-year business plans that reflects priority initiatives and activities to be carried out during fiscal years 2013 2014 to 2015 2016. In 2010 and 2011, CIHI undertook a number of key planning and consultation activities, so we could learn from our clients, partners and stakeholders about future needs for health information in Canada. With this information in hand, we drafted a new strategic plan for 2012 to 2017, a public document that provides a high-level statement of CIHI s future directions. The strategic plan also includes a new vision and renewed mandate for CIHI. Built on our new strategic plan, this business plan is the result of a comprehensive priority-setting exercise that was carried out across the organization. The plan is a living document that describes the major initiatives and activities that will be pursued over the next three fiscal years to deliver on our mandate. It will be updated annually to reflect our progress. Appendix 1 contains a detailed list of activities for each of the next three years. Our Vision Better data. Better decisions. Healthier Canadians. Our Mandate To lead the development and maintenance of comprehensive and integrated health information that enables sound policy and effective health system management that improve health and health care. Our Values Respect, Integrity, Collaboration, Excellence, Innovation The business plan will be complemented by annual operational plans, which will provide more detailed information on our program of work and more specific information on targets and resource allocation. Finally, the plan also includes a performance framework and indicators that will allow us to report to stakeholders on progress against established targets. See Appendix 2 for the framework and indicators. 1
CIHI Overview CIHI is an independent, not-for-profit corporation that plays a unique role in Canada s health sector and is funded by the federal and provincial/territorial ministries of health. Its work is guided by a Board of Directors made up of health leaders from across the country. CIHI leads the development and coordination of a common approach for health information in Canada. This includes the development of standards and methodologies, the creation and maintenance of databases that hold reliable and nationally comparable data, and the promotion of improved understanding and use of health information in a way that ensures the privacy of Canadians. Working with our partners, we help improve the depth and breadth of Canada s health data by building and maintaining 27 critical pan-canadian databases that enable comparisons within and among jurisdictions. We produce data analyses that respond to important questions about Canada s health systems and that assist policy-makers, health system managers and practitioners in making informed decisions. CIHI s core functions include Identifying health information needs and priorities; Coordinating and promoting the development and maintenance of national health information standards; Developing and managing health databases and registries; Conducting analysis in the area of population health and health services; Developing national health indicators; and Conducting education sessions. Our Plans This business plan details specific priorities for CIHI over the next three years related to the goals that were identified during our process of strategic planning and priority setting. It builds on many accomplishments achieved by CIHI since its creation in 1994, including those guided by our most recent strategic directions for 2008 to 2012: Enhancing the scope, quality and timeliness of our data holdings; Producing quality information and analyses that are relevant and actionable; and Working with stakeholders to help them better understand and use our data and analyses. 2
Table 1 outlines our three strategic goals for 2012 to 2017, as well as a number of specific priorities for 2013 to 2016, in keeping with what stakeholders have told us through targeted consultations, client surveys and an independent evaluation and performance audit. Our plans reflect the needs of our priority customers: funders, policy-makers and health system managers, as well as other important customers including data providers, analysts, clinicians and researchers. Table 1: Our Strategic Plan 3
The business plan does not provide details on the full scope of CIHI s activity; rather, its purpose is to highlight specific, high-profile or time-limited activities that build on the key components of our core mandate: Collecting and managing high-quality, standardized pan-canadian data on health and health systems; Producing analyses that are relevant, timely and actionable for our clients; and Increasing the understanding and use of our data and methods in Canada through a range of tools and strategies. As such, the next section of this document provides an overview of the major initiatives being pursued to deliver on each of the priorities set out in Table 1. More detailed information on our plans for the next three years can be found in Appendix 1. Goal 1: Improve the comprehensiveness, quality and availability of data Priority 1: Provide timely and accessible data connected across health sectors Today, the needs of stakeholders are more diverse and sophisticated than ever. Our stakeholders have told us they want us to continue to make improvements in timeliness of data so it can be put to use immediately in improving health care and the health of Canadians. They also want us to invest in tools that will allow them to customize their own reports using only the most relevant data for their specific needs. Finally, they want CIHI to connect the dots between these different data sources, providing a more complete picture of health care in Canada, from the perspective of patients and citizens. Over the next three years, CIHI will Implement a multi-year plan to enhance ereporting, with a focus on tools for health system performance management. We will launch an integrated ereporting system to support performance management at the regional level in Canada, and will continue to enhance existing e-reports with new functionality, as well as enhance the timeliness and efficiency of these e-reports. Improve the timeliness and accessibility of our data. We will work with jurisdictions to improve the timeliness of data submissions; implement options to further enhance access to our data; and implement various new initiatives aimed at enhancing data quality. We will also continue to monitor and improve turn-around time for data requests. Provide patient-focused health information by integrating data from across sectors. Working with the jurisdictions, we will implement strategies to ensure the receipt of integrated and linkable data. We will also increase the number of analytical reports using this linked data. 4
