Document Sample
					              Queens School of Business
               Executive MBA Program

               STAGE 1:

Key Information about Canada’s Health Care System

                                            Derek Clarke
                                           Valerie McCoy
                                          Michael Rowley
                                           Shiva Sharma
                                          Rick Szymczyk
                                Queens School of Business
                                 Executive MBA Program

Executive Summary
To meet the current and future needs of Canadians with respect to healthcare services,
the federal and provincial governments are increasing spending commitments for new
technologies and initiatives to the amount of billions of dollars in grants annually. The
current development of information communications and technology standards places
the Canadian medical system at the ready point for the investment in new products and
services. New Zealand companies can benefit greatly by these opportunities because of
New Zealand’s recent history of reform of a medical system not too different than
Canada’s, as well as knowledge of a legislative system that originates from a common

There is the willingness in Canada to increase investment in healthcare information and
communications technologies (ICT) considerably. Currently, only $2 to $3 billion is
spent annually on ICTs. This represents less than 2 per cent of operating budgets in
health care. The Information Technology Association of Canada is calling on the
government to triple this amount, matching the operating budgets of the United States.

National synergies and emerging partnerships such as the Western Health Information
Collaborative are defining regional, provincial, and national strategies for healthcare IT.
These groups are vying for millions of dollars in grants from organizations such as the
Canada Health Infostructure Partnerships Program (CHIPP). WHIC alone has an
annual budget of $500,000 to sustain its secretariat, and has several projects under way
led by the individual provinces that have already established expertise in these areas.

Identified is the need to improve security and privacy with technologies that match the
requirements of national privacy legislation. As such, several government bodies have
been created to act as focal points for privacy issues, communications standards, and
the development of an Electronic Health Record system with the objective of becoming
pan-Canadian in the next 5 years. With $1.1 billion in its budget, Infoway is leading this
initiative, co-ordinating healthcare and IT companies that are working together. Infoway
plans to have the critical building blocks of the EHR system in place by the spring of
2004, and with the power to borrow and invest in the Canada-wide health infostructure,
Infoway plans to invest up to $1.5 billion over the next five years.

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Healthcare represents the last big vertical market to get into. Technology firms should
view this as a unique opportunity as the growth in the healthcare market converges with
the collapse in other sectors. The increasing maturity of provincial plans and strategies,
demonstrated through the initiation of bodies like Smart Systems for Health and the
Ontario e-Health Council, further reinforces the commitment of the provinces and the
federal government in investing in technologies that meet identified needs and

To aid New Zealand companies in identifying market opportunities, and to assist with
formulating plans for market penetration, Canadian Healthcare IT Opportunities
distinguishes key people and associations in three of Canada’s largest provinces: British
Columbia, Alberta, and Ontario. These true decision makers can provide the opportunity
for products and services to gain a foothold in the Canadian market. Furthermore,
Canada represents an excellent training ground to develop and enhance intellectual
property and skills, which can then be exported to the higher priced markets of the
United States and Europe. Knowing who to contact, and which groups are the influential
ones, provides an opening for New Zealand firms to showcase their products and
services to the right audience.

Among the ICTs that Canada’s healthcare system is in immediate need of are secure
electronic transmission technologies, secure and robust database systems that will co-
ordinate specialty and geographic wait lists, and data mining and warehousing systems
that can store an ever increasing amount of information about Canada’s healthcare

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                Stage 1 TABLE OF CONTENTS
Executive Summary ..................................................................... 2
Opening Remarks ........................................................................ 7
1.1 Federal Government Funding of Healthcare ................................... 8
     1.1.1 Canada Health and Social Transfer ......................................... 8
     1.1.2 February 2003 First Ministers’ Accord ...................................... 8
     1.1.3 A Growing Source of Revenue............................................. 10
1. 2 Health Canada’s 5 Year Plan ................................................... 11
     1.2.1 What is Health Canada? .................................................... 11
     1.2.2 Background ................................................................... 11
     1.2.3 Canada Health Infoway Inc. ................................................ 13
     1.2.4 Membership .................................................................. 14
     1.2.5 Details of Infoway’s Implementation & Timing Plan ..................... 14
     1.2.6 Infoway’s Priorities .......................................................... 16
     1.2.7 Canada Health Infoway Business Plan (2002) .......................... 17
1.3 Short-term Opportunities ........................................................ 18
     1.3.1 Wait lists ...................................................................... 18
     1.3.2 Data Warehousing ........................................................... 19
     1.3.3 Ontario ........................................................................ 20
1. 4 Provincial Priorities............................................................... 21
   1.4.1 WHIC ............................................................................ 21 BC Lead Projects .......................................................... 21 Alberta Lead Projects ..................................................... 21 WHIC Secretariat Lead Projects ........................................ 22
   1.4.2 Ontario........................................................................... 23
1.5 Key Players / Decision Makers .................................................. 24
   1.5.1 Health Canada – Federal Government...................................... 24 Infoway ..................................................................... 24 Canadian Institute for Health Information (CIHI) ...................... 24
   1.5.2 Provincial: British Columbia .................................................. 25 Western Health Information Collaborative (WHIC).................... 25 B.C. Ministry of Health Services ......................................... 25 healthnet BC .............................................................. 25
   1.5.3 Regional / Municipal - British Columbia ..................................... 26 Acute Care (Hospital) British Columbia ................................ 28 Long-Term Care British Columbia....................................... 28
   1.5.4 Provincial: Alberta ............................................................. 28 Ministry of Health & Wellness ............................................ 28 Health Accountability...................................................... 28 Alberta WellNet ............................................................ 29
   1.5.5 Regional / Municipal – Alberta ............................................... 29 Regional Health Authorities (RHAs) .................................... 29
     1.5.6 Emergency Medical Services .............................................. 31 Acute Care (Hospital) ..................................................... 31

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                                 Executive MBA Program Long-Term Care ........................................................... 31
   1.5.7 Provincial: Ontario............................................................. 32 Ontario e-Health Council (OEHC) ....................................... 32 Ontario Ministry of Health & Long Term Care ......................... 32 Smart Systems for Health ................................................ 33 Ontario Family Health Network .......................................... 33 Acute Care (Hospital) ..................................................... 33 Ontario Hospital e-Health Council ....................................... 34
   1.5.8 Regional / Municipal: Ontario ................................................. 34 Community Care Access Centers ....................................... 34 Emergency Medical Services (EMS).................................... 34 Long-Term Care ........................................................... 35
1.6 Key Associations/Publications ................................................. 36
   1.6.1 Magazines ...................................................................... 36
   1.6.2 Associations .................................................................... 36 Medical Associations...................................................... 36 Hospital Associations ..................................................... 37 Other ........................................................................ 37
1.7 Competitor Analysis .............................................................. 38
   1.7.1 Standards ....................................................................... 38
   1.7.2 Opportunities ................................................................... 38
   1.7.3 Key Decision Makers .......................................................... 38
   1.7.4 Non-Market Strategies and Market opportunities .......................... 38 Lobbying of Councils ...................................................... 38 Internet Portals ............................................................ 39 Consulting .................................................................. 39
   1.7.5 Competitor Overview: ......................................................... 39 Overview.................................................................... 39 Hospitals .................................................................... 39 Community Care .......................................................... 40 Primary Care ............................................................... 40 Pharmacies ................................................................ 40
1.8 Regulations and Standards Framework & Environment: .................. 41
   1.8.1 Federal Government ........................................................... 41
   1.8.2 Provincial Governments ....................................................... 42
   1.8.3 Organizations ................................................................... 42 COACH ..................................................................... 42 CIHI ......................................................................... 43 OHIH's Role ................................................................ 44 A Legal "Patchwork" ...................................................... 44 Important Federal legislation ............................................. 45 Provincial legislation ...................................................... 45
1.9 Investment Environment ......................................................... 46
   Infoway ................................................................................. 46
   Investment Technology Association of Canada (ITAC) .......................... 46
APPENDICES ............................................................................ 48

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Appendix I: Short-Term Opportunities ................................................ 49
  Appendix II: Federal Organization Chart .......................................... 54
  Appendix III: Contact List For Health Chief Information Officer Council ..... 55
  Appendix IIIB: Key Organizational Members and Contact Information ....... 56
  Appendix IV: Contact List for Northern Interior Health Areas ................. 62
  Appendix V: OACCAC Board of Directors 2002/2003 .......................... 63
  Appendix VI: 2003 Directory of Healthcare I.T. Suppliers ....................... 64
  Appendix VIII: Provincial Legislation .............................................. 87
  Appendix IX: Infoway Talks About Alliances, Partnerships & Collaborations 89
  Appendix X: ITAC and Potential Investment Opportunities ..................... 92
  Appendix XI: Common Acronyms .................................................. 94

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Opening Remarks
The information contained in this report, Canadian Healthcare IT Opportunities: Key
Information about Canada’s Healthcare System, is the result of significant research and
consultation with a leading expert about Canada’s Healthcare system. The objective of
presenting this material is to simplify the understanding of an otherwise very complex
system. Organizations wishing to establish a presence North America should consider
Canada as an entry point to this marketplace. The number of opportunities for new
technologies and services is large, and experiences in Canada can assist firms develop
the skills and training programs as they look towards the American and European

Stage One is the first of three stages involving five Executive MBA candidates at the
Queen’s School of Business. Stage Two will focus on key issues and challenges facing
the New Zealand Healthcare IT cluster and its member organizations that are looking to
establish a presence in Canada. Critical factors for success in the Canadian market
place will be identified and explored in preparation towards going forward to the
concluding phase. Stage Three will focus on assisting New Zealand companies develop
Canadian market penetration strategies and government contract procurement,
especially in the Canada’s largest city, Toronto, home of the New Zealand Health IT

To compliment this work, we will be visiting New Zealand in the later months of 2003.
During our visit, we will meet with interested organizations to better understand their
needs and goals. With this understanding, we will be better able to provide salient
recommendations about the direction these organizations will need to concentrate on as
they look at Canada as an opportunity for global expansion.

The research material presented herein is only a start. The opportunities for growth are
not exclusive to the three provinces that we have focused on. Nonetheless, successful
penetration into one or more of these three marketplaces will give an organization a
substantial presence within the entire Canadian Healthcare IT sector.

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1.1 Federal Government Funding of Healthcare
1.1.1 Canada Health and Social Transfer

The Canada Health and Social Transfer (CHST) is the largest federal transfer to
provinces and territories, providing them with cash payments and tax transfers in support
of health care, post-secondary education, social assistance and social services,
including early childhood development. A tax transfer provides the same support as a
cash transfer. The tax transfer component of the CHST occurred in 1977 when the
federal government agreed with provincial and territorial governments to reduce its
personal and corporate income tax rates, thus allowing them to raise their tax rates by
the same amount. As a result, revenue that would have flowed to the federal
government began to flow directly to provincial and territorial governments. The CHST
gives provinces and territories the flexibility to allocate payments among social programs
according to their own priorities, while upholding the principles of the Canada Health Act
and the condition that there can be no period of minimum residency with respect to
social assistance.

1.1.2 February 2003 First Ministers’ Accord

Canada’s First Ministers (provincial premiers and the prime minister) agreed in February
2003 on a shared action plan for renewing health care, building on their earlier
September 2000 agreement. As confirmed in the 2003 budget, federal support to
health care will increase, relative to 2002-03 levels, by $17.3 billion over three years and
by $34.8 billion over five years. This includes:

      $9.5 billion in increased cash transfers (through the CHST and its successor
       programs) over five years;
      $2.5 billion in an immediate investment through a CHST supplement to relieve
       existing pressures; and
      $16.0 billion over five years for a Health Reform Fund targeted to primary health
       care, home care and catastrophic drug coverage. Subject to a review of progress
       made in achieving the agreed-upon reforms and following a First Ministers’
       meeting, the level of funding provided through the Health Reform Fund will
       be integrated into the new Canada Health Transfer starting in 2008-09.

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In order to improve the transparency and accountability of federal support to provinces
and territories, the CHST will be restructured effective April 1, 2004 to create two new

            A Canada Health Transfer (CHT) in support of health; and
            A Canada Social Transfer (CST) in support of post-secondary education,
             social assistance and social services, including early childhood development

The existing CHST (cash and tax transfers) will be apportioned between the CHT and
the CST. The percentage of cash and tax points apportioned to the CHT will reflect the
percentage of provincial health spending within overall provincial spending in the health
and social sectors supported by the CHST. The remaining cash and tax points will be
allocated to the CST. The existing legislated five-year funding track for transfers in
support of health care and other social programs was extended in Budget 2003 for an
additional two years to 2007-08. Cash transfers will grow from $19.1 billion in 2002-03 to
$22.2 billion ($27.7 billion including the Health Reform Fund) in 2007-08. The 2003
budget also indicates planned levels for cash transfers to 2010-11 to provide a ten-year
predictable and growing funding framework for provinces and territories. Cash transfers
in support of health and other social programs are thus planned to double over a ten-
year period, growing to $31.5 billion in 2010-11 from $15.5 billion in 2000-01. This
means that cash transfers will grow at 7.3 per cent annually on average during that
period. Tax transfers continue to be an important element of the growing and
predictable funding provided to provinces and territories. They will bring total transfers to
$48.8 billion by 2007-08 and to $56.0 billion by 2010-11.

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    Note: Years 2008-09 to 2010-11 reflect the roll-in of $5.5 billion from the Health
    Reform Fund (subject to review by First Ministers by the end of 2007-08).

1.1.3 A Growing Source of Revenue

The commitments made under the 2003 First Ministers’ Accord build on a series of
enhancements to the CHST that the federal government has made since 1996:

   Budget 1996 established an annual CHST cash floor of $11 billion.
   Budget 1998 raised the annual CHST cash floor to $12.5 billion.
   Budget 1999 announced an $11.5 billion investment in health over five years.
   Budget 2000 provided a further $2.5 billion in cash, raising annual cash to $15.5

As a result of the September 2000 First Ministers’ Agreement, the federal government
committed to invest $21.1 billion of additional cash in the CHST over five years,
including $2.2 billion for early childhood development.

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1. 2 Health Canada’s 5 Year Plan
1.2.1 What is Health Canada?1

Health Canada is the federal department responsible for helping the people of Canada
maintain and improve their health. In partnership with provincial and territorial
governments, Health Canada provides national leadership to develop health policy,
enforce health regulations, promote disease prevention and enhance healthy living for all
Canadians. Through its administration of the Canada Health Act, Health Canada is
committed to:

          1) Maintaining this country's world-renowned health insurance system which is
          universally available to permanent residents
          2) Comprehensive in the services it covers
          3) Accessible without income barriers
          4) Portable within and outside the country and
          5) Publicly administered.

Each province and territory administers its own health care plan with respect for these
five basic principles of the Canada Health Act.

It is the responsibility of each individual province or territory to manage and deliver
health services. Provinces and territories plan, finance, and evaluate the provision of
hospital care, physician and allied health care services, some aspects of prescription
care and public health.

1.2.2 Background
The Office of Health and the Information Highway (OHIH) 2 was created in the summer
of 1997 as Health Canada's focal point for all matters concerning the use of information
and communications technologies (ICTs) in the health sector. Its mission is to foster and
accelerate the development adoption of electronic health information systems using
compatible standards and communication technologies. The stated vision of OHIH is
“to provide residents of Canada, and their health care providers’ timely, appropriate and

    Health Canada Web site:
    OHIH website: or
bsi/about_apropos/index_e.html. More information about OHIH, and Infoway can be found in
Section 1.7.3: Organizations , and 1.7.4: Legislated Privacy Protection across Canada

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secure access to the right information when and where they enter into the health care
system. Respect for privacy is fundamental to this vision.”