Priority 2: Support new and emerging data sources, including electronic records CIHI s mature databases are valuable because they provide continuity over time and enable pan-canadian comparability. However, new data sources need to be developed in response to emerging challenges and to fill important gaps in health information. CIHI must be involved in these changes to ensure that Canada has data that is complete, comparable and continuous. This includes data that is emerging from Canada s investment in electronic records, which can have a significant impact on health information in Canada in the future. Over the next three years, CIHI will Support the recent launch of the Canadian Multiple Sclerosis (MS) Monitoring System. We will continue implementation of this system, and work with data providers to increase the amount of data submissions. We will use the data collected in this system to report on Patient Reported Outcome Measures. Lead key elements of the pan-canadian vision for the effective use of electronic records by health systems. We will explore recommendations resulting from the readiness assessment of select CIHI databases to receive data from electronic medical records (EMRs) and implement steps to allow CIHI to receive electronic records data across select databases. Enhance primary health care (PHC) information through development and access to new data and information sources. We will continue to support the adoption and implementation of Electronic Medical Records (EMR) content standards, and funding permitting, we will initiate development of a PHC information system. We will also produce analytical reports using available PHC performance indicators. Priority 3: Provide more complete data in priority areas In Canada, most jurisdictions have made significant changes to how they organize, deliver and pay for health services. For instance, a growing number of physicians are working under mixed models of payment, rather than traditional fee-for-service models. Jurisdictions want assistance not only with understanding how health and health care is changing as a result of these changes but with designing systems of resource allocation that best serve the different populations and communities that are accessing health services. In addition, jurisdictions want to have information in key areas to support efforts to improve efficiency, as well as quality of care and patient safety. Finally, as health services continue to shift from acute care to community services, there is a greater need for integrated information across care settings. Over the next three years, CIHI will Provide more comprehensive information on Canada s physicians. We will continue to expand our collection of physician-level billing data, as well as data about physicians on alternate payment plans, and use this information to produce a number of analytical reports. 5
Expand health care financing and funding information. We will continue to support jurisdictions in activity-based funding initiatives and expand the collection and analysis of patient-level cost data. We will also, if deemed feasible, report financial data for the long-term care and home care sectors. Expand information in key data holdings to support health care quality and patient safety. We will continue analysis and reporting of medication incidents via the National System for Incident Reporting (NSIR) and, funding permitting, develop plans to expand the collection of NSIR data beyond hospitals and medication incidents. We will also continue to expand coverage for the Canadian Joint Replacement Registry (CJRR) across Canada. Goal 2: Support population health and health system decision-making Priority 1: Produce relevant, appropriate and actionable analysis As the quality and quantity of health information in Canada continue to grow, so too do the expectations of stakeholders about how this information can be put to use. Today, our customers want access to increasingly sophisticated analytical reports. They want to go beyond the numbers and deal with complex issues, such as appropriateness of care and the link between health services and health outcomes. To do this, CIHI, as a health information organization, needs to be on the cutting edge developing new methods and indicators, assisting stakeholders with understanding results, and assisting stakeholders in building their own capacity to use data and information. Over the next three years, CIHI will Implement a corporate analytical plan that is focused on the most relevant themes for decision-makers and system managers. We will continue to deliver analyses that focus on critical health system priorities, such as population health, quality of care and patient safety, access to care, and international comparisons. We also explore development of interactive tools to support dissemination and use of analytical findings. Build the capacity of health system stakeholders to be able to use health data and information to support decision-making through education and engagement. We will continue to offer education in line with our new business model and corporate priorities; adapt and reposition our current education offerings with a focus on capacity building; and implement initiatives aimed at building the capacity of our stakeholders to make better use of our data and information products. 6
Priority 2: Offer leading-edge performance management products, services and tools Canada has made improvements in reporting on the performance of hospitals. Stakeholders want this information to be enhanced, reporting on more aspects of health care performance, and looking at performance across the continuum of care. Health system performance needs to be considered in an integrated way that allows jurisdictions, as well as regions, to compare their performance with regional, provincial/territorial and, in some cases, international benchmarks. Over the next three years, CIHI will Deliver a health system performance agenda focused on meeting the needs of the public and health system managers and policy-makers. We will release an enhanced public website on health system performance, and continue to develop and release new reports and tools to facilitate benchmarking activities and improve health system performance. We will also continue to release new indicators in emerging priority areas. Fill in performance measurement gaps in health system efficiency and productivity. We will develop and release new hospital efficiency and productivity indicators, and examine variations in health system efficiency. Use international comparisons, when possible, and initiate international benchmarking efforts. We will expand our analytical work in the area of international comparisons, including the production and release of comparable Canada U.S. performance indicators for university hospitals and long-term care. We will also continue our participation in the Organisation for Economic Co-operation and Development (OECD). Priority 3: Respond to emerging needs while considering local context Needs and interests vary across jurisdictions, and it s important that we remain responsive to the unique needs of our partners, whether that entails building data or developing analysis and methodologies. CIHI s unique strength is in its partnerships across the Canadian health systems. For example, because of the support of all Canadian jurisdictions, CIHI is the only organization able to produce health information with a truly pan-canadian scope. At the same time, our partners are diverse and unique. Over the next three years, CIHI will Enhance our partnerships and linkages to assist improved priority-setting to meet the needs of health system stakeholders. We will continue to identify and build new partnerships with key pan-canadian, provincial/territorial and regional organizations, as relevant, and leverage these partnerships to identify and respond to emerging health information needs. 7
Undertake targeted local initiatives that provide a solid basis for potential scaling up across Canada. We will continue to support work on activity-based funding initiatives underway in various jurisdictions, and work with priority stakeholder groups to support their local analytical needs with a view to translate knowledge at the pan-canadian level. We will also continue to support capacity building and produce tailored analysis to support stakeholders in lowpopulation areas. Goal 3: Deliver organizational excellence Priority 1: Promote continuous learning and development An organization s greatest strength is its people. In the competitive area of health information, we need to be able to recruit staff with specialized skills in areas such as data, analysis and information technology (IT). We also need to invest in continuous learning for staff both in maintaining their specialized skills and in building their capacity to take on new roles, including leadership roles within the organization. Over the next three years, CIHI will Develop leadership capabilities to enhance leadership at all levels of the organization. We will continue to promote a series of core leadership capabilities within CIHI, which will involve the implementation of new leadership development programs, such as a formal support program for new leaders and a rotation program for supervisory staff. Share knowledge and promote adoption of leading practices. We will investigate and implement a coaching and mentoring program. Enhance learning and professional development offerings. We will review our learning and professional development programs, launch new offerings and evaluate their effectiveness. We will also focus on implementing enhanced analytical and technical skills training for our analysts and information technology staff. Priority 2: Champion a culture of innovation Whether in developing new methodologies or modes of delivery, stakeholders want us to continue to improve products and services. To do that, we need to work with our external partners and also invest in continuous improvement in our products and internal processes, including finding better ways to recognize and reward innovation within CIHI. Over the next three years, CIHI will Implement an agenda to improve innovation awareness and create the conditions for successful innovation within CIHI. We will continue with corporate implementation of the Lean program, including ongoing evaluation and enhancement of the program. 8
Priority 3: Strengthen transparency and accountability CIHI s mandate is to support improvements to the health of Canadians and to health systems. We are funded by taxpayers and we hold their personal health information. It is critical that we are accountable to Canadians, not only for how we use their health information but also for delivering results that have been promised. Over the next three years, CIHI will Implement a new rolling three-year multi-year business plan and associated processes. We will implement enhanced corporate reporting mechanisms; revise and update our multi-year business plan; and conduct formal planning sessions with our Board of Directors. Enhance accountability through a new performance measurement framework. We will continue to monitor and report on organizational performance against targets. We will also conduct a performance audit and implement recommendations arising from the audit. Enhance