OHIH works collaboratively with its Health Canada partners, Government of Canada
departments, provincial/territorial governments, and other stakeholders to develop
privacy policies and guidelines and standards; research domestic and international
medical developments; provide strategic advice to its partners; promote awareness
about the benefits of adopting technology; and identify and share best practices and
lessons learned

The OHIH is a key player in the formation of government policy at both the regional and
federal level. The current priority is to implement the major components of interoperable
Electronic Health Record (EHR) solutions in place within five to seven years across

To assist with the realization of this goal, Infoway was created in January 2001 as a non-
profit corporation with the power to borrow and invest in the Canada-wide health
infostructure to improve the quality of health care for Canadians. It is set up to co-
ordinate health care companies in Canada to work effectively together. Created by the
federal, provincial and territorial governments, it is provided $500 million in funding by
the government. An additional $600M was provided to Infoway after the Romanow
report re-confirmed the importance of e-Health in Canada.

“Infoway [seeks] to identify public and private sector partners to build health information
and electronic health record solutions with immediate application in Canada. [Its]
commitment is to have the critical building blocks of EHR in place within 12 to 18 months
and to have the basic content elements up and running in Canada in five to seven
years.” 3

  Source – Infoway Annual Report for 2001

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1.2.3 Canada Health Infoway Inc.

Infoway is a strategic response by federal, provincial and territorial governments to this
situation. The immediate priority of this independent, not-for-profit corporation is to foster
and accelerate the development and adoption of cost-effective, sustainable and effective
EHR solutions with compatible standards and communication technologies across
Canada. This infostructure will support high-quality care, giving Canadians and their
healthcare providers’ timely, appropriate and secure access to the right information
whenever and wherever they enter the health system. Respect for privacy is
fundamental to this vision.

Focusing on interoperability, and working in collaboration with partners ranging from
governments to health care providers, patient groups and information technology
experts, Infoway seeks to enhance the effectiveness of existing initiatives and avoid
duplication of efforts and investments as it builds a strong foundation for national EHR

In accordance with commitments made for its creation, Infoway has adopted policies on
Intellectual Property and Conflict of Interest, which are updated regularly.

In most cases Infoway will not make purchasing decisions. Instead, Infoway essentially
provides funding for projects and develops standards and facilitates communications
across groups working on e-Health strategies. Proposals are brought forward by other
interested groups. Infoway does review these proposals, and may be an influencer.
Occasionally Infoway will call for a proposal. Details on investment criteria are available
on the Infoway website.4

The main objectives that are to be carried out by Canada Health Infoway include:

     Accelerate the development and adoption of modern systems of health information
      and communication technologies
     Promote standards governing shared data to ensure the compatibility of health
      information networks (available online at its website)

    Infoway Website:

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     Support the adoption of such standards for health information and compatible
      communications technologies for the health sector in Canada
     Enter into collaborative arrangements as required with the governments of Canada,
      provinces and territories, corporations, not-for-profit organizations and other public
      and private partners for the development and adoption of standards and
     Incorporate standards that protect personal privacy and confidentiality of individual
      records and the security of health information
     Carry out the work of Infoway in both official languages (English and French)

1.2.4 Membership

Currently, a total of 13 members represent ‘Corporation Membership’ on Infoway
Canada. These are typically Deputy Ministers of provincial and federal government
levels (non-elected administrative branch of provincial and federal government). A total
of 11 members sit as the board of directors from across Canada - two federal
representatives, one representative from each of the five regions of Canada, and four
independent members from across the healthcare industry.

1.2.5 Details of Infoway’s Implementation & Timing Plan

Immediate Priority:

Support the accelerated development of interoperable health care record solutions
(EHRs) on a Canada Wide basis.

Infoway’s 12-18 Month Tactical Plan (begun October, 2002):5
There are ten key areas of activity:

1) Fully ‘Operationalize’ Infoway
   Hiring of Infoway team
   Establish offices in Montreal, Toronto, Eastern & Western Canada

2) Complete Architecture/Design with Experts in the field
   Develop architectural foundation
   Identify infostructure needs for pilot rollout
3) Test Architecture through Electronic Health Record Pilot project

5   From Infoway’s ‘Guide to Investment Strategy Framework’ document – Created Oct. 10, 2002

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   Implement Pilot using population > 200K to prove concept
   Develop components to replicate for other jurisdictions

4) Establish Priority Project Targets
   EHR projects to focus on clinician adoption
   DI (Diagnostic imaging projects) focusing on clinician adoption
   Registry projects (provider & Client) across Canada

5) Establish Benefits Framework
   Develop methods to measure benefits from $500M investment
   Develop ‘pipeline’ to identify future projects based on a six month proposal cycle

6) Change management
   Research physician & patient attitudes regarding EHRs
   Research privacy issues

7) Privacy & consent
   Identify privacy issues from consumer viewpoint
   Work with teams to research & implement privacy components

8) Marketing & communications
   Develop & implement marketing & communications plan
   Raise awareness among the public

9) Knowledge management & transfer
   Conduct information sharing seminars & workshops
   Establish user friendly online repository for the field

10) Partnerships & funding
   Facilitate an investment deal with one major investment partner with a jurisdiction

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1.2.6 Infoway’s Priorities6

Success to be measured across the following areas:
  Service Delivery enhancement
  Accelerated Development
  Ongoing Demand
  Leveragability of Funds
  Achievement of Infoway’s annual tactical Plans ($500 million to 1.5 billion within five

OHIH will invest, but only in specific areas including:
 Public Sector Sponsorship required
 Initiatives that promote privacy
 Compliance to standards

OHIH will avoid:
 Physical bandwidth, devices or long term operating costs

  Source – Infoway Annual Report for 2001

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1.2.7 Canada Health Infoway Business Plan (2002)

How will the EHR Evolve?7

Table 1.2.7.a
                    Generation 1            Generation 2              Generation 3                 Generation 4
                    The Foundation          The Documentor            The Helper                   The Mentor

    Goals           Basic building          Development of            Healthcare professionals
                    blocks                  ‘viewers’                 can view and modify
    5 year          100% availability for   50% adoption rate         50% adoption rate
    objectives      jurisdictions to        50% of authorized users   50% adoption rate by
                    employ                  have access to view lab   providers and institutions
                                            results, drug             for drugs & related areas
                                            formulations, current
                                            medications etc…
    Examples                                Laboratory results        On-Line order entry with
                                            Drug formulations         drug interaction
                                            Current medications       notification
                                            Diagnostic images         Access to decision
                                            Transcripted notes        support tools
                                                                      Out of range notification
                                                                      of lab results
    Infostructure   EHR standards and       Drug data uploaded        PLUS
    component       technology              Laboratory data           Factor authentication
                    Replicate patient,      uploaded                  Electronic signature
                    provider & facility     Registry entries          Irregular alerts for
                    registries              Standard core data set    unauthorized access
                    Implement change        Security & privacy        Business rules and
                    management              infostructure             workflow
                    processes                                         Customized user
Infoway’s Implementation plan (Timeline)

    From Infoway’s General Annual Meeting June 26, 2002

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1.3 Short-term Opportunities
Appendix I contains some specific examples of recent short-term opportunities available
to healthcare IT vendors, including the language and requirements of the RFPs. These
opportunities were presented on (, Canada’s public-sector
electronic tendering service. As a tendering service for the public, MERX can connect
suppliers to buyers in the federal, provincial and MASH (municipal, academic, school
and hospital) sectors to get the information needed to bid on public sector contracts.

Two other areas have been identified as significant areas for opportunity in the Canadian
health care IT market.

1.3.1 Wait lists

Health Canada as early as 1998 recognized that wait lists are non-standardized,
capriciously organized, poorly monitored, and in grave need of retooling. “There is
consequently an urgent need for a national investment in the design and development of
information and management systems that can provide the public with a greater sense
of confidence about access to, and quality of care. Such an initiative affords Canada an
opportunity to examine the nature and impact of measures taken in countries, such as
New Zealand, which have made clear commitments in this area.”                   One official within
the Ontario government recently confirmed that this is still a key area for market
opportunities. Efforts in recent years towards increasing the efficiencies of wait lists in
various Canadian jurisdictions have been limited at best, constitute short-term goals, and
because of the very nature of their design have actually increased the number of
patients waiting to receive care.

Health Canada canvassed provincial and territorial officials, and some opportunities for
entrance into this market were identified.

     The perceived causes of wait lists were inadequate resources, lack of coordination
      and changes in demand due to population aging, technology and changes in

8 , July 1998.

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     The services for which wait lists were of greatest concern included: orthopaedic
      surgery, cardiac surgery, ophthalmologic surgery, magnetic resonance imaging
      (MRI), out-patient mental health services, and cancer care. Organ transplants have
      recently been identified as another important service that would benefit from a co-
      ordinated wait list database.
     With the exception of cardiac surgery in two provinces, no province or territory
      actively participated in the supervision / monitoring of wait lists.
     Only in certain jurisdictions are there co-ordinated wait lists, but these are limited to
      specialty areas only (e.g. cardiac surgery, radiation oncology).

1.3.2 Data Warehousing

There have been some recent initiatives in this area, but generally data warehousing
and data mining projects are limited in Canada. The Western Health Information
Collaborative (WHIC) has already started to monitor British Columbia’s HNData project,
which is a very large specialized database for information related to the health sector in
British Columbia (see section 1.4, Provincial Priorities, for more information about WHIC
and HNData).

In 2000, Vision 2020, a workshop facilitated by Health Canada's Office of Health and the
Information Highway (OHIH), in conjunction with the Canadian Healthcare Association
(CHA), consulted with health care officials from across Canada to find out what their
vision of the health care system is for the year 2020. The Vision 2020 Workshop
identified that the need for data warehousing and data mining systems capabilities
“would give health care managers new knowledge and new insights into a wide range of
health trends, and would enable them to better manage and use the resources and tools
already available to them”. 9

In Health Canada’s 2002 “A Modern Management Strategy”, improved records
management, data warehousing and records retrieval were reaffirmed as key
components to the management and sharing of information across ministry’s
departments. 10


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1.3.3 Ontario

The recent SARS outbreak in Ontario has forced politicians to re-examine recent
financial commitments to the provincial medical system. Specifically, calls for more co-
ordination and the sharing of information have been made. There could be opportunities
in these areas as provincial health officials begin to examine the lessons learned from
the SARS outbreak.

One area in the Canadian system which is not considered to be an opportunity is
Electronic Billing. York Medical and Mac Medical are the 2 main competitors, and there
are a variety of smaller companies providing applications for specialties.

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1. 4 Provincial Priorities
The four western provinces and the three territories have joined together to explore
collaborative opportunities with respect to health infostructure initiatives. Searching
common opportunities that meet the provincial and territorial health information needs,
and developing the strategic directions and initiatives for health infostructure at the
national level, the Western Health Information Collaborative (WHIC) can be considered
acting as one body with respect to important provincial priorities.

1.4.1 WHIC

Each of the provinces is leading specific projects. British Columbia and Alberta have
taken on some of the more complex initiatives. BC Lead Projects

Provider Registry (PRS)
The Provider Registry is a standards-based repository of core data supplied by
authorized sources, and available to authorized consumers, that facilitates the formal
exchange of health information. The ability to uniquely identify and transmit health
information among the partners is considered to the fundamental building block to
establishing a pan-Canadian EHR system. The PRS is being designed with the
potential of being adopted by other provinces should they decide to join in creating a
Canadian EHR system.

E-Claims Standard
Along with defining a standard for electronic transmission of health claim data between
providers and payers, other standards being developed (or have been completed)
include data, security, audit, compliance, and communications standards Alberta Lead Projects

Laboratory Information
A vision and common business model for laboratory business approaches, strategies
and options has been developed by WHIC. Along with a series of standards related to
laboratory information exchange, WHIC anticipates that a pan-Canadian standard for

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laboratory information will be developed in conjunction with CIHI (The Canadian Institute
for Health Information).

Primary Health Care
The WHIC partners are currently validating opportunities for collaboration in the area of
primary health care, the first point of contact people have with the health system.
Promoting health and wellness, common programs to increase public awareness in
areas such as diabetes, cardiac and lung disease, arthritis and mental illness are the
larger projects underway. Strategies to address the challenges in primary care, and
developing cost-effective collaborative programs using information technology are
headed by Alberta. WHIC Secretariat Lead Projects
Two areas that have been identified as opportunities for market entrance are Data
warehousing and Wait Lists.

Data Warehousing
Currently BC’s HNData project is being monitored by WHIC. HNData integrates
information regarding regional care, hospital, ambulance, Continuing Care, Mental
Health, Medical Services Plan, Pharmacare, Surgical Wait List, Vital Statistics, and
Preventive Health.

Wait Lists
Although no lead has been assigned to date, Alberta has indicated its interest in
assuming this role, and BC has indicated a strong involvement in the project as well.
Determined to be a cost effective venture, the Provider Registry project is a sample
project closely watched by the WHIC to determine the direction of developing a Wait List

Strategic plans for Alberta and BC are available for download on their provincial
websites. 11


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1.4.2 Ontario
Ontario has recognized the need to establish a more structured, integrated and
coordinated primary care system, to support and invest in family physicians, to enhance
how patients receive service, and to improve how primary care connects to the rest of
the health care system. This co-ordination is overseen by the Ontario Family Heath
Network (OFHN). The objective of the OFHN is to move family practitioners away from
solo operations into a co-ordinated network, and as such provides funding for these
physicians to improve communications and information sharing technologies. The
ePhysician Project (ePP) has been established to assist with the effective
implementation of IT for primary care providers, and to maximize the benefits from
investments in this area. Eventually the OHFN will link primary care physicians and
facilities with other areas of the Ontario Ministry of Health and Long-Term Care

Ontario is also working on projects similar to the WHIC, specifically in the areas of a
centralized provider registry, laboratory information sharing network, and unique patient
identifiers (UPI) that will identify all clients of the health care system and their eligibility
for MOHLTC programs, such as the Ontario Health Insurance Plan.

Ontario maintains close relations with the western provinces through WHIC, especially in
the areas of continuing care (Alberta) and all provinces and territories for electronic
health records.

Like the other provinces, Ontario is also committed to reducing heart and lung disease,
diabetes, and increasing health and fitness activities through the use of public
awareness campaigns.

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1.5 Key Players / Decision Makers
1.5.1 Health Canada – Federal Government

Within the Federal government resides Health Canada, responsible for providing
“national leadership to develop health policy, enforce health regulations, promote
disease prevention and enhance healthy living for all Canadians”. 12             Within Health
Canada lies the Information, Analysis and Connectivity Branch (IACB), established to
facilitate the use, the creation and development of information through the “information”
highway. See Appendix II for an organization chart.

Under the IACB resides the Office of Health and the Information Highway (OHIH).
Among OHIH’s mandates are those to develop federal policies and guidelines,
contribute to the development of standards and research domestic and international

This structure is essential to understanding the federal players, but Health Canada can
not be considered a decision maker with respect to IT solutions. Infoway
See section 1.1.2: Canada Health Infoway Inc. for more information about Infoway.
See Appendix IIIB Key Organizational Members. Canadian Institute for Health Information13 (CIHI)
This is a not for profit organization with the mandate of providing quality, timely
information to improve the Health Care system. It was created to promote national co-
ordination. Its activities include the maintenance and promotion of standards. CIHI
offers licensed products related to CIHI’s grouping methodologies and other standards to
the vendor community. This ensures software developed and distributed by vendors is
based on comprehensive CIHI specifications.