CIHI security standards. We will continue to develop and refine policies, standards and guidelines, as required, and in alignment with the International Organization for Standardization (ISO) security best practices. Our Resources Our People Our greatest asset at CIHI is our staff; they are the key to delivering on our strategic goals and priorities. CIHI has approximately 725 professionals working across Canada, most of whom work in offices located in Ottawa, Toronto, Montréal, St. John s and Victoria. We employ a variety of different people, including Analysts and senior analysts, who assist with activities related to system maintenance, data collection, analysis, production of reports, data quality and data requests; Information technology professionals, who build software applications that are used to capture and disseminate information about health systems; Classification specialists, who participate in the development and maintenance of national classification standards that allow health information to be compared across the country; Clinical specialists, who often have a background as a health practitioner, who assist with providing education sessions and adding the clinical context to our analysis and reports; and Team leads and project managers, who lead and coordinate the work of interdisciplinary teams for specific databases, programs and projects, liaise with external stakeholders, write reports and present at stakeholders meetings and conferences. Due to a reduction in funding, CIHI will absorb the loss of 29 positions over the next three years. Our intention is to accomplish these reductions through attrition and staff reassignment to vacancies and new investment initiatives. At the same time, we will continue to develop and implement additional strategies to support the recruitment, development and retention of a highly skilled and motivated workforce. 9
Our Financing CIHI receives funding from several sources, with approximately 95% of our annual revenue coming from Health Canada and the provincial/territorial ministries of health. The specific priorities and activities outlined in this business plan, including our ongoing program of work related to our core functions, are based on our current three-year agreements expiring in 2014 2015 with these key partners and successful renewal of them, with a modest increase effective 2015 2016. As shown in Table 2 below, the total sources of revenue reflect an estimate of $236.2 million from Health Canada in funding for the Health Information Initiative (HII) and $52.3 million in contributions from the provinces and territories toward CIHI s Core Plan. Table 2: Annual Sources of Revenue* ($ Millions), 2013 2014 to 2015 2016 Revenue Source 2013 2014 Approved Budget 2014 2015 Estimate 2015 2016 Estimate Three- Year Total Estimate Federal Government Health Information Initiative (HII) 79.3 77.7 79.2 236.2 Provincial/Territorial Governments Core Plan 17.1 17.4 17.8 52.3 Other** 4.5 4.8 4.0 13.3 Total Annual Source of Revenue 100.9 99.9 101.0 301.8 Note *Reflects annual revenue on a cash basis; therefore, excludes depreciation and pension plan accounting expenses related revenue. ** Includes contributions from provincial/territorial governments for one-time special purpose programs/projects. As summarized in Table 3 below, based on our annual funding level and current financial commitments, CIHI s total expenses for the next three years will be, on average, $100 million per annum, with 73% relating to salaries and benefits, including pension plan contributions for current service cost. A provision has been factored in to salaries and benefits to reflect an annual salary increase (that is, cost of living and performance). The staff complement has been established at 725 people in 2013 2014 and is expected to slightly decrease below 700 by 2015 2016. Our external professional services, travel and advisory committee expenses will be higher in the initial two years of our three-year plan to account for one-time activities necessitating external expertise to support specific projects (e.g., Health System Performance project, LEAN initiative) as well as specific contributions towards externally-funded projects (e.g., Ambulatory Care Reporting System implementation in BC). With the exception of our occupancy costs increasing year-over-year as per our office-space leases with our current landlords, the information technology and other expenses will remain relatively stable over the three-year period. The capital expenditures will range from $1.2 million in 2013 2014 to $1.8 million in 2015 2106, reflecting essentially the planned renewal of our IT infrastructure. 10
CIHI s contributions to the CIHI Pension Plan (Plan) will be in the order of $28 million over the three-year period comprising of $15.8 million in employer contributions for the current service cost and $12.2 million in actuarial deficit payments. To align ourselves with other defined benefit pension plans, the current service cost related contributions estimate is based on a phased-in employee contributions rate increase that will aid the organization in reaching a cost sharing ratio of 55-employer and 45-employee by January 2015. The actuarial deficit payments result from an extrapolation of the Plan funded status as at January 1, 2013 performed in October 2012 by CIHI s external actuaries. The reported funded status indicated a going-concern surplus (assumes that the Plan will be maintained indefinitely) of approximately $1 million and a significant solvency deficit (assumes a wind-up of the Plan) of approximately $29.5 million. As the economic/market conditions are not expected to improve significantly in the near future, CIHI will make payments to the Plan to address the solvency deficit sooner rather than later. Accordingly, a provision of $4.2 million has been included in our 2013 2014 budget. As per legislation, the next actuarial valuation for funding purpose is not required before January 1, 2014 at which time minimal special payments would resume. A provision of $4 million