     Health Canada Web site
     Canadian Institute for Health Information

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1.5.2 Provincial: British Columbia Western Health Information Collaborative (WHIC)14
See section 1.4, Provincial Priorities, for information on WHIC. B.C. Ministry of Health Services
The B.C. Ministry of Health provides funding in the province for health care, education,
services and prevention programs. Within the ministry are six newly formed health
authorities, headed by a governor. Five are geographic and one is provincial wide.
Each governor is responsible for identifying the needs of the authority, planning and
procuring funding. The six authorities are:
          1. Provincial Health Services Authority
          2. Northern Health Authority
          3. Interior Health Authority
          4. Vancouver Island Health Authority
          5. Vancouver Coastal Health Authority
          6. Fraser Health Authority

The Provincial Health Services Authority works with the five regions on provincial
programs and highly specialized services such as transplants and cardiac care. It
develops province wide standards, and allocates resources as well as managing
provincial wide organizations such as the B.C. Centre for Disease Control, Cancer
Agency, Children's & Women's Health Centre15.

Don Henkelman, the Chief Information Officer, is “responsible for providing vision and
leadership in the development of integrated information systems to support the business,
human resources and clinical needs of all PHSA agencies.” Contact information is
provided in Appendix III. healthnet BC 16
This organization is the source of information and standards for Electronic Health
Records (EHR). The Health Chief Information Officer Council was formed to co-ordinate
each health authority’s e-Health initiatives. A contact list for each Health Chief

14 WHIC    website

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Information Officer which provides a contact for each Authority as well s provided in
Appendix III.

1.5.3 Regional / Municipal - British Columbia

The province is divided into five Health Authorities. Within each Health Authority are
sixteen health service delivery areas. Contact information for each Authority is available
in Appendix IIIB. Northern Health Authority 17
This authority employees 6,000 people working in 26 acute care facilities and 14 long
term care facilities, as well as public health units located in most communities within the
NHA. The region governed by this authority has the highest growth rate of seniors in the

The NHA is further divided into three regions with a COO for each; Northern Interior
Health, Northeast Health Service Delivery Area and Northwest Health Service Delivery
Area. Interior Health Authority 18
This health authority serves 690,000 people and makes available 35 Acute Care Sites,
4,427 residential beds, has 18,000 employees, and 1,200 physicians
There are 4 regions within the authority:
         1. Thompson Cariboo Shuswap
         2. Okanagan
         3. East Kootenay
         4. Kootenay Boundary Vancouver Island Health Authority 19
This authority serves a population of 700,000 people with 16,400 health professionals.
Facilities include:
        1534 Acute Care Beds

   NHA Website:
   Interior Health Website:
   VIHA Website:

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        2294 Residential/Mental Health Beds
        2957 Affiliate / Contract Beds (acute / continuing / residential) Vancouver Coastal Health Authority 20
This is a large Authority serving twenty-five percent of BC’s population. It receives
approximately $1.9 billion in funding annually. Its resources include;
        27,020 staff
        14 Acute care facilities
        2 Diagnostic and treatment centres
        9,000 acute, rehabilitation and residential beds

The four areas the Vancouver Costal Health Authority covers and contacts are:
         1. North Shore / Coast Garibaldi, which is governed by an advisory committee.21
         2. Providence Health Care22. H.E. (Hal) Schmidt is the Executive Vice
             President & Chief Operating Officer
         3. Richmond Health Services23
         4. Vancouver24. Contact information for this region is the same as the VCHA Fraser Health Authority 25
This Authority serves 1.3 million people, or 33% of BC’s population with a $1.4 billion
annual budget and 20,000 staff. Facilities include;
            13 acute care hospitals
            2,000 acute care beds
            8,000 community residential beds
            2,000 doctors

   VCHA Website:
   Committee members are shown at:

                                 Queens School of Business
                                  Executive MBA Program British Columbia Ambulance Service (BCAS) 26
The BCAS is a “single unified operation, decentralized by design, but providing the
organizational structure necessary for system improvements in operational efficiency,
effectiveness and quality of care”. The British Columbia Ambulance Service is Canada’s
only provincially operated ambulance service. The province is divided into geographical
administrative districts, each under the authority of a Superintendent, who reports to one
of four Regional Directors in Victoria, Vancouver, Kamloops and Prince George.

The BCAS Executive Director, Headquarters Directors and provincial management staff
is located at the Headquarters in Victoria where telecommunications and Ambulance
Fleet Operations are also directed. Acute Care (Hospital) British Columbia
All Acute Care facilities fall under the five geographic Health Authorities described in the
Provincial and Regional sections. Long-Term Care British Columbia
The province is investing in long term care by increasing the number of beds and
creating more independent living units, and is administered by the Home and
Community Care Branch of BC Ministry of Health Services.27

1.5.4 Provincial: Alberta Ministry of Health & Wellness
The Ministry is administered by the Government of Alberta28 , with the responsibility of
setting strategic direction, policy, and standards for the health care system. The ministry
allocates operational funding to Regional Health Authorities and health services are
delivered at the regional level. In 2002 this funding was $3.8 billion. Health Accountability
A Division of Alberta Health & Wellness, its responsibilities include managing
information, technology resources and promotion of knowledge based decision making29

28 Government of Alberta website

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Branches within are:

         Standards and Measures
         Information Technology
         Research and Evidence
         Information Management
         Alberta WellNet Alberta WellNet
Alberta WellNet ”coordinates with key public and private sector stakeholders to build
Alberta's health information network, including Alberta Health and Wellness, Alberta's
nine regional health authorities, the Alberta Cancer Board and the Alberta Mental Health
Board, medical professional associations” such as the “Alberta Medical Association, the
College of Physicians and Surgeons, the College of Family Physicians, the Alberta
College of Pharmacists, Pharmacists Association of Alberta, and the Alberta Association
of Registered Nurses, the Alberta Research Council, and university Faculties of
Medicine”. Provincial Health Authorities of Alberta (PHAA)
The PHAA is an organization that exists to provide business services to Alberta's nine
Regional Health Authorities, Provincial Boards and Voluntary Health Organizations.
Services such as Secretariat Support, Human Resources Management and Insurance
Services as are offered at a fee to the Authorities.

1.5.5 Regional / Municipal – Alberta Regional Health Authorities (RHAs)
Alberta’s nine RHAs “deliver health care services to residents and are responsible for all
hospitals, continuing care facilities, community health services and public health
programs in their region”30. The Calgary and Capital Health Authorities are by far the
largest followed by seven much smaller Authorities. RHA demographic breakdown and
contact information are found below. It should be noted that many of these regions are in
the process of restructuring.


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The three fastest-growing regions in Alberta are Capital (city of Edmonton), Calgary and
David Thompson31.

Calgary Health Region 32
This is the largest region in Alberta serving 1,085,496 people or 35.3% of the population.
Their website is focused on patient services; therefore, statistics are not available. On
April 1st, 2003 Calgary Health Region formed a partnership with Headwaters Health
Authority and Wheatland County.
Capital Health 33
Capital Health is the second largest region behind Calgary Health serving 31.1% of
population. It claims to be one of the largest integrated health regions in Canada. In
April 2003, Capital “received $78.2 million in additional funds from Alberta Health and
Wellness for the health region’s 2003-04 budget year”. Its annual operating budget is
$1.8 billion.

Chinook Regional Health Authority34
This Authority serves 4.9% of population with 3300 employees and 200 physicians.
Facilities include 11 acute and continuing care facilities, and 15 community health sites.

Palliser Health Region35
The Palliser Health region has an annual operating budget of approximately $100 million
to serve 3.2% of population with 601 Continuing Care Beds, 260 Acute Care Beds and
five Community Health Sites. There are 12 Board Members, 2300 staff and100

David Thompson Regional Health Authority 36
This region also has been recently been restructured to include other regions. It serves
9.6% of population.

   Calgary Health Region web site:
   Capital Health web site:
   Chinook Regional Health Authority website
  Palliser Health Region web site:
   David Thompson Regional Health Authority web site:

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East Central Health 37

East Central has a $178 million budget to serve 3.8% of the population.

Aspen Regional Health Authority 38
This authority has recently been restructured to bring together four regions to serve
5.7% of population.

Peace Country Health 39
This region is in the midst of restructuring under a temporary region called Health
Region 8.

Northern Lights Health Region 40

Northern Lights did serve 2.2% of population but now has recently amalgamated with
Northwestern Health Services Region, now called Health Region 9.

1.5.6 Emergency Medical Services

In Alberta, Emergency Medical Services are under the jurisdiction of the cities or
municipalities. The two major services are in the cities of Calgary 41 and Edmonton42. Acute Care (Hospital)

All acute care facilities fall under the Regional Health Authorities described above in the
Regional section. Long-Term Care
There is some limited long term care in hospital and institutions provide by RHA’s, and
private facilities are also widely available. The Alberta Long Term Care Association
(ALTCA)43 is a voluntary non-profit organization, representing executives, owners and
operators of Long Term Care Facilities throughout the province of Alberta.

   East Central Health web site:
   Aspen Regional Health Authority web site
   Peace Country Health Authority web site:
   Northern Lights Health Region web site:
   Calgary EMS:
   Edmonton EMS:

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1.5.7 Provincial: Ontario Ontario e-Health Council (OEHC)
A key provincial organization is the Ontario e-HEALTH Council formed to facilitate the
adoption of e-health across the health care sectors in Ontario and to advise the Deputy
Minister. OEHC acts as a common voice to federal bodies on issues of information, e-
Health and opportunities for collaboration with other provinces. Council members
represent the following healthcare sectors: diagnostics, physicians, hospitals, community
care, public health and children’s services. Council members are from federal and
provincial organizations, including Smart Systems for Health (SSH), Ministry of Health
and Long Term Care (MOHLTC) and Human Services I&IT Cluster (part of MOHLTC).
Council members represent their individual healthcare sectors by bringing issues
forward to the council, and communicate with and advocate initiatives to their respective

Within the healthcare sectors, e-health councils have formed such as the Ontario
Hospital e-Health Council44.

Communications with Infoway are through this Council, and not through the individual
sectors. IT solutions are best brought through the various healthcare sectors to the
attention of the e-Health Council, and as such there is potential dispersion to other
healthcare sectors or possibly other Canadian provinces. Ontario Ministry of Health & Long Term Care
The appendix contains an Organization Chart (separate from this document, called
OMHLTC_orgchart.pdf), and is also available on the Internet. 45

     Ontario Hospital Foundation
     Organization Chart, OMHLTC.

                                Queens School of Business
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This component of the OMHLTC is responsible for developing infrastructure components
and standards. Its key initiatives 46 are;
    Shared infrastructure based on Public Key Infrastructure (PKI)
    TCP/IP based Managed Private Network (MPN)
    A Secure Messaging Infrastructure to provide e-mail and an on-line provider
     directory to health care providers

A significant person of influence is Michael Connolly, Chief Executive Officer, Lead
Smart Systems for Health. The Ontario Health Informatics Standards Committee
(OHISC) is an arm of SSH, which works with the OMHLTC to ensure participation in of
Ontario’s healthcare community in recommending health informatics standards. Ontario Family Health Network
Another organization under the OMHLTC umbrella is the Ontario Family Health Network
(OFHN). This body advances primary care reform in Ontario by encouraging groups of
health care providers to work together. The OFHN provides information, administrative
support and technology funding. Acute Care (Hospital)

Ontario Hospital Association (OHA) 47

The Ontario Hospital Association is an independent, non-profit organization of major
influence and financial resources. It is a “voluntary organization representing
approximately 160 public hospital corporations, or 225 sites, in Ontario”. OHA is
“governed by a 28-member Board of Directors comprised of hospital trustees and chief
executive officers from across the province, as well as a physician and a nurse”.

The OHA is organized into five Regions: north, east, south-western, south-central
regions, and the Greater Toronto Area. 48 The largest concentration of beds is in
Toronto, Canada’s biggest city.

   eHealthUpdateMarch2002.pdf, Ontario Hospital e-Health Council newsletter, March 2002
   OHA Website:
   A listing by region and number of beds is available at

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Important centres of excellence are found around Ontario’s medical schools, and are
home to many of Ontario’s leading medical researchers and practitioners. These
schools are McMaster University (Hamilton); the University of Ottawa; Queen's
University (Kingston); The University of Toronto; The University of Western Ontario
(London), and the Northern Ontario Medical School. Ontario Hospital e-Health Council
Associated with the OHA, the Ontario Hospital e-Health Council provides leadership,
support and co-ordination of e-Health initiatives for Ontario's hospital system.        Six
areas of focus for this council are:

      1.   Common unique patient identifier
      2.   Privacy and security
      3.   Ontario Electronic Health record
      4.   ePharmacy
      5.   Telehealth
      6.   Wait List Management

1.5.8 Regional / Municipal: Ontario Community Care Access Centers

There are 43 Community Care Access Centers (CCACs) in Ontario, providing care to
400,000 through simplified points of access. These include home visits; managing
admissions to long term care facilities; special needs, and long term palliative care.
These centres were “converted from independent community boards to statutory
corporations that comply with Ministry policies, directives and guidelines”, and are
organized into 7 regions.

Contact names for each region are provided in Appendix V, OACCAC Board of Directors
2002/2003. Emergency Medical Services (EMS)
The province partially funds EMS, but like Alberta, the responsibility falls under the
municipality and there is no single governing body. This system is usually accessed by


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the public through use of the provincial 911 phone system. Toronto’s EMS50 is the
largest such system in Canada. Other significant Ontario cities which may be contacted
for EMS opportunities are Ottawa, Hamilton, London, Kitchener, St. Catharines–Niagara,
Windsor and Oshawa. Long-Term Care

In Ontario there are three separate options for long-term care;
 1. Nursing homes which are privately owned and operated
 2. Municipal facilities and
 3. Charitable facilities

The MOHLTC sets the standards and does inspections. Applications for entry and
referral services are done through the Community Care Access Centers 51 as a
provincial service. The government may fund all or a portion of the care.

     City of Toronto EMS web site

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1.6 Key Associations/Publications
1.6.1 Magazines

Canadian Healthcare Technology

This publication informs readers about new and noteworthy IT implementations in
hospitals and other healthcare sites across the country.


Healthcare Information Management & Communications Canada

1.6.2 Associations

COACH: Canada’s Health Informatics Association 52

“COACH is an organization dedicated to promoting a clear understanding of health
informatics within the Canadian health system through education, information,
networking and communication”.

CHITTA : Canada's Healthcare Information Technology Trade Association 53

An industry association with the goal of increasing market share for Canadian healthcare
ICT companies both nationally and internationally. Medical Associations

Ontario Medical Association (OMA)
Website -

BC Medical Association (BCMA)
Website -

Alberta Medical Association (AMA)
Website -


                                    Queens School of Business
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Ontario Hospital Association (OHA)
Website - Other
Canada’s Infoway Newsletter
Individuals and organizations can subscribe at:

e-Health KnowledgeWay

A resource centre for all areas related to the Electronic Health Record and health

A free e-health virtual community, registration is available on-line via Infoway at:

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1.7 Competitor Analysis
1.7.1 Standards

The Ontario Health Information Standards Committee (OHISC) is charged with the
responsibility of developing recommendations on data and technology standards for
endorsement by the Minister of Health & Long-Term Care.

1.7.2 Opportunities

Previously identified in Section 1.3, Short -Term Opportunities, and Section 1.4,
Provincial Priorities, there are several immediate opportunities for New Zealand
companies to become involved with. These include:

   The need to link specialists to hospital systems
   Inter-hospital information sharing systems
   Data redundancy, warehousing and back-up systems
   Wait lists (a centralized database with a single point of co-ordination)
   A need for a system which allows laboratories to send test results electronically with
a priority system for doctors to review results.

1.7.3 Key Decision Makers

Section 1.5, Key Players and Decision Makers, contains the contact information of many
of the more influential organizations and personnel in the Canadian health care system.

1.7.4 Non-Market Strategies and Market opportunities

Strategies that have been identified as vehicles through which to penetrate into the
healthcare market, include, but are not limited to: Lobbying of Councils
The Ontario e-Health Council must sanction / approve / co-sign any Infoway
(Government) funding to companies / organizations / groups. Lobbying Infoway directly
as well has been identified as a potential method of entering the market. Other

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associations that are members of Ontario e-Health Council should be considered for

The Ontario e-Health Council take about 1 year to make a decision. Meetings are held
on a quarterly basis. Internet Portals
Information portals: there are many opportunities for companies to offer / broadcast
services and general health information across the Internet using the infrastructure that
is currently being set up. Smart Systems for Health currently has some information
portals operating. Consulting
Regulation consulting: Canada’s health care system is similar to New Zealand’s, and as
such previous experience is a potential opportunity to enter the market New Zealand
companies have an advantage in this area because of the past experience in New
Zealand with respect to providing products and services to the health care system.

1.7.5 Competitor Overview: Overview
There are many IT competitors in the healthcare market in Canada, offering a variety of
services. More information on who is in the market, a brief summary of their services,
contact information and web addresses is included in Appendix VI.

Those already in the Canadian market are global healthcare IT players, including those
from the United States, the United Kingdom, Belgium and New Zealand. The majority of
these internationally based companies already have offices in Canada. Hospitals
The Hospital IT market is already strongly serviced by companies such as Cerner
( and Meditech ( IBM, Digital and Oracle are
the other major organizations in this market segment.

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The key market strategy for gaining access to the hospital sector is to target the most
important hospitals in region first, which are usually those associated with the Centres of
Excellence, as they generally set the direction for all the other hospitals in their region. Community Care
The IT market is relatively open in this sector. Community health information is currently
being broadcast through groups like OFHN. Currently the largest competitor in this
sector is MDS. 54 Primary Care
The IT market is relatively open in this sector. The OFHN has a presence is this sector
as well. Opportunities exist among physicians and specialists, getting these
professionals networked and communicating with laboratories, pharmacies and
hospitals. Pharmacies
Pharmacies are fairly established because of the dominance of large pharmaceutical
chains (Shoppers Drug Mart, Pharma Plus, Walmart, etc.), although opportunities exist
to link these different operations together. Further, pharmacists may want access to
EHRs for patients who request a prescription to be filled, and as such store systems will
need to be made compatible with the industry in terms of their IT structure and security. Infostructure
Networking: Smart Systems for Health, Bell & EDS are the major players. Entrust is the
dominant firm in the area of data security.

     MDS Website:

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1.8 Regulations and Standards Framework &
1.8.1 Federal Government

The Canada Health Act is the basis for the entire healthcare system. The Canada
Health Act can be accessed at:

The five criteria of the Canada Health Act are:

   1. Public administration: The administration of the health care insurance plan of a
       province or territory must be carried out on a non-profit basis by a public
   2. Comprehensiveness: All medically necessary services provided by hospitals and
       doctors must be insured;
   3. Universality: All insured persons in the province or territory must be entitled to
       public health insurance coverage on uniform terms and conditions;
   4. Portability: Coverage for insured services must be maintained when an insured
       person moves or travels within Canada or travels outside the country; and
   5. Accessibility: Reasonable access by insured persons to medically necessary
       hospital and physician services must be unimpeded by financial or other barriers.

The Canada Health Act establishes criteria and conditions related to insured health care
services and extended health care services that the provinces and territories must meet
in order to receive the full federal cash contribution under the Canada Health and Social
Transfer (CHST).

For an important reference for interpretation of the Canada Health Act, refer to Appendix
VII, which is a letter from then Health Minister Jake Epp to the provincial and territorial

The Office of Health and the Information Highway (OHIH) was created in the summer of
1997 and is Health Canada's focal point for e-health, multi-channel government service

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delivery and privacy issues. See section 1.1.1, Background on Health Canada for more
information about OHIH.

1.8.2 Provincial Governments
Regulatory power is controlled by the individual provinces. Provincial governments are
relatively prepared when it comes to the issue of Privacy (see below). Legislation exists
to govern the way hospitals, insurance companies, and similar institutions conduct
business, found in provincial Hospitals Acts and Healthcare Insurance Acts. However,
the use of IT and electronic information, and the related issues of privacy and security,
are not fully addressed in current legislation. Advances in information and
communication technologies have significant potential for the improved delivery of health
care services. A number of important health information and technology initiatives,
particularly in the area of electronic health record (EHR) solutions, are underway across
Canada. Nonetheless, they vary in scope and size, and tend to be islands of innovation
that would benefit from greater collaboration and support to achieve their full potential.

1.8.3 Organizations
In 1975, several health professionals and vendors involved in health information
technology recognized that significant sharing of ideas and efforts must take place in
order to enable Canadian health institutions to effectively use information systems.

They also recognized that little of the pioneering work in Healthcare informatics under
way throughout North America and Europe was known or available to the Canadian
Healthcare community. As a result, the Canadian Organization for Advancement of
Computers in Health, (COACH) 55 was formed. COACH
COACH was formed as a user group of information and information technology in
Healthcare, independent of any vendor, government, or organizational affiliation. Its
purpose is to create a forum for the exchange of ideas, concepts, and developments
relative to information and information technology as it applies to the Canadian
Healthcare environment.

     Coach Website:

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COACH is an organization dedicated to promoting a clear understanding of health
informatics within the Canadian health system through education, information,
networking and communication.

COACH has a membership of almost 900 individuals, who range from healthcare
executives, physicians, nurses and allied health professionals, researchers and
educators to CIO's, information managers, technical experts, consultants, and
information technology vendors. Organizations represented include healthcare service
delivery, government and non-government agencies, consulting firms, commercial
providers of information and telecommunications technologies, and educational

COACH believes in the importance and the value of strategic alliances with other
organizations involved in the field of health informatics in Canada and internationally. It
is committed to building a strong international network in health informatics through
international organizations such as the International Medical Informatics Association
(IMIA), and other national associations around the world. CIHI
Another group of organizations working together on standards for electronic health
record systems is the Canada Health Infoway and the Canadian Institute for Health
Information (CIHI). This is a collaboration of associations to ensure cost-effective and
consistent approach the development and maintenance of EHR data definitions and

Infoway acts as the lead for the development of EHR Solution standards and as the
overall program manager for EHR standards-related work. As it is widely recognized as
a leader in the development of health informatics standards, CIHI will act in the capacity
of Preferred Partner to Infoway. CIHI is responsible for data definitions, content
standards and classification systems which are core to CIHI's business.

The key benefits of developing standards include: driving down costs as they relate to
initial design and development; supporting re-use and replication of components
application integration and interoperability; and, systems integration.

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All of this will reduce the total cost of ownership over the long term. In addition, common
standards will provide the necessary flexibility to handle the business needs of a wide
range of organizations.

Infoway and CIHI have partnered on a number of initiatives including the National e-
Claims Standards Project to develop national standards for exchanging electronic health
claims information. This CIHI-led project is funded by Infoway and has received strong
support and participation from provinces, territories and the private sector.

1.8.4 Legislated Privacy Protection across Canada 56
The OHIH is examining how privacy and confidentiality can be safeguarded when patient
health information flows among health care providers and sites on a "need-to-know"
basis. OHIH's Role
OHIH works with many partners to develop a policy framework to protect personal health
information, and to integrate privacy concerns as a key component of a pan-Canadian
health infostructure. Contributing to the development of a federal, provincial, and
territorial harmonized framework for the protection of personal health information and
producing guidelines to facilitate the development of privacy legislation in all
jurisdictions, OHIH works closely with the Office of the Privacy Commissioner.

For more information about the OHIH and its relationship with Health Canada, refer to
section 1.2.2, Background. A Legal "Patchwork"
Currently, the protection of personal health information in Canada is shared among
federal, provincial, and territorial governments with a "patchwork" of legislation, policies,
regulations, and voluntary codes of practice.

     Web site information:

                                Queens School of Business
                                 Executive MBA Program Important Federal legislation

Access to Information Act (Revised Statutes of Canada 1985, c. A-1). The Access to
Information Act is exactly as the title suggests. Its purpose is to extend the present laws
of Canada to provide a right of access to information in records under the control of a
government institution.

As of January 2002, the Personal Information Protection and Electronic Documents Act
(PIPEDA) (Statutes of Canada 2000, c. 5) applies to personal health information
collected, used, or disclosed in the course of commercial activities across provincial,
territorial and national boundaries.

The Privacy Act (Revised Statutes of Canada 1985, c. P-21) applies to the public sector.
Its purpose is to extend the present laws of Canada that protect the privacy of individuals
with respect to personal information about themselves held by a government institution
and provide individuals with a right of access to that information.

The Statistics Act (Revised Statutes of Canada 1985, c. S-19) applies to collected
information about Canadians, including patient-identifiable health information that is to
be or could be used for statistical purposes. Provincial legislation
Many provinces/territories have legislation protecting personal information in the public
sector. New provincial privacy legislation that applies to personal information (including
health information) collected, used, or disclosed in the course of commercial activities
within a province or territory that will supercede PIPEDA.

For a more complete list of legislation that currently exists for each Canadian province,
refer to Appendix VIII, Provincial Legislation.

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                                       Executive MBA Program

1.9 Investment Environment

For more information about Infoway, refer to Section 1.2.8, Canada Infoway Inc.

Infoway primarily targets current initiatives for potential investment by using an up-to-
date registry of initiatives and by consulting with experts. The initiatives chosen for
investment will be based on Infoway's priorities. This is not to suggest that Infoway will
not consider unsolicited submissions. Information about the submission process, and
Infoway’s investment strategy and submission templates is available on the Infoway

Occasionally Infoway will develop formal calls for proposals to address specific gaps that
have been identified.

Appendix IX contains an excerpt from an interview with Myrna Francis, Senior Vice-
President, Strategic Alliances, about Infoway’s investment strategy. The key point she
raises is that healthcare represents the last big vertical market for industry to become
involved in. The natural convergence with other market segments makes investment in
healthcare a growth opportunity. To compliment this opportunity, Francis does suggest
that Canada is an excellent place to develop intellectual property and skills, and then sell
them to other highly priced international markets, specifically the United States and

Investment Technology Association of Canada (ITAC)

ITAC 58 is the voice of the Canadian information technology industry. Together with its
affiliated organizations across the country, the association represents 1300 companies
in the information and communications technology (ICT) industry in all sectors including
the production of hardware, microelectronics, software and electronic content and the
delivery of ICT services. ITAC's network of companies accounts for more than 70 per
cent of the 597,000 jobs, $123 billion in revenue, $11.2 billion in R&D investment, $21

     Submission information:
     ITAC website:

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                                 Executive MBA Program

billion in exports and $12.3 billion in capital expenditure that the sector contributes
annually to the Canadian economy.

ITAC’s mission is to “is to identify and lead on issues that affect our industry and to
advocate initiatives, which will enable its continued growth and development.”

Appendix X contains an excerpt from ITAC about the potential for further investment in
Canada. The important point of the article is that there are lobbying opportunities for
increased investment in Health Care and improved technology in Canada’s health

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                            Executive MBA Program


Appendix XII: MOHLTC Organization Chart file name OMOHLTC_orgchart.pdf, is a
separate file accompanying this report.

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Appendix I: Short-Term Opportunities

The following is a sample of recent postings currently under competition on,
Canada’s tendering service for the public sector. This sample is intended to illustrate the
language, timelines, and requirements common to RFPs posted on the website. The
site is updated on a regular basis.

          Ontario Laboratories Information System, Ontario Government:

HER MAJESTY THE QUEEN in Right of Ontario as represented by the Minister of
Health and Long-Term Care (the “Ministry”) is issuing this RFP to select a Respondent
to implement a single provincial system that would allow all laboratory information to be
exchanged electronically between practitioners and laboratory providers, and to provide
the Ministry of Health and Long-Term Care (MOHLTC) with program management

Phase 1 (Clinical Services). All applications and infostructure to allow use of laboratory
tests information by external stakeholders.
Phase 2 (MOHLTC Adjudication). All applications and infostructure to allow for real-time
adjudication of MOHLTC funded tests.
Phase 3 (Financial Management). A comprehensive MOHLTC financial management
and reporting sub-system

Who to contact:
The Ministry RFP Coordinator is:
Jim Kovacs Ministry of Health and Long-Term Care Facsimile: 416 - 327 - 0762 E-mail:

               Calgary Health Region - Endoscopy Facility/Services:

The Calgary Health Region is initiating a process to determine the extent of interest and
suitability of third party solutions in establishing a community-based endoscopy centre
within metro Calgary, which will service the Region's growing endoscopy caseload. The
Region will consider alternative solutions including, but not limited to, contracted
services, P-3 partnerships and turn-key arrangements. Copies of the EOI will be
available for pick-up beginning July 8, 2003 at the above listed address. Closing date for

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this EOI will be 1400 hours (MST), September 5, 2003. An information session will be
held on July 17, 2003. Details concerning this session will be available in the EOI

Contact information:
Client Agency : Susan Drblik Company Name : Calgary Health Region Address: 10101
Southport Road S.W. City : Calgary Province : AB Postal Code : T2W 3N2 Telephone :
(403)943-0420 Fax : (403)943-1498 E-mail :

    Woodstock General Hospital - Information Systems Solution RFP (Ontario):

Management Information System

Woodstock General Hospital has recently completed the development of an Information
Systems Strategic Plan. The plan addresses the needs of the organization over the next
five years. The IS plan is founded on a vision for information systems and technology
that is in alignment with the overall corporate strategic and operational objectives. Key
components of the IS vision include:

   Enables the delivery of high quality services
   Supports the coordination of patient care
   Provides a mechanism for the integration of information flow across applications so
    as to reduce duplication ·
   Encourages learning and professional development

This Request for Proposal (RFP) is intended to solicit responses for an Information
Systems solution. The RFP is being issued to vendors or other potential partners
offering innovative solutions to meet the needs of the organization as it is structured
today – and for the new services and programs that are envisioned in the future. This
RFP addresses the requirements for the following applications:

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Priority One (to be addressed in years one and two) · Patient Registration (ADT) and
Central Patient Index · Accounts Receivable · Pharmacy · Diagnostic Imaging · Order
Entry · Clinical View

Priority Two (to be addressed in years three and four) · Financial Management
Systems · Abstracting/Chart Locator · Patient Appointment Scheduling · Electronic
Clinical Documentation

Key Dates:
   Key dates pertinent to selection process are presented below:
   RFP issued -Friday, July 4, 2003 -Deadline for submission of questions …
   Monday, July 21, 2003 -Proposal Submission Deadline
   Friday, August 15, 2003 -Initial Short Listing for presentations
   Friday, August 29, 2003 -On-site Vendor Demonstrations
   Week September 8, 2003 -Short List
   To follow Site Visits/Further evaluation -To follow Preferred Respondent Selection -
   Friday, October 10, 2003

Administration of the Skills Enhancement for Health Surveillance Online Training

                           Program Statement of Work (SOW)

The Skills Enhancement for Health Surveillance program is one of the initiatives of
Health Canada’s Centre for Surveillance Coordination, whose mandate is to build
capacity in public health across Canada. The foundation for effective health surveillance
in Canada is the ability to use and understand information. This requires some very
specific skills that vary across the country and are limited in many public health
jurisdictions. In order to fill this public health gap it is necessary to build human
infostructure to respond to community needs.
The Skills Enhancement for Health Surveillance program aims to help public health
practitioners in regional health authorities and local public health departments across
Canada to acquire the skills necessary to do effective surveillance. Targeting key areas
such as epidemiology, surveillance, information management, needs-based planning
and the use of surveillance tools will help to accomplish this aim. In doing so, it will
strengthen sound evidence-based decision-making and planning at the local level to