per year for 2014 2015 and 2015 2016 has been included in our financial plan. Table 3: Annual Expenses ($ Millions), 2013 2014 to 2015 2016 Expenses* 2013 2014 Approved Budget 2014 2015 Estimate 2015 2016 Estimate Three- Year Total Estimate Operating Expenses Salaries and Benefits 67.6 67.2 69.0 203.8 External Professional Services, Travel and Advisory Committee Expenses Occupancy, Information Technology and Other 9.0 8.5 7.1 24.6 13.2 13.5 13.9 40.6 Capital Expenditures 1.4 1.5 1.8 4.7 Pensions Plan Contributions 9.7 9.2 9.2 28.1 Total Annual Expenses 100.9 99.9 101.0 301.8 Note * Reflects annual expenses on a cash basis; therefore, excludes depreciation and pension plan related accounting expenses. Measuring Our Progress As a result of our strategic-planning and priority-setting process, CIHI s performance framework and indicators were redefined to establish a more targeted and effective set, which appear in Appendix 2. Specific targets will be developed and included in CIHI s annual operational plans, and a report on our progress against these targets will be included in our corporate annual reports. 11
Appendix 1: CIHI s Strategic Goals, Priorities, Initiatives and, 2013 2014 to 2015 2016 Goal 1: Improve the comprehensiveness, quality and availability of data Priority 1: Provide timely and accessible data connected across health sectors Initiative: Implement a multi-year plan to enhance ereporting, with a focus on tools for health system performance management Enhance infrastructure to support improved health system performance ereporting across health sectors Produce integrated long-term care and acute care hospital e-reports Launch production of integrated ereporting to support health system performance management at the regional level Enhance existing e-reports with new functionality; improve timeliness and efficiency Initiative: Improve timeliness and accessibility of data Align data access strategy with ereporting strategy Monitor turn-around time for data requests and report on performance against targets Explore new initiatives aimed at enhancing data quality Explore options to provide data access Continue to monitor and improve turn-around time for data requests Work with jurisdictions to improve timeliness of data submissions Implement options to enhance data access Continue to monitor and improve turnaround time for data requests Continue to work with jurisdictions to improve timeliness of data submissions Initiative: Provide patient-focused health information by integrating data from across sectors Work with jurisdictions to implement strategies to ensure the receipt of integrated and linkable data from jurisdictions Improve data infrastructure to facilitate improved linkages Produce analysis using linked data Further investigate options relating to Population Risk Adjustment Grouping methodologies Increase amount of linkable patient-level data received from jurisdictions Increase number of analytical reports using linked data Increase amount of linkable patientlevel data received from jurisdictions Deliver integrated ereporting at regional level, using linked data across health sectors 12
Goal 1: Improve the comprehensiveness, quality and availability of data (cont d) Priority 2: Support new and emerging data sources, including electronic records Initiative: Support recent launch of the Multiple Sclerosis (MS) Monitoring System Continue implementation of MS Monitoring System, and work with data providers to initiate data submissions Begin to collect Patient Reported Outcome Measures Continue implementation of MS Monitoring System, and work with data providers to increase the amount of data submissions Continue collection of Patient Reported Outcome Measures Continue implementation of MS Monitoring System, and work with data providers to increase the amount of data submissions Continue collection of Patient Reported Outcome Measures Initiative: Lead key elements of the pan-canadian vision for the effective use of electronic records by health systems Explore recommendations resulting from readiness assessment regarding CIHI s ability to receive data from electronic records in select databases Implement steps to ensure CIHI s readiness to receive electronic records data across select databases Continue to implement steps to ensure CIHI s readiness to receive electronic records data across select databases Initiative: Enhance primary health care (PHC) information through development and access to new data and information sources Support adoption and implementation of Electronic Medical Records (EMR) content standards Produce analytical reports using available PHC performance indicators Consider development of a PHC information system, if funding is made available Produce analytical reports using available PHC performance indicators Initiate development of a PHC Information System, if funding is made available Produce analytical reports using available PHC performance indicators 13
Goal 1: Improve the comprehensiveness, quality and availability of data (cont d) Priority 3: Provide more complete data in priority areas Initiative: Provide more comprehensive information on Canada s physicians Continue to expand collection of physician data Use of new physician data in analytical reports Continue to expand collection of physician data Use of new physician data in analytical reports Continue to expand collection of physician data Use of new physician data in analytical reports Initiative: Expand health care financing and funding information Support jurisdictions in activitybased funding initiatives Expand collection of patient-level cost data Assess the feasibility of releasing financial data for the long-term care and home care sectors Support jurisdictions in activitybased funding initiatives Expand collection and analysis of patient-level cost data Develop plan to expand collection of patient-level cost data beyond acute care If feasible, report financial data for the long-term care sector Support jurisdictions in activitybased funding initiatives Expand collection and analysis of patient-level cost data Implement plan to expand collection of patient-level cost data beyond acute care If feasible, report financial data for the home care sector Initiative: Expand information in key data holdings to support health care quality and patient safety Continue to increase the number of facilities submitting to the National System for Incident Reporting (NSIR) Develop plan to expand NSIR beyond hospitals and medication incidents Increase coverage in the Canadian Joint Replacement Registry (CJRR) Conduct analysis and reporting of medication incidents Implement plan for expansion of NSIR beyond hospitals and medication incidents, if funding is made available Continue analysis and reporting of medication incidents Expand collection of NSIR data beyond hospitals and medication incidents, if funding is made available 14
Goal 2: Support population health and health system decision-making Priority 1: Produce relevant, appropriate and actionable analysis Initiative: Implement corporate analytical plan focused on most relevant themes for decision-makers and system managers Deliver a corporate analytical plan focusing on population health, quality of care and patient safety, access, and international comparisons Deliver a corporate analytical plan that is better aligned with the health system performance agenda Explore development of interactive tools to support dissemination and use of analytical findings Deliver a corporate analytical plan that is aligned with the health system performance agenda and which reflects the priorities of jurisdictions Conduct pilots and refine strategy for interactive dissemination and use of analytical findings Initiative: Build the capacity of health system stakeholders to be able to use health data and information to support decision-making through education and engagement Offer education in line with new business model and corporate priorities Adapt and reposition current educational offerings with a focus on capacity building Introduce new capacity building initiatives Offer education in line with new business model and corporate priorities Implement enhanced capacity building initiatives Offer education in line with new business model and corporate priorities Implement enhanced capacitybuilding initiatives 15
Goal 2: Support population health and health system decision-making (cont d) Priority 2: Offer leading-edge performance management products, services and tools Initiative: Deliver a health system performance agenda focused on meeting the needs of the public and health system managers and policy-makers Release of public interactive website for health system performance Release redesigned hospital reporting tool using integrated e- reporting requirements Release repository for health system performance indicators Pilot benchmarking activities for regional health authorities and hospitals (such as the Collaborative for Excellence in Healthcare Quality (CEHQ) and Western CEO s Forum) Release new indicators on patient experience Release interactive tool for longterm care (LTC) performance Release regional and provincial health system performance reports Release new indicators on inhospital harmful incidents and hospital infections Release new indicators on continuity of care Continue to release health system performance reports Initiative: Fill in performance measurement gaps in health system efficiency and productivity Release analytical report on variations in health system efficiency at regional level Develop new hospital efficiency and productivity indicators Expand performance measurement work on efficiency and productivity Expand performance measurement work on efficiency and productivity Initiative: Use international comparisons when possible and initiate international benchmarking efforts Release second iteration of How Canada Compares Work with the University Health Consortium to pilot comparable Canada/US performance indicators for university hospitals Work with the CEHQ to pilot comparable Canada/US performance indicators for longterm care Continue participation in OECD work Release comparable Canada-US performance indicators for university hospitals and long-term care Continue participation in OECD work Release third iteration of How Canada Compares Continue to release comparable Canada U.S. performance indicators for university hospitals and long-term care Continue participation in OECD work 16
Goal 2: Support population health and health system decision-making (cont d) Priority 3: Respond to emerging needs while considering local context Initiative: Enhance partnerships and linkages to assist improved priority-setting to meet the needs of health system stakeholders Continue to identify and build new partnerships with key pan- Canadian, provincial and regional organizations, as relevant Leverage these partnerships to identify and respond to emerging health information needs Continue to identify and build new partnerships with key pan-canadian, provincial and regional organizations, as relevant Leverage these partnerships to identify and respond to emerging health information needs Continue to identify and build new partnerships with key pan- Canadian, provincial and regional organizations, as relevant Leverage these partnerships to identify and respond to emerging health information needs Initiative: Undertake targeted local initiatives that provide a solid basis for potential scaling up across Canada Continue work on activity-based funding initiatives underway in various jurisdictions Continue to support capacity building and produce tailored analysis to support stakeholders in low-population areas Work with priority stakeholder groups to support their local analytical needs with a view to knowledge translation at the pan- Canadian level Conduct pilot data linkage study with a jurisdiction to analyze diagnostic imaging data Continue work on activity-based funding initiatives underway in various jurisdictions Continue to support capacity building and produce tailored analysis to support stakeholders in low-population areas Work with priority stakeholder groups to support their local analytical needs with a view to knowledge translation at the pan- Canadian level Expand diagnostic imaging analysis to other jurisdictions Continue work on activity-based funding initiatives underway in various jurisdictions Continue to support capacity building and produce tailored analysis to support stakeholders in low-population areas Work with priority stakeholder groups to support their local analytical needs with a view to knowledge translation at the pan- Canadian level Expand diagnostic imaging analysis to other jurisdictions 17