                                Queens School of Business
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protect and maintain the health of the public. The core component of the Skills
Enhancement program is a series of Internet-based training modules in both official
The Skills Enhancement for Health Surveillance program is soliciting proposals for the
administration and support of the online modules. The scope is to administer the training
modules in both official languages until March 2006. This would involve general
administration; end-user support and management; management of online facilitators;
maintenance of records and resources; basic evaluation; and infostructure support and

Mandatory requirements

Attention Bidders: Write beside each of the criteria the relevant page number(s) from
your proposal which addresses the requirement identified in the criteria. Criteria Page #
Yes No Expertise and Experience of the Firm 1. The Bidder must possess the
infostructure required to administer the program in its entirety on an ongoing basis. This
includes connectivity infostructure; hardware and software to support project
management functions and end-user management. 2. The Firm has been in the e-
learning/ distance education administration business since 1997 or longer. 3. The Firm
has at least three (3) cumulative years of experience in Service Management offerings
similar in complexity to this requirement. Expertise and Experience of Proposed
Personnel 4. At least one (1) member of the proposed team possesses at least 2
cumulative years of technical (IT) experience in supporting online learning programs. 5.
At least one (1) member of the proposed team possesses at least 2 cumulative years of
experience in course delivery with WebCT within the past five years. 6. The proposed
Team Leader possesses a minimum of 3 or more cumulative years of direct and
successful experience in managing projects of similar complexity to this requirement. 7.
At least one (1) member of the proposed team possesses at least 2 cumulative years of
experience in Help Desk service offerings within the past five years. 8. At least one (1)
member of the team has proven written and oral communication skills in both official
languages (English & French). 9. The Bidder must identify the proposed personnel who
will be assigned to this project, outlining in detail the assignment of individuals and the
level of effort, expressed in days worked by task for individual personnel. 10. The Bidder
must demonstrate that backup resources of equal skill are available in the event that any
of the proposed personnel cannot complete the contract as stated. Backup personnel

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must be different than the original proposed team. 11. All resources (including backups)
must include their resumes. Cost 12. The Bidder must submit within the technical
component of the proposal a written statement indicating that the cost of the proposal
does not exceed $550,000 (including travel, expenses and all applicable taxes).
Approach and Methodology 13. The proposal complies with the requirements for the
technical proposal.

Key contacts:
Enquiries to: Materiel Management Division Assets Management Directorate Corporate
Services Branch, Health Canada Jeanne Mance Building, Room B-1110 Tunney’s
Pasture AL #1911B1 Ottawa, Ontario K1A 0K9 Contracting Officer: Émile Beauchamp
Contracting Authority: Emile Beauchamp Address: Corp. Svcs. Branch, Assets Mgmt.
Dir., Locator 1911B1, Jeanne Mance Building Tunney's Pasture City : Ottawa Province :
ON Postal Code : K1A 0K9 Telephone : (613)954-2507 Fax : (613)957-8601 E-mail :

        Queens School of Business
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Appendix II: Federal Organization Chart

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        Appendix III: Contact List For Health Chief Information Officer
                                   Council 59

     Contact List For Health Chief Information Officer Council

     John Schinbein                                    Joseph Mendez
     Chief Information Officer                         Chief Information Officer
     Information Management Group                      Northern Health Authority
     BC Ministry of Health Services &                  NHA Administration Office
     Ministry of Health Planning                       TD Tower, 300-299 Victoria Street
     7-1, 1515 Blanshard Street                        Prince George, BC V2L 5B8
     Victoria, BC, V8W 3C8                             250-565-2780
     Pat Ryan                                          Brian Shorter
     Chief Information Officer                         Chief Information Officer
     Interior Health Authority                         Vancouver Island Health Authority
     204-2355 Acland Road                              2101 Richmond Avenue
     Kelowna, BC, V1X 7X9                              Victoria, BC, V8R 4R7
     250-491-6723                                      250-370-8428
     Dr. David Ostrow                                  Neil Currie
     Chief Information Officer                         Chief Information Officer
     Third Floor - Room 380                            Fraser Health Authority
     Centennial Pavilion                               34194 Marshall Road
     Vancouver General Hospital                        Abbotsford, BC, V2S 5E4
     855 West 12th Avenue                              604-556-5081
     Vancouver, BC, V5Z 1M9
     Don Henkelman
     Chief Information Officer
     Provincial Health Services Authority
     700 - 1380 Burrard Street
     Vancouver, BC V6Z 2H3

     Health Chief Information Officer Council website:

                                Queens School of Business
                                 Executive MBA Program

Appendix IIIB: Key Organizational Members and Contact Information


   Linda Lizotte-MacPherson, President and Chief Executive Officer
   Myrna Francis, Senior Vice-President, Strategic Alliances (Myrna is responsible for
    new business development and partnerships and alliances with the private sector
   Susan J. Hyatt, Vice-President, Portfolio Management and General Manager
    (Toronto Office)
   Dennis Giokas, Chief Technology Officer
   Brian G. Philbin, Chief Financial Officer
   Mariana Catz, Vice-President, Knowledge Management/Transfer
   Nancy Desormeau, Vice-president, Telehealth

   Executive Sponsor - Linda Miller, Alberta Health & Wellness;
   Co-coordinators - Don Newsham, Sierra Systems Group Inc. and Linda Miller,
    Alberta Health & Wellness; and
   Secretariat Support - Tannis McBean and June Leister, Sierra Systems Group Inc.

21st Floor 10025 Jasper Avenue
Telus Plaza North Tower
Edmonton, Alberta T5J 2N3
Phone: (780) 427-5135 Fax: (780) 427-2411

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                                Executive MBA Program

British Columbia Regional Authorities

Northern Health Authority

      Malcolm Maxwell, CEO, (250) 565-2649.
      Barry Cheal, Vice President, Finance and Information, (250) 565-2764.

Interior Health Authority

Alan Dolman, Chairman of the Board
Interior Health Administrative Offices
phone: (250) 862-4200
fax: (250) 862-4201
2180 Ethel Street
Kelowna, BC V1Y 3A1

Vancouver Island Health Authority (VIHA)

       1. VIHA South –
   Dr. Ernie Higgs, Director & Medical Consultant
   1952 Bay Street
   Victoria, British Columbia
   V8R 1J8
   Phone :(250) 370-8699
   Fax:(250) 370-8750

       2. VIHA North –
   Doug Marrie, Area Medical Director, 381 Second Avenue
   Campbell River, British Columbia
   V9W 3V1
   Phone: (250) 830-6950
   Fax: (250) 830-6952

       3. VIHA Central
   Chuck Rowe, E.D.
   201 - 6551 Aulds Road
   Nanaimo, British Columbia
   V9T 6R2 Phone:(250) 740-6999
   Fax:(250) 390-7421

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                               Executive MBA Program

Vancouver Coastal Health Authority

Ida J. Goodreau,
President & Chief Executive Officer.
Tel: (604) 736-2033.
#200 - 520 West 6th Avenue
Vancouver, BC, V5Z 4H5

Fraser Health Authority

Bob Smith, President and Chief Executive Officer
Fraser Health Authority
Corporate Office
300 – 10233 153 Street
Surrey, BC V3R 0Z7
Phone 1-877-935-5669 or 604-587-4600
Fax 604-587-4666

British Columbia Ambulance Service (BCAS)

PO Box 9600 Stn Prov Govt,
712 Yates St, 5th Fl,
Victoria BC V8W 9P1
Phone (250) 953-3298
Fax (250) 953-3119

                               Queens School of Business
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Alberta Regional Authorities
Calgary Health Region

David Tuer, Chair,
Mr. Jack Davis, Chief Executive Officer
10101 Southport Road SW
Calgary, AB
T2W 3N2
Phone: 403-943-1110
Fax: 403-943-1138

Capital Health

Neil Wilkinson, Chair
Sheila Weatherill, Chief Executive Officer
1J2 Walter Mackenzie Center
8440 - 112 Street
Edmonton, AB
T6G 2B7
Phone: 780-407-1000
Fax: 780-407-7481

Chinook Regional Health Authority

Jack W. Ady, Chair
Gilbert Tourigny, Chief Executive Officer
960 - 19 Street South
Lethbridge, AB
T1J 1W5
Phone: 403-382-6009
Fax: 403-382-6011

Palliser Health Region

Leonard Mitzel, Chair
Tom Seaman, Chief Executive Officer
666 - 5 Street SW
Medicine Hat, AB
T1A 4H6
Phone: 403-529-8042
Fax: 403-529-8998

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David Thompson Regional Health Authority

Jean Graham, Chair
John Vogelzang, Chief Executive Officer
602, 4920 - 51 Street
Red Deer, AB
T4N 6K8
Phone: 403-341-8622
Fax: 403-341-8632

East Central Health
Chair: Ed Andersen
Mr. Steve Petz, President & Chief Executive Officer
4703 - 53 Street
Camrose, AB
T4V 1Y8
Phone: 780-608-8800
Fax: 780-672-5023

Aspen Regional Health Authority
Robert Jackson, Chair
Mr. Robert Cable, Chief Executive Officer
Provincial Building
10003 - 100 Street
Westlock, AB
T7P 2E8
Phone: 780-349-8705
Fax: 780-349-4879

Peace Country
Marvin Moore, Chair
Dalton M. Russel, Chief Executive Officer
# 2101, 10320 - 99 Street
2nd Floor Provincial Building
Grande Prairie, AB
T8V 6J4
Phone: 780-538-5387
Fax: 780-538-5455

Northern Lights Health Region
Scott Garner, Chair:
Patricia Pelton, Chief Executive Officer
7 Hospital Street
Fort McMurray, AB
T9H 1P2
Phone: 780-791-6024
Fax: 780-791-6029

                             Queens School of Business
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Ontario: Key Councils

Ontario e-Health Council (OEHC)

   Chair, Lorelle Taylor, CIO, Human Services I&IT Cluster, OMHLTC
   Tom Closson, CEO, University Health Network
   David Pattenden, CEO, Ontario Medical Association (OMA)

Ontario Family Health Network

Ruth Wilson , M.D., C.C.F.P, Chair
Regency Court Building, 80 Queen Street
3rd Floor, Kingston, ON
K7K 6W7
Tel : 613 544-7700,
Fax : 613 544-6310

Ontario Hospital Association

Kurt Rose
Director, eHealth Strategies
Tel: 416-205-1438

Ontario Hospital e-Health Council

Sam Marafioti, Vice President, eHealth and Chief Technology Officer,
Tel: 416-480-4127

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       Appendix IV: Contact List for Northern Interior Health Areas              60

     East Kootenay Health Service              Kootenay Boundary Health Service Area
     Area                                      phone: (250) 304-4211
     phone: (250) 426-1650                     fax: (250) 304-4223
     fax: (250) 426-1577                       1464 Columbia Avenue
     1212 Second Street N.                     Castlegar, BC V1N 3K3
     Cranbrook, BC V1C 4T6                     Rick Riley, CCO
     Linda Basran, COO

     Okanagan Health Service Area              Thompson Cariboo Shuswap Health
     phone: (250) 770-3440                     Service Area
     fax: (250) 770-3443                       phone: (250) 851-7374
     740 Carmi Avenue                          fax: (250) 851-7375
     Penticton, BC V2A 8P9                     519-B Columbia Street
     Ken Burrows, COO                          Kamloops, BC V2C 2T8
                                               Martin McMahon, COO

     Interior Health Administrative Offices
     phone: (250) 862-4200
     fax: (250) 862-4201
     2180 Ethel Street
     Kelowna, BC V1Y 3A1

     Adapted from

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           Appendix V: OACCAC Board of Directors 2002/2003
REGION                                      LOCATION
Central East Region
                                            Durham Region
Board Member                                Haliburton, Northumberland and Victoria Counties
Howard Hall                                 Peterborough County
                                            Simcoe County
Stephen Kay, E.D.                           York Region
Howard J. Phee (Member at Large)

Central South Region                        Brant County
                                            Haldimand-Norfolk Region
Board Member, Edward Bennett                Hamilton-Wentworth Region
Carole Taylor, E.D.                         Niagara Region

Central West Region
                                            Halton Region
                                            Peel Region
Board Member,
                                            Waterloo Region
Edward Bennett
                                            Wellington-Dufferin Counties
Ross McCrimmon, E.D.

East Region                                 Eastern Counties
Jackie Redmond                              Hastings and Prince Edward Counties
Executive Director                          Kingston, and Frontenac, Lennox and Addington Counties
                                            Lanark, Leeds and Grenville Counties
Wes Libbey (Chair)                          Ottawa Region
                                            Renfrew County

North Region                                Algoma District
Jim Dalgliesh (Treasurer)                   Cochrane District
William Russell, Board                      Kenora and Rainy River Districts
Tom Trainor, Board                          Manitoulin, and Sudbury County and Region
                                            Muskoka, and (East) Parry Sound Counties
                                            Nipissing County
                                            Thunder Bay District
                                            Timiskaming District
                                            (West) Parry Sound County

South West Region                           Chatham, and Kent County
                                            Elgin County
Phyllis Cohen (Vice-Chair)                  Grey-Bruce Counties
Mick Peters, Board                          Huron County
                                            London, and Middlesex County
John Oosterink, E.D.                        Oxford County
                                            Perth County
                                            Sarnia, and Lambton County
                                            Windsor, and Essex County

Toronto Region                              East York
Stephen Handler (Secretary)                 Etobicoke
Executive Director                          North York
Gabriella Tino, Board                       Scarborough
                                            York (former City of)

                                            Carole Weir, Board KFLA
                                            Dr. Jim Armstrong (Chief Executive Officer)
                                            Lori Hay (Executive Assistant)

                                  Queens School of Business
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           Appendix VI: 2003 Directory of Healthcare I.T. Suppliers

The following list of Healthcare IT Suppliers is a partial list only, and is provided to illustrate
the variety of vendors in the market, the diversity of products and services, and the
geographic regions that they are headquartered in.

3Com Canada
5560 Explorer Drive, 1st Floor
Mississauga ON L4W 5M3
T: 905-602-3266 F: 905-602-3201

3Com is a provider of networking products for enterprises of all sizes and public sector

3M Health Information Systems
201-5520 Explorer Drive
Mississauga ON L4W 5L1
T: 800-561-5115 x3845 F: 888-452-8053
Contact: Stefanie Sigurdson

Ease the pain in your health information department. With “guided encoding”, Codefinder (ICD10
CA & CCI) uses expert logic to help coders evaluate and apply coding and grouping rules. HDM
helps capture CIHI-required information along with customizable fields. HDM Reporter turns the
data entered by health records department into meaningful reports. The new Rehab Module
facilitates the data entry process for the National Rehabilitation Reporting System.

ACP Communications
Technologies Inc.
885 Main Street East, Suite 6
Milton ON L9T 5A7
T: 905-876-4026 F: 905-876-4697
Contact: Carl Starkes

ACP Communications offers a full range of integrated call care communications systems and
applications. ACP is an authorized reseller for the AUSTCO products offering integrated call
management solutions for Critical and LTCF. ACP Communications can also provide voice, e-mail
and data communications solutions specific to the healthcare industry.

Adjuvant Informatics Corp.
204 Chesley Street
Hamilton ON L9C 3W3
T: 905-389-2996 F: 905-388-1941
Contact: Dan Meyer

Adjuvant Informatics Corp. is a software company that has created an application to manage
hospital based Acute Pain Services. Our product, the APS Manager, tracks patient enrollment, drug
orders, visits, and critical incidents.

                                  Queens School of Business
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Agfa Corp.
77 Belfield Road
Toronto ON M9W 1G6
T: 877-753-2432 F: 416-614-2260
Contact: Nancy Harris, National Sales Director

Agfa is one of the world’s leading suppliers of imaging and information management solutions for
healthcare. More than 400 IMPAX-connected hospitals worldwide are now able to enjoy the
synergies of sharing digital information – images, data and reports. This sharing of resources
produces concrete benefits such as improved healthcare and organizational efficiency.

Ahearn & Soper Inc.
100 Woodbine Downs Blvd
Toronto ON M9W 5S6
T: 416-675-3999 x4225 F: 416-675-3457
Contact: Christopher Bejnar

Ahearn & Soper provides integrated solutions for: access control systems, datacard photo id &
embossers, addressograph imprinters, bar code printers & scanners, wireless 802.11b carts,
tablets, terminals and access points, patient identification wristbands, specialty labels & ribbons and
dot matrix/laser printers.

Andromed Inc.
4610 Chemin du Bois-Franc
St-Laurent QC H4S 1A7
T: 514-336-0043 F: 514-336-9337

Andromed is the inventor and leading supplier of a fully electronic stethoscope, developed in
partnership with foremost medical professionals. We’re proud of a growing reputation in non-
invasive diagnostics and telemonitoring of biological sounds for cardiac and pulmonary applications.
Our Androfact is a state-of-the-art patient satisfaction monitoring system enabling the development
and support of continuous quality improvement (CQI) programs.

Artificial Intelligence in Medicine Inc.
2 Berkeley Street, Suite 403
Toronto ON M5A 2W3
T: 416-594-9393 F: 416-594-2420
Contact: Victor Brunka

Artificial Intelligence in Medicine Inc. is a Canadian software engineering firm. ISIS-Registrar, a
pathology indexing and abstracting system for cancer registries. AutoCode, a semantic analyzer for
free text. TransMed, an integration engine for exchanging data using HL7. TissueMetrix manages
tissue/tumor banks of any size or complexity.

Austco Marketing & Service (Canada) Ltd.
60 Granton Drive, Unit 6
Richmond Hill ON L4B 2N6
T: 905-731-1830 F: 416-932-2955
Contact: Celia Missios

                                 Queens School of Business
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Austco is your source for Nurse-Call, Dementia-Care, Patient Wandering, pagers, phones, data and
integration. Our distinctive design enables you to add to your current system or have a new system
configured that will allow for future growth.

Avaya Canada
1380 Rodick Road
Markham ON L3R 4G5
Tel: 1-877-982-8292
F: 1-877-982-8292
Contact: Patrick Lance, V.P. Marketing

Avaya enables businesses to achieve superior results by designing, building and managing their
communication networks. More than one million businesses worldwide, including 90 percent of the
Fortune 500, rely on Avaya solutions and services to enhance value, improve productivity and gain
competitive advantage.

Th. Sevenslaan 106
Kortrijk, Belgium 8500
T: +32 56 233 569 F: +32 56 233 460

Barco supplies high-resolution CRT and LCD display systems, imaging boards, QA management
software, DICOM-compliant projection system and custom-designed subsystems for a wide range of

Betterhealth Global (Canada) Ltd.
2101-8308 114th Street
Edmonton AB T6G 2E1
T: 780-414-1627 F: 780-414-1633

BHG is an international software and services company specializing in the field of the electronic
health record and chronic disease management. Headquartered and incorporated in the UK, BHG,
through its subsidiaries has activities in the UK, Ireland, Belgium, Switzerland, France, Canada,
USA, India, New Zealand and Australia.

Bulletproof Solutions Inc.
7 Mill Street, Suite 301
Fredericton NB E3A 4L5
T: 506-452-8558 F: 506-472-8558
Contact: Norma Bradley

Bulletproof Solutions Inc. offers leading edge security and integration solutions. Service offering
includes Network Security Assessments, Vulnerability Assessments, Firewalls and VPNs, Security
Policy Development, Network Analysis and Design. Partners include CISCO, CheckPoint and

Campana Systems Inc.
99 Randall Drive
Waterloo ON N2V 1C5
T: 519-747-5222 x214 F: 519-746-4421
Contact: Mark Grundy

                                  Queens School of Business
                                   Executive MBA Program

Campana’s GoldCare software includes applications for MDS, health records, staff scheduling,
payroll, full financials, and advanced reporting tools.

CareNET Services Inc.
2375 Skymark Avenue
Mississauga ON L4W 4Y6
T: 905-602-8841 F: 905-629-2670

CareNET Services Inc. is an association of Canadian health care providers and suppliers
promoting, educating, facilitating and supporting the use of Electronic Commerce. Our goal is to
improve business processes and reduce costs throughout the healthcare supply chain.

CCD Health Systems
301-8657 51st Avenue
Edmonton AB T6E 6A8
T: 780-469-4292 x230 F: 780-469-4595
Contact: Nevil Ghadially

AEMS is a fully functional incident and unusual event management system designed to support
accurate recording and resolution of incidents and patient complaints within healthcare facilities.
Within AEMS’ set-up module, users define all the data collection requirements for each incident
type. The workflow processor helps ensure that incidents are tracked to closure.

Cedara Software Corp.
6509 Airport Road
Mississauga ON L4V 1S7
T: 905-671-7955

Cedara solutions span all aspects of imaging workflow from image acquisition through image
management, diagnosis and image guided therapy and its software has been implemented across
all digital imaging modalities, including angiography, computed tomography (CT), echo-cardiology,
digital x-ray, fluoroscopy, mammography, magnetic resonance imaging (MRI), nuclear medicine,
and ultrasound. Cedara has extensive expertise in DICOM connectivity, development, maintenance
and deployment.

Christie Group Ltd.
516 Rue du Parc
St-Eustache QC J7R 5B2
T: 450-472-9120 F: 450-472-9410

Christie Group Ltd. is the exclusive distributor in Canada for Fuji Photo Film’s Synapse “Next
Generation” PACS that can transform any film based imaging department or regional enterprise into
a fully digital environment and beyond. Synapse features include full Dicom support, HIS/RIS
integration and IHE compliance, and it operates in a total Windows environment on industry
standard hardware and software. Using Internet Explorer for the user interface, Synapse is friendly
and exceptionally easy to implement. Christie also distributes Fuji’s leading Computed Radiography
systems, network laser printers, film handling and processing equipment, film and chemistry.

Christie Group Ltd.
516 Rue du Parc
St-Eustache QC J7R 5B2
T: 450-472-9120 F: 450-472-9410

                                  Queens School of Business
                                   Executive MBA Program


Christie Group Ltd. is the exclusive distributor in Canada for Fuji Photo Film’s Synapse “Next
Generation” PACS that can transform any film based imaging department or regional enterprise into
a fully digital environment and beyond. Synapse features include full Dicom support, HIS/RIS
integration and IHE compliance, and it operates in a total Windows environment on industry
standard hardware and software. Using Internet Explorer for the user interface, Synapse is friendly
and exceptionally easy to implement. Christie also distributes Fuji’s leading Computed Radiography
systems, network laser printers, film handling and processing equipment, film and chemistry.

Cientis Technologies
201-6051 Gilbert Road
Richmond BC V7C 3V3
T: 604-813-6729 F: 604-276-8717
Contact: Clay Braziller

Cientis Consulting facilitates dialogue between healthcare providers and technology innovators. We
provide market research and consulting services to corporations, governments and healthcare
organizations on the selection and implementation of technology solutions in clinical practice

Citrix Systems, Inc.
2680 Skymark Avenue, Suite 200
Mississauga ON L4W 5L6
T: 800-805-9154 F: 905-625-3201

Citrix Systems, Inc. is the global leader in access infostructure solutions. Citrix MetaFrame Access
Suite enables people to easily and securely access the enterprise on-demand, from anywhere,
anytime, over any connection. The product suite offers device and network services, aggregation
and personalization, security and identity management, and presentation and conferencing.

1545 Bathurst Street, Suite 110
Toronto ON M5P 3H6
T: 416-652-1614 F: 416-652-1613
Contact: Scott Nimmo

The Clinetix team builds highly scalable and secure data repositories, distributed systems and
networks. Services include project management, system design, software development and
integration. Our focus is to improve overall patient care, leverage current I.T. investments and
reduce costs across the healthcare enterprise.

300, 3553-31 Street NW
Calgary AB T2L 2K7
T: 1-800-563-0579 F: 403-259-2400
Contact: Brent Mitchell, Marketing Manager

CLINICARE is a provider of Practice Management (billing and scheduling) and Electronic Medical
Records applications to group medical practices. Over 50 percent of our sites are “chartless”,
meaning they no longer pull or file paper charts.

                                  Queens School of Business
                                   Executive MBA Program

ClinSaver Software Inc.
84-556 Edward Ave.
Richmond Hill ON L4C 9Y5
T: 905-787-8280 F: 905-508-4608

ClinSaver Software Inc. provides healthcare agencies with clinical, financial and statistical
benchmarking, balanced scorecard, strategic planning, impact assessment, financial analyses and
budgeting software. Using the software enables management to focus on making informed
decisions resulting in optimal performance and resource utilization.

Computer Associates
5935 Airport Road
Mississauga ON L4V 1W5
T: 905-676-6858 F: 905-676-6734
Contact: Wayne W. Wood

CA provides industry-leading technologies to address the many clinical, technical and business
challenges faced by healthcare professionals. These solutions include: tools that address security
concerns and privacy regulations; applications to improve the quality of patient care; the ability to
proactively monitor and forecast financial and clinical outcomes; and tools to reduce administrative
and I.T. staffing costs and ensure high availability of life critical systems.

Continuum solutions
189 Elm Street, PO Box 2007
St. Thomas ON N5P 3W2
T: 519-631-0306 F: 519-631-3188
Contact: Larry Vanier

Continuum solutions provides Clinical Utilization Management solutions. Promoting quality care and
improved resource management, the Continuum solutions’ daily reports show patient care status,
care delays and readiness for discharge.

Courtyard Group
445 King Street West, Suite 302
Toronto ON M5V 1K4
T: 416-349-2600 F: 416-349-2608
Contact: Jack Shaw

Courtyard Group is a professional services firm that applies information to meet the complex needs
of healthcare.

Cygnal Technologies
15-100 Leek Crescent
Richmond Hill ON L4B 3E6
T: 905-707-3500 F: 905-707-3520
Contact: Horst Schmidt, VP Sales & Marketing

Voice, data wired and wireless, telecom systems, design, installation and ongoing service and

                                 Queens School of Business
                                  Executive MBA Program

DataGlider Inc.
25 Leek Crescent
Richmond Hill ON L4B 4B3
T: 905-707-4215 F: 905-707-1944
Contact: David Lewis

DataGlider’s Point of View portal solution for healthcare provides clinicians and executives with
customizable views of aggregated information that is seamlessly assembled in real-time from
multiple modules and systems. DataGlider’s Business Portal provides the right Point of View to each
individual in the Enterprise so they can do their job best.

Datex-Ohmeda Canada
1093 Meyerside Drive, Unit 2
Mississauga ON L5T 1J6
T: 800-268-1472 F: 905-565-8592
Contact: Peter Fenwick, Director of Business

At Datex-Ohmeda Canada we are dedicated to assisting our customers in their efforts to improve
both patient care and the working environment of their staff. We design and implement electronic
health-record systems and physiologic data measuring/monitoring systems in Anesthesia and
Surgery, critical and Peri-Natal Care. These integrated systems contribute to local clinical and
business intelligence tools, and to databases within community care based EHR models.

Deloitte & Touche LLP
79 Wellington Street West, Suite 1900
Toronto ON M5K 1B9
T: 416-601-6150 F: 416-601-6151
Contact: Irene Podolak

Deloitte & Touche provides a range of services. Expertise in health services includes strategic
planning; clinical resource optimization; operations improvement; supply chain management;
performance/risk management; information technology planning/implementation; e-health; financial
management; and human capital advisory services.

DeltaWare Systems Inc.
90 University Avenue, Suite 300
Charlottetown PE C1A 4K9
T: 902-368-8122 F: 902-628-4660
Contact: Wendy Deveaux, Business
Development Officer

DeltaWare Systems Inc. is an I.T. consulting firm specializing in health, e-business, and ERP
(Oracle) solutions. Our service areas include consulting and integration, project management,
software engineering and network and application support.

Dictaphone Canada
2355 Skymark Avenue
Mississauga ON L4W 4Y6
T: 905-625-0300 F: 905-625-0225

                                  Queens School of Business
                                   Executive MBA Program


Dictaphone Corporation’s Healthcare Solutions Group (HSG) has a strong base of dictation,
transcription, and report management system solutions currently being deployed in some of the
world’s premier healthcare organizations. Its solutions automate and integrate several critical
reporting and processing elements in the creation and management of health information, helping
healthcare organizations and clinicians improve productivity and the quality of patient care.

Digital Group of Telehealth Companies
One Research Drive
Dartmouth NS B2Y 4M9
T: 902-461-4883 F: 902-466-6889
Contact: Wayne Bell

Complete Telehealth and EHR solutions: telehealth consulting, telehealth training programs and
telehealth policy and procedures development. Provided through Digital Telehealth Inc.: Web sites
and portals, on-line training (CME/CNE) and database development provided through Digital Image
FX Inc. Also project management, telehealth hardware and software provided through Digital
Healthcare Solutions Inc.

1525 Carling Avenue, Suite 512
Ottawa ON K1Z 8R9
T: 613-725-5162 F: 613-725-0285
Contact: Allison Larsen

DINMAR has worked since 1992 to deliver solutions that help healthcare organizations achieve
their business objectives. Whether DINMAR consultants are managing key I.T. functions for their
clients, or whether DINMAR solutions like Oacis are effectively streamlining clinician workflow and
enhancing patient care, DINMAR focuses on improving healthcare delivery through effective
information management.

Eclipsys Corporation
13711 International Place, Suite 300
Richmond BC V6V 2Z8
T: 604-273-4900 F: 604-273-2764
Contact: Heidi Brown

Eclipsys is The Outcomes Company, founded with a mission of better healthcare through
knowledge. More than 1,500 healthcare facilities rely on Eclipsys software and service solutions to
improve patient safety, revenue cycle management and operational efficiency.

Ergotron Canada
Suite 920, 706-7th Avenue SW
Calgary AB T2P 0Z1
T: 403-264-2650 F: 403-262-6758

Canadian distributor for Ergotron Inc., manufacturers of computer and monitor mounting solutions
for flat panel and CRT applications. Products include wall, ceiling and floor mounts as well as mobile
carts and wireless carts.
First DataBank

                                   Queens School of Business
                                    Executive MBA Program

1111 Bayhill Drive
San Bruno CA 94066
T: 800-633-3453 or 650-872-4585 F: 650-588-4003

First DataBank is a leading provider of electronic drug information. We deliver proven knowledge
bases for integration into varied healthcare applications, with particular expertise in clinical decision
support within the workflow. Our portfolio also includes comprehensive reference products;
integrated content software, and specialty software for nutritionists.

Fuji Photo Film Canada Inc.
600 Suffolk Court
Mississauga ON L5R 4G4
T: 905-890-6611 F: 905-890-6446
Fuji is a world leader in the provision of medical and diagnostic imaging technologies and supplies.