Goal 3: Deliver organizational excellence Priority 1: Promote continuous learning and development Initiative: Develop leadership capabilities to enhance leadership at all levels of the organization Implement new leadership support program Enhance current management orientation program Extend job rotation program for pay grade 6 staff (e.g. supervisory staff) Continue implementation of leadership development programs and tools Assess new leadership support program Enhance new leadership support program Initiative: Share knowledge and promote adoption of leading practices Research a formal coaching and mentoring program Implement coaching/mentoring program Evaluate and enhance coaching/mentoring program Initiative: Enhance learning and professional development offerings Launch new professional development offerings Assess technical skills training for data analysts and identify enhancements Implement enhanced technical skills training program for data analysts Assess technical skills training for information technology staff and identify enhancements Implement enhanced technical skills training program for information technology staff 18
Goal 3: Deliver organizational excellence (cont d) Priority 2: Champion a culture of innovation Initiative: Implement an agenda to improve innovation awareness and create the conditions for successful innovation within CIHI Continue with corporate implementation of Lean, including training, projects and support Evaluate Lean implementation and identify opportunities for enhancements Implement enhancements where required and continue with corporate Lean program Priority 3: Strengthen transparency and accountability Initiative: Implement new three-year rolling multi-year business plan and associated processes Implement enhanced corporate reporting mechanisms Revise and update multi-year business plan Conduct planning session with the Board of Directors Revise and update multi-year business plan Conduct planning session with the Board and update multi-year business plan in line with renewed funding agreements with provincial/territorial/federal ministries of health Initiative: Enhance accountability through a new performance measurement framework Monitor and report on organizational performance against targets based on a recently developed performance measurement framework Continue to monitor and report on organizational performance against targets Conduct performance audit Continue to monitor and report on organizational performance against targets Implement recommendations arising from performance audit Initiative: Enhance CIHI security standards Implement new governance model and other security enhancements Continue to develop/refine policies, standards, guidelines, as required, and in alignment with security best practices (ISO - International Organization for Standardization) Continue to develop/refine policies, standards, guidelines, as required, and in alignment with security best practices (ISO) Consider options for expanding the scope of ISO security standards Continue to develop/refine policies, standards, guidelines, as required, and in alignment with security best practices (ISO) Implement, where appropriate, new/enhanced security standards 19
Appendix 2: Performance Measurement Framework and Indicators, 2013 to 2016 20
*NA Not Applicable Indicators Logic Model Program Level Indicators Baseline Measure Target Indicator Source/Definition Data Collection Method/Reporting Frequency STRATEGIC GOAL OUTPUTS MORE AND BETTER DATA Data Standards Minimum data set (MDS) for each database 100% 100% Availability of an MDS for each data holding CIHI Administrative Data (Annual) Databases and registries # of databases and registries 27 27 Report the number of databases and registries currently available and maintained by CIHI including active and inactive data holdings CIHI Administrative Data (Annual) Data quality assessments Data quality framework assessments completed % TBD 100% Data quality framework assessments completed for each active data holding Baseline measure to be determined end of 2012-13 CIHI Administrative Data (Annual) RELEVANT AND ACTIONABLE ANALYSIS Analytical and health indicator products (including integrated products) # of analytical and health indicator products developed # products TBD # TBD Report the number of analytical and health indicator products developed/released during the year based on analytical work plan and according to priority information needs CIHI Administrative Data (Annual) Baseline measure to be determined end of 2012-13 Target will be a range determined at the beginning of each year # of analytical products that use integrated data (linked datasets) # products TBD # TBD Report the number of analytical products that use data from more than one database Baseline measure to be determined end of 2012-13 CIHI Administrative Data (Annual) Target will be a range determined at the beginning of each year 21