For information about Fuji Photo Film medical products, including world-class PACS and digital
imaging solutions, please refer to Christie Group Ltd. who are the exclusive distributors in Canada.
(Please see Christie Group’s listing in this directory, or check

GE Medical Systems Information Technologies
2300 Meadowvale Blvd
Mississauga ON L5N 5P9
T: 905-567-3775 F: 905-567-2115
Contact: Dave Roeder

GE Medical Systems Information Technologies provides hospitals, ambulatory clinics and
physician’s offices with advanced solutions to improve their clinical performance. The company’s
expertise spans the areas of image and information management for radiology (PACS, RIS),
cardiology, patient monitoring, clinical communications, and clinical information systems to enable a
real-time, integrated EMR.

Genesis Communication Inc.
14721 123rd Avenue
Edmonton AB T5L 2Y6
T: 780-455-3000 F: 780-455-3060
Contact: Matt Buffam

Genesis Communication specializes in systems integration. We have expertise in a wide variety of
low voltage communications systems such as Nurse Call, Wired/Wireless Telephone, Card Access,
Security, CCTV, Audio/Video and IT. Our healthcare clients benefit the most when we integrate and
streamline these technologies and make them work seamlessly together.

Global Healthcare Exchange
10 Carlson Court, Suite 610
Etobicoke ON M9W 6L2
T: 416-798-1029 F: 416-798-8287
Contact: Nils Clausen

Providers of an Internet-based trading exchange, hosting the first industry standard electronic
catalogue for healthcare. Complete integration and connectivity of all provider and supplier
information systems to facilitate supply chain transactions seamlessly. Web-based reporting tools
that provide real-time order status and tracking information.

                                 Queens School of Business
                                  Executive MBA Program

Healthtech Inc.
210 Glencairn Avenue
Toronto ON M4R 1N2
T: 416-483-5974 F: 416-483-9197

Healthtech is an information technology consulting company specializing exclusively in healthcare.
Our broad base of knowledge allows us to provide a full range of services in consulting,
implementation and PACS project management, technical services, clinical documentation and
ePhysician strategies.

1476 Netherly Court
Mississauga ON L5M 3K4
Tel: 905-858-2000

HealthworksTMS is a provider of integrated software/hardware and consulting solutions for the e-
health sector. Focused on integration clinical applications and IP based technologies to enabling
remote patient monitoring, clinical consultation and information sharing. HealthworksTMS
specializes in desktop technologies including Web-Phones, Videoconferencing enabled-Tablet PC,
VideoPhones and Point-of-Care clinical technologies.

Heron Technology Corp.
3075 14th Avenue, Suite 218
Markham ON L3R 0G9
T: 905-475-8050 F: 905-475-5842
Contact: Ron Hebert

HTC offers the Patient Administration System (PAS) to hospitals and clinics in the domestic and
international markets. It operates with the open-source free LINUX operating system.

Hewlett-Packard (Canada) Co.
5150 Spectrum Way
Mississauga ON L4W 5G1
T: 905-206-4725 F: 905-206-4739
Contact: Anne Lawrence

HP is a leading global provider of products, technologies, solutions and services to consumers and
businesses. The company’s offerings span I.T. infostructure, personal computing and access
devices, imaging and printing, and global services.

Hospitality Network
Suite 1600, 2002 Victoria Avenue
Regina SK S4P 0R7
T: 1-877-282-2614 F: 306-347-9991
Contact: Robert Reid, National Sales & Contract Manager

Hospitality Network (HN) is a broadband interactive television and telephone service provider
focusing on communications and entertainment to the healthcare industry in Canada. With over 200
customers, HN is Canada’s leading supplier of managed communication solutions and rental
services for patients in Acute Care hospitals and residents in Long Term Care facilities.

                                   Queens School of Business
                                    Executive MBA Program

in4tek Ltd.
20 Barrington Road
Altrincham, Cheshire UK WA14 1HB
T: +44 161 941 5833 F: +44 161 927 7629
Contact: John Hopkins

Developers of the Paris system, which provides a secure, person-centric integrated care index to
facilitate the exchange of critical care information to multi-disciplinary care providers. Paris delivers
all aspects of Home Nursing, Mental Health, Drug & Alcohol, Child & Adult Services and
Immunization programs while providing inherent flexibility to record profession specific information.

Institute for Health Informatics Research
University of Waterloo
Davis Centre 3327, 200 University Avenue West
Waterloo ON N2L 3G1
T: 519-888-4567 x5996 F: 519-746-5422

We are an academic research organization developing new concepts, methods, techniques, and
tools in the field of Health Informatics. Our purpose is to improve the function of the health system
and to make it sustainable through the use of informatics solutions.

Instruments for Science and Medicine Inc.
250 Authier Street
St-Laurent QC H4M 2C6
T: 514-744-2893 F: 514-744-2596

Instruments for Science and Medicine Inc. (ISM) is the exclusive Canadian distributor of ALOKA
ultrasound systems and INSTRUMENTARIUM IMAGING mammography equipment, with offices in
Montreal, Toronto, Calgary and Vancouver. We provide Canadian public and private health centres
with high-end imaging equipment.

InterSystems Corp.
One Memorial Drive
Cambridge MA 02142
T: 617-621-0600
F: 617-494-1631

InterSystems Corp. is the developer of Caché, a post-relational database offering advanced objects
and robust SQL, with a multidimensional engine for lightning-fast speed and massive scalability.
Caché is the world’s leading database in healthcare.

Jonoke Software Development Inc.
8709-102 Ave.
Edmonton AB T5H 4E5
T: 780-448-3647 F: 780-448-3741
Contact: Brandon C. Plaizier

MediFile is your EMR solution, featuring a fully paperless record system integrated with practice
management and accounting tools. The customizable, secure, medical-legal MediFile system is
proven to save you time and money, with support that goes the extra mile. Visit
today and discover the best way to a modern practice.

                                   Queens School of Business
                                    Executive MBA Program

Keston Group
6350 Savary Street
Nanaimo BC V9V 1S8
T: 250-760-0194 F: 250-760-0195

International provider of consulting services in telehealth and various medical imaging modalities.

Kodak Canada Inc.
Health Imaging Division
3500 Eglinton Avenue West, 4th Floor, Bldg 7
Toronto ON M6M 1V3
T: 416-766-8233 F: 416-760-4487

Kodak Health Imaging Group’s portfolio includes computed radiography and digital radiography
systems, laser imagers, PACS, dental imaging and services as well as traditional mammography
and X-ray film systems.

Language and Computing
3 Neshaminy Interplex, Suite 301
Trevose PA 19053 USA
T: 215-245-2231
F: 215-245-2232
Contact: Dan Wasserstrom

Language and Computing specializes in cutting edge information management solutions for the
healthcare and pharmaceutical markets, supported by the latest Natural Language Processing
(NLP) technologies. L&C offers solutions for semantic indexing of free text documents, information
analysis, document mining, information retrieval and extraction, terminology management and
automated clinical coding.

Lexmark Canada Inc.
50 Leek Crescent
Richmond Hill ON L4B 4J3
T: 1-800-539-6275
F: 905-763-0290

Lexmark Canada Inc. is a wholly owned subsidiary of Lexmark International Inc., a leading
developer, manufacturer and supplier of printing solutions including laser and inkjet printers,
multifunction products, and associated supplies and services for offices and homes in over 150

Loki Management Systems Inc.
5-7218 Progress Way
Delta BC V4G 1H2
T: 800-378-5654 F: 604-948-3427
Contact: Bill Dartnell

Loki specializes in developing resource management systems for healthcare. StaffRight is a
technologically advanced rules-based staff scheduling system. HCMS, our Home Care

                                  Queens School of Business
                                   Executive MBA Program

Management System, supports every facet of home support, including staff and client scheduling,
billing and interfaces to your payroll and accounts receivable systems.

March Networks
555 Legget Drive, Tower B
Ottawa ON K2K 2X3
T: 613-591-8181 F: 613-591-7337
Contact: Sandra Lowenstein

The March Networks Home Telehealth Solution allows homecare organizations to supplement
home nursing visits with remote visits using secure, interactive voice, video and data technology.
Solution features include: comprehensive encryption technology, authentication processes, secure
networks, biometrics, database integration, administration functions and billing processes to
streamline both remote and home visit management.

McKesson Information Solutions Canada Ltd.
PO Box 43223 Sheppard Centre RPO
4841 Yonge Street
Toronto ON M2N 6N1

McKesson Information Solutions is a leader in helping healthcare organizations provide quality care
in the most cost-effective manner possible. Healthcare organizations use our comprehensive
solutions to improve patient safety, reduce the cost and variability of care, as well as to better
manage their revenue stream and resources.

MED e-care
577 Kingston Road
Toronto ON M4E 1R3
Tel: 1-800-387-8903 F: 416-686-3861
Contact: Lisa Beaulne

MED e-care Healthcare Solutions, Inc. provides software and consulting for the continuing care
sector. Modules include MDS (CCRS), Rehabilitation (NRS), Care Plans, Incidental Charting,
Resident Billing & Trust, Activity Scheduling, Staff Scheduling, and Home Care (MDS-HC) and
MDS-Mental Health.

Mediamounts, Inc.
400 Collier MacMillan Drive
Cambridge ON N1R 7P3
T: 800-263-8901 F: 519-621-0755
Contact: Renee Fallows

Mediamounts supplies innovative mounting solutions to position computer workstations running
clinical applications from the wall, ceiling or mobile cart. Improve access, efficiency and accuracy in
the OR, ICU, radiology and labs by professionally integrating your LCD/CRT monitor, keyboard and
CPU at the point of care.

MEDICA (Messe Duesseldorf)
1410-480 University Avenue
Toronto ON M5R 1N4
T: 416-598-1524 F: 416-598-1840

                                  Queens School of Business
                                   Executive MBA Program

Contact: Stefan Egge

MEDICA is the world’s leading annual medical tradeshow. With over 3,600 exhibitors and 130,000
visitors from more than 50 countries, MEDICA is a uniquely international business platform for
Canadian exporters.

Medical Information Technology, Inc. (MEDITECH)
Westwood MA 02090
T: 781-821-3000 F: 781-821-2199
Contact: Paul Berthiaume

A world leader in healthcare information systems for 34 years, MEDITECH develops, installs and
services integrated information systems with products that are designed to work together.
MEDITECH develops all of its own software applications in order to maintain the integration that is
critical for today’s healthcare information systems.

MediSolution Ltd.
110 Cremazie Blvd W, 12th Floor
Montreal QC H2P1B9
T: 514-850-5000 F: 514-850-5005

MediSolution Ltd. is a leading Canadian healthcare information technology company with offices in
Canada and the United States. The company markets a comprehensive suite of information
systems and professional services to the healthcare industry.

Momentum Healthware
308-131 Provencher Blvd
Winnipeg MB R2H 0G2
T: 204-231-3836 F: 204-231-8238
Contact: Keith Brownell

Momentum solutions are complete, modular product offerings that include financial, billing, dietary,
MDS, clinical care management, patient scheduling, resource scheduling, ADT, laboratory,
pharmacy and diagnostic imaging applications. Products can be deployed on stand-alone, client-
server or web-enabled systems, or via an Application Service Provider (ASP) and are scalable to
accommodate individual or regional implementations.

Nightingale Informatix Corp.
2900 John Street, Suite 300
Markham ON L3R 5G3
T: 1-866-852-3663 F: 905-415-8780

Nightingale’s flagship product, myNightingale, is a web-based scheduling, billing, electronic medical
record and workflow solution. All patient information can be documented at the point-of-care,
including encounters, prescriptions, letters and follow-up actions. It can be implemented using
existing hardware infostructure.

                                   Queens School of Business
                                    Executive MBA Program

Orion Systems International
10104-103rd Avenue, Suite 1300 Bell Tower
Edmonton AB T5J 0H8
T: 877-763-4666 F: 206-374-2576

Orion Systems International supplies and implements integrated medical records solutions.
Features include single sign-on security and integration of existing computer systems. Orion’s
solutions are ideal for region-wide/enterprise-wide EHR projects.

Ormed Information Systems Inc.
700-10216 124 Street
Edmonton AB T5N 4A3
T: 780-482-7200 F: 780-482-6886
Contact: Steve Caughers

ORMED HIS software drives efficiency in Healthcare Supply Chain Management, Finance, Human
Resources, Operating Room Management, Systems Management and Decision Support. ORMED
X is the B2B portal that embeds e-commerce and other services in the ORMED HIS software to
provide real-time communication between healthcare teams and their partners.

PeopleSoft Canada
4101 Yonge Street, Suite 600
Toronto ON M2P 1N6
T: 416-227-3000 F: 416-227-3001

PeopleSoft is a leading provider of application software for the real-time enterprise. PeopleSoft’s
integrated, best-in-class applications include Customer Relationship Management, Supply Chain
Management, Human Capital Management, Financial Management and Application Integration.

Per-Sé Technologies
2840 Mt. Wilkinson Parkway
Atlanta GA 30339
T: 877/73PER-SE F: 770-444-5243

Per-Sé Technologies delivers resource management and clinical software solutions. Per-Se offers
Patient1, an interactive point-of-care solution integrating all aspects of the patient-care process with
a computer-based patient record.

Philips Medical Systems
281 Hillmount Road
Markham ON L6C 2S3
T: 905-201-4500 F: 905-201-4317
Contact: Heather Reed

Philips Medical Systems, a global leader in the growing medical device and diagnostic industry, is
committed to providing innovative technology and services that enable healthcare providers to
achieve clinical excellence. Through the acquisitions of Marconi Medical Systems, Agilent’s
Healthcare Solutions Group, ADAC Laboratories and ATL Ultrasound, Philips Medical Systems is
positioned to deliver solutions with unique clinical benefits that meet healthcare’s challenges today
and in the future. Its extensive portfolio includes X-ray, ultrasound, magnetic resonance, computed
tomography, nuclear medicine and PET, patient monitoring, information management and

                                  Queens School of Business
                                   Executive MBA Program

resuscitation products, as well as a complete range of services that include asset management,
training and education, business consulting, financial services and e-care business services.

200 Quannapowitt Parkway
Wakefield MA 01880
T: 781-557-3000 F: 781-557-3140

Picis delivers total peri-operative automation with proven and comprehensive solutions that drive
process improvements and optimize outcomes.

Planar Systems
400 Fifth Avenue
Waltham MA 02451
T: 781-895-1155 F: 781-895-1133

Planar Systems is a leader in flat-panel display solutions for challenging medical applications. We
offer a range of display products for the healthcare market including radiological and medically
certified flat panels, and point-of-care workstations.

Primex Wireless
8150 Keele Street
Concord ON L4K 2A5
T: 800-330-1459 F: 905-669-7075
Contact: Paul Lawlor

Primex Wireless provides wireless time & tone solutions to healthcare facilities, schools and
businesses. Our commitment to excellence and accuracy led to the development of an innovative
wireless timekeeping system, the Primex GPS Wireless Master Clock System.

623 Discovery Street, 2nd Floor
Victoria BC V8T 5G4
T: 877-776-2872 F: 250-380-1866
Contact: Warren Brown

Procura provides management software for home and community healthcare providers. The
Procura Health Management System meets the mission critical needs of U.S. and Canadian
homecare case management and provider organizations. They include private pay agencies, multi-
site organizations, health regions and Medicaid based agencies.

Psyche Systems Corp.
321 Fortune Blvd
Milford MA 01757
T: 508-473-1500 F: 508-478-4717
Contact: Patricia Salem

Psyche Systems delivers laboratory information systems to customers throughout North America.

                                 Queens School of Business
                                  Executive MBA Program

Purkinje, Inc.
740 Notre Dame Street West
Montreal QC H3C 3X6
T: 514-355-0888 x252 F: 514-355-0481

Purkinje is a Canadian corporation providing the Electronic Health Record market with advanced
clinical and administrative software and related services.