Logic Model Program Level Indicators Baseline Measure Target Indicator Source/Definition Data Collection Method/Reporting Frequency IMPROVED UNDERSTANDING AND USE Capacity building products and services # of education sessions delivered # TBD # TBD Report the number of sessions delivered Target will be a range determined at the beginning of each year CIHI Administrative Data from Education department (Quarterly) # of communities of practice # TBD # TBD Report the number of communities of practice Target will be a range determined at the beginning of each year CIHI Administrative Data (Annual) STRATEGIC GOAL # of data requests OUTCOMES (IMMEDIATE - 1-3 years) # TBD NA Report of the number of data requests completed by aggregate and record - level requests Target is not applicable as number is driven by external client requests CIHI Administrative Data obtained from the data request tracking tool (DaRT) (Quarterly) MORE AND BETTER DATA Compliance with established standards % of databases reporting according to established standards TBD 80% Report of databases included in the Deputy Minister Reports. Composite rating for data holdings. Baseline measure to be available March 2014 Deputy Minister Data Quality Reports. Document Review (Annual) More pan- Canadian and timely data available for use % of databases with more than 80% jurisdictional participation 77% 80% Report of current data collection rates for each data holding by jurisdiction CIHI administrative data (Annual) % of databases containing data which is one year old % of open year data available 77% 80% Currency of data by data holding CIHI administrative data (Annual) %TBD 100% Availability of open year data CIHI administrative data (Annual) 22
Logic Model Program Level Indicators Baseline Measure Target Indicator Source/Definition Data Collection Method/Reporting Frequency Improved quality of data Summary measure to assess that data quality is improving overall and overtime TBD Improving Overall data quality assessment by data holdings Baseline measure to be determined end of 2012-13 Annual Deputy Minister Data Quality Reports Document review (Annual) RELEVANT AND ACTIONABLE ANALYSIS Increased awareness of and satisfaction with, health system and population health analyses # of downloads of analytical reports from website TBD Increasing Webtrends statistics for analytical products only plus ad hoc charts from time to time on specific analytical products Baseline measure to be determined end of 2012-13 Data review (Quarterly) Media coverage 3100 total mentions Increasing Communication department metrics for print, broadcast and web circulation Data review (Quarterly) Rating of awareness and satisfaction of analytical products 94% (good or excellent) 95% (good or excellent) Rating of awareness and satisfaction of analysis products from stakeholder survey Survey review (Biennial) # of media requests for information # TDB NA Communication department metrics on ad hoc media requests for data and information Target not applicable as number is driven by external client requests Data review (Quarterly) IMPROVED UNDERSTANDING AND USE Increased understanding of CIHI standards, data and analysis Stakeholder satisfaction with education sessions 86% (overall rating) 90% (overall rating) Results from education session evaluations CIHI Administrative Data (Quarterly) 23
Logic Model Program Level Indicators Baseline Measure Target Indicator Source/Definition Data Collection Method/Reporting Frequency Increased access to data and analysis Reduced turnaround time for data requests TBD 85% within service standards Report of average turnaround time for data requests Baseline measure to be determined end of 2012-13 CIHI Administrative Data obtained from the data request tracking tool (Quarterly) Stakeholder satisfaction with accessing data and analytical products 75% (good or excellent) 80% (good or excellent) Stakeholder satisfaction with accessing products on website Stakeholder surveys (Biennial) OUTCOMES (INTERMEDIATE - 3-5 years) Increased use of standards and data to support decision-making Frequency of use of CIHI data collection resources/stand ards 71% 70% Stakeholder survey question on frequency of use of data collection standards/resources Survey (Biennial) Frequency of use of CIHI data from data holdings 63% 65% Stakeholder survey question on frequency of use of data from data holdings Survey (Biennial) Increased use of analysis to support decision-making Frequency of use of CIHI analytical products 56% 60% Stakeholder survey question on frequency of use of analytical products Survey (Biennial) Frequency of use of health indicators 63% 65% Stakeholder survey question on frequency of use of health indicators Survey (Biennial) 24
Logic Model Program Level Indicators Baseline Measure Target Indicator Source/Definition Data Collection Method/Reporting Frequency Satisfaction with analytical products 92% 90% Stakeholder survey question on the satisfaction with analytical products Survey (Biennial) Satisfaction with health indicators 93% 90% Stakeholder survey question on the satisfaction with health indicators Survey (Biennial) OUTCOMES* (LONG TERM - 5+ years) Improved decision making regarding health policy and effective management of the Canadian health system NA NA Baseline measure and target not applicable as no specific indicators have been identified Outcomes to be documented through stakeholder surveys and anecdotal information e.g. case studies * Given the number of factors that may be involved in achieving health system and service results, the causal relationship of component efforts to health system results may be difficult to prove. Therefore, we use the perceptions of surveyed stakeholders and clients on % improvement indicators to assess their possible association with outcome measures. 25
Support Function Indicators STRATEGIC GOAL Outputs Outputs - Performance Indicator Baseline Target DELIVER ORGANIZATIONAL EXCELLENCE Engaged workforce Employee overall engagement 5% above norm (Benchmark against Hay Group norm) above norm Turnover rate 6.9% Below market rate (Benchmark Conference Board of Canada) Up to 1% below benchmark Vacancy rate (+/-1% of budgeted rate) 6% 6% Employee satisfaction with learning and career development opportunities (from employee survey) 62% 70% Average sick leave days per employee Benchmark against Conference Board of Canada statistics At average benchmark or below IT systems are dependable and robust Number of responses of Central Client Services to: a)client Support b)order Desk c)education TBD 100% response rate for a, b, c within two (2) working days 26