QHR Software Group Inc.
210-1632 Dickson Avenue
Kelowna BC V1Y 7T2
T: 250-763-3122 F: 250-712-9516
Contact: Cindy Danielson

Quadrant HR is an integrated, modular Human Resources, Staff Scheduling and Payroll software
solution designed to help organizations with complex multiple-site; multiple-position workplace
environments standardize processes and assist with strategic workforce planning.

Rogue Data
232 Herzberg Drive, Suite 204
Kanata ON K2K 2A1
T: 613-260-1653 613-248-2421
Contact: John Mihailov (

E-enable your customers, suppliers and partners over the Internet, no matter the standards. Rogue
Data’s e-Procurement Desktop and our cost-effective, managed e-Business Exchange Service is
flexible, scalable, secure and easy to implement.

Saint Elizabeth Health Care
90 Allstate Parkway, Suite 300
Markham ON L3R 6H3
T: 905-940-9655 F: 905-940-9934
Contact: Paul Ting

Developed by Saint Elizabeth Health Care, @YourSide provides personalized health education,
information and monitoring tools that allow clients to track their health and well-being.

Sand Technology Inc.
215 Redfern, Suite 410
Westmount QC H3Z 3L5
T: 514-939-3477 F: 514-939-2042
Contact: Jerry Shattner

The SAND Discharge Record Analytic Server provides healthcare organizations with a 100%
indexed privacy-protected analytical view of discharge information. The SAND Clinical Analytical
Server extends this solution by integrating laboratory data, Electronic Health Records and any other
relevant data (including medical notes automatically encoded for SNOMED, ICD-9-CM, ICD-10 and

                                  Queens School of Business
                                   Executive MBA Program

Science Applications International
Corp. (SAIC)
10 Research Drive, Suite 360
Regina SK S4V 2M3
T: 306-791-6329 F: 306-791-4172
Contact: Punam Burnett

SAIC Canada offers a range of vendor-neutral expertise in application integration services, vendor
product selection, technical support services, project and program management, and information
technology consulting services.

Sentillion, Inc.
300 Brickstone Square
Andover MA 01810 USA
T: 978-749-0022 F: 978-749-0023
Contact: John Gobron

Sentillion’s Vergence product suite offers healthcare organizations simplified access to healthcare
applications. Vergence was designed to meet the productivity, privacy and security needs of
hospitals, access strong authentication, single patient selection and privacy management across
multiple applications.

Siemens Canada Limited
2185 Derry Road West
Mississauga ON L5N 7A6
T: 905-819-8000 F: 905-819-5793
Contact: DL Leslie

Siemens provides a full range of integrated services for the health care industry, from multi-vendor
solutions to asset planning and management. Specifically, Siemens offers advanced medical
technologies such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT),
radiography, oncology care systems, and image management and networking systems, such as
PACS and telemedicine.

Sierra Wireless
13811 Wireless Way
Richmond BC V6V 3A4
T: 604-231-1100 F: 604-231-1109

Sierra Wireless, Inc. is a leader in providing wireless data solutions that enable mobile professionals
to improve their productivity and lifestyle. The company develops and markets the AirCard, a
wireless PC Card for portable computers, OEM modules for embedded applications, and rugged
vehicle-mounted wireless systems, while providing customers and partners with world-class

Sonosite-Northstar Medical Systems
468 Osborne Street
Beaverton ON L0K 1A0
T: 888-683-1534 F: 705-426-1554
Contact: Vince Arsenault

                                  Queens School of Business
                                   Executive MBA Program

Ultrasound, Handheld and portable-Sonosite Canadian distributor. Crainscain; handheld-laser,

Sun Microsystems of Canada Inc.
27 Allstate Parkway
Markham ON L3R 5L7
T: 905-477-6745 F: 905-477-9423

Since its inception in 1982, a singular vision – “The Network is the Computer” – has propelled Sun
Microsystems, Inc. to its position as a leading provider of industrial-strength hardware, software and
services that make the Net work.

Talk 2 Me Technology Inc.
1150 Blair Road, Suite 2S
Burlington ON L7M 3T4
T: 800-518-2552
F: 905-335-4542
Contact: Charles Marriott

Canada’s leading supplier of digital dictation and speech recognition products. Products include
Dragon Naturally Speaking Medical Solutions Speech Recognition. Philips, Dictaphone and
Olympus Digital dictation products.

6505 Trans-Canada Highway, Suite 610
Montreal QC H4T 1S3
T: 514-748-5224 F: 514-748-1002

TANDBERG is a global leader in videoconferencing. Specializing in telehealth and distance
education solutions.

3777 Kingsway
Burnaby BC V5H 3Z7
F: 403-206-7771

TELUS has established itself as a leading supplier of hosted infostructure in practice management
for care providers.

Triple G Systems Group, Inc.
3100 Steeles Avenue East, Suite 600
Markham ON L3R 8T3
T: 905-305-0041 F: 905-305-0046

Triple G Systems Group, Inc. is a leading global provider of Laboratory Information Systems (LIS)
that automate and integrate laboratory processes in the hospital, clinic and private reference
laboratory settings.

                                  Queens School of Business
                                   Executive MBA Program

True North Consulting & Associates Inc.
52 Park Street East, Suite 506
Port Credit ON L5G 1M1
T: 905-271-4060 F: 905-271-0435
Contact: Thomas Hough

TNC is a consortium of leading Diagnostic Imaging Consultants who focus on providing healthcare
professionals with services and solutions required to achieve and improve their key strategic

1175 Klarecroft Way
Oakville ON L6M 2W1
T: 905-847-6800 F: 905-847-6584

For over 12 years UNIS LUMIN has helped healthcare organizations adopt and use technology to
securely connect to critical applications, networks and to each other.

Videoconference Solutions Inc.
5750 Timberlea Blvd, Suite 2
Mississauga ON L4W 5N8
T: 905-602-7799 x22 F: 905-602-7811
Contact: Sean Lynch

Video, audio, data, web-based integrated solutions. Installation, consultation, design and technical
support. Simplified solutions for complex environments.

ViewSonic Corporation
100 Mural Street, Suite 202
Richmond Hill ON L4B 1J3
T: 905-709-9774 F: 905-709-0685

ViewSonic offers a comprehensive family of sleek, space-saving displays and Mobile & Wireless
Tablet PC solutions to provide Healthcare professionals with next-generation power, control, data
access and information-sharing capabilities for mobility, speed and productivity.

Wolf Medical Systems
5460 152nd Street, Suite 207
Surrey BC V3S 5J9
T: 604-576-6969 or 1-866-879-9653
F: 604-576-6903
Contact: Andrea Lundel

Our mission is to create, provide and implement physician designed software tools that enable
physicians to manage their practices and their businesses more efficiently, effectively and
enjoyably. Our core competence is our ability to understand physician needs and create physician-
centered solutions.

                                 Queens School of Business
                                  Executive MBA Program

65 Iber Road
Stittsville ON K2S 1E7
T: 613-831-2018 F: 613-831-1836
Contact: Hal Tierney

xwave has extensive integration capabilities with healthcare information systems. This includes
systems supporting regionally accessible patient care records, hospital and physician portals,
Medicare solutions management, billing and adjudication systems and evidence-based clinical
management solutions. Aware of the constant demand for real-time health care critical information,
xwave has the experience and the knowledge to integrate and manage both current and future
eHealth solutions.

Source of information 61

  All company information, including product and service descriptions are up-to-date as of July
29, 2003. Product and Service descriptions are directly quoted from source of data.

                                 Queens School of Business
                                  Executive MBA Program

                           Appendix VII: The Epp Letter
          The Canadian government’s approach to regulating healthcare
In June 1985, approximately one year following the passage of the Canada Health Act in
Parliament, then federal Health Minister Jake Epp wrote to his provincial and territorial
counterparts to set out and confirm the federal position on the interpretation and
implementation of the Canada Health Act.

Minister Epp’s letter followed several months of consultation with his provincial and
territorial counterparts. The letter sets forth statements of federal policy intent which
clarify the criteria, conditions and regulatory provisions of the CHA. These clarifications
have been used by the federal government in the assessment and interpretation of
compliance with the Act. The Epp letter remains an important reference for interpretation
of the Act.

[Following is the text of the letter sent on June 18, 1985 to all provincial and territorial
Ministers of Health by the Honourable Jake Epp, Federal Minister of Health and Welfare.
(Note: Minister Epp sent the French equivalent of this letter to Quebec on July 15,

“In regard to information, I remain committed to maintaining and improving national data
systems on a collaborative and co-operative basis. These systems serve many purposes
and provide governments, as well as other agencies, organizations, and the general
public, with essential data about our health care system and the health status of our
population. I foresee a continuing, co-operative partnership committed to maintaining
and improving health information systems in such areas as morbidity, mortality, health
status, health services operations, utilization, health care costs and financing.

I firmly believe that the federal government need not regulate these matters.
Accordingly, I do not intend to use the regulatory authority respecting information
requirements under the Canada Health Act to expand, modify or change these broad-
based data systems and exchanges. In order to keep information flows related to the
Canada Health Act to an economical minimum, I see only two specific and essential
information transfer mechanisms:
1. Estimates and statements on extra-billing and user charges;

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                                Executive MBA Program

2. An annual provincial statement (perhaps in the form of a letter to me) to be submitted
approximately six months after the completion of each fiscal year, describing the
respective provincial health care insurance plan's operations as they relate to the criteria
and conditions of the Canada Health Act.”

Jake Epp, Minister of Health, Canada Health Act Annual Report, 2001-2002

                              Queens School of Business
                               Executive MBA Program

                    Appendix VIII: Provincial Legislation

British Columbia:
Freedom of Information and Protection of Privacy Act (Revised Statutes of British
Columbia 1996, Chapter 165)
Freedom of Information and Protection of Privacy Regulation

Freedom of Information and Protection of Privacy Act (Revised Statutes of Alberta
2000, F-25)
Health Information Act (Revised Statutes of Alberta 2000, H-5)
Health Information Regulation

Freedom of Information and Protection of Privacy Act (Statutes of Saskatchewan,
1990-91, Chapter F-22.01; amended to 2001)
Health Information Protection Act (Bill 29, Royal Assent May 6, 1999; to be proclaimed)
Local Freedom of Information and Protection of Privacy (Statutes of Saskatchewan,
1990-91, Chapter L-27.1; amended to 2002)
Local Freedom of Information and Protection of Privacy Regulations

Freedom of Information and Protection of Privacy Act (Continuing Consolidation of the
Statutes of Manitoba, c.F175)
Personal Health Information Act (Continuing Consolidation of the Statutes of Manitoba,

Freedom of Information and Protection of Privacy Act (Revised Statutes of Ontario
1990, Chapter F.31; amended to 2002)
Municipal Freedom of Information and Protection of Privacy Act (Revised Statutes of
Ontario 1990, Chapter M.56; amended to 2002)
Personal Health Information Act, 2000 (Bill 159, First Reading, December 7, 2000 (37th
Parliament, 1st sess) )

Act Respecting Access to Documents Held by Public Bodies and the Protection of
Personal Information (Revised Statutes of Quebec, A-2.1, updated to November 1,
Act Respecting the Protection of Personal Information in the Private Sector (Revised
Statutes of Quebec, P-39.1, updated to November 1, 2002)

New Brunswick:
Protection of Personal Information Act (Consolidated Statutes of New Brunswick,
Chapter P-19.1)

Nova Scotia:
Freedom of Information and Protection of Privacy Act (Statutes of Nova Scotia 1993,
Chapter 5; amended Statutes of Nova Scotia 1999, Chapter 11)

                              Queens School of Business
                               Executive MBA Program

Prince Edward Island:
Freedom of Information and Protection of Privacy Act (Bill 47, Royal Assent, May 15,
2001; to be proclaimed)

Newfoundland and Labrador:
Access to Information and Protection of Privacy Act (Statutes of Newfoundland and
Labrador 2002, c.A-1.1; to be proclaimed)
Freedom of Information Act (Revised Statutes of Newfoundland and Labrador 1990,
Chapter F-25; repealed by 2002 cA-1.1 s76)
Privacy Act (Revised Statutes of Newfoundland and Labrador 1990, Chapter P-22;
amended to 1996)

Northwest Territories:
Access to Information and Protection of Privacy Act (part 1 of 2) and (part 2 of 2)
(Statutes of the Northwest Territories 1994, c.20; amended to 1999)

Access to Information and Protection of Privacy Act

Access to Information and Protection of Privacy Act (Statutes of the Yukon 1995,
Chapter 1; amended by Statutes of the Yukon 1997, c.4)

                                     Queens School of Business
                                      Executive MBA Program

         Appendix IX: Infoway Talks About Alliances, Partnerships &
The following is an excerpt from an interview published in Healthcare Information
Management & Communications Canada magazine (Spring 2003, Vol.1, No. 2).
Infoway's Senior Vice-President of Strategic Alliances Myrna Francis discusses how
public-private collaborations are key to the successful implementation of EHR solutions
in Canada. 62

Dave Wattling: The Infoway business plan emphasizes the importance of
partnerships and collaboration. Why do you feel that this strategy is central to
your success?

Myrna Francis: Infoway has set an ambitious goal – having the elements of an
interoperable EHR across half this country within seven years. One entity alone cannot
accomplish this – there has to be alignment with local initiatives and players. The result
will then be greater and faster solutions in place at a lower cost.

DW: What are Infoway's plans to establish these alliances?

MF: We have already met with senior officials from some 30 or 40 companies,
comprising IT vendors and investors. We intend to complement this with an open and
ongoing dialog with industry, facilitated by industry groups such as CHITTA (Canadian
Healthcare Information Technology Trade Association) and ITAC (Information
Technology Association of Canada). This dialog might include cross-sector industry
workshops on a variety of topics such as architecture and capacity building.

DW: Partnerships, alliances and collaborations are such overused and
misunderstood terms. What expectation does Infoway have of those it will work

MF: My hope is that there will be a good enough dialog in the working relationship that
companies will start to look at how they can better align their business strategy with the


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                                  Executive MBA Program

Infoway mission. In fact, I already see companies starting to align their solution
architecture, standards and development activities in areas that we are interested in
investing. I think that is a good start.

DW: You talk of architecture, standards and alignment in the industry. Do you
have such alignment across the jurisdictions of the health system?

MF: No. That is a separate effort that is well underway. We are just completing
workshops in each of the provinces with health system CIOs. We will be conducting a
similar exercise with industry. Then we'll bring forward an architectural blueprint.

DW: What will Infoway do to help ensure the success of such alliances? For
example, will you develop best practices for successful partnerships?

MF: Absolutely. Not only do we see this as a key issue, but also we will put resources
against it. We have an expert investment panel of senior people from other industries
who bring real partnering experience and have helped us develop success criteria based
on their experiences. We will also pilot different models in a controlled setting and feed
that experience into the evolution of our best practices.

DW: How would industry engage with you to tell you what it thinks?

MF: Right now I am receiving phone calls from different companies that are trying to get
a better understanding of what we are about and how we operate. During the calls, the
vendors will take the opportunity to let us know what they are about, where they are
going and what their product is. We've also seen interest from vendors in other
industries where they see a crossover opportunity. I think that it would be good to do a
sort of solution fair with some of the industry association members.

DW: Does Infoway have any plans to help encourage the introduction and
expansion of skilled IT professionals in the Canadian health care industry?

MF: There is no question about this issue. We need more people with the right
combination of technology, informatics and health care skills. I fear that we are not

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currently training enough people for this endeavour. Once we start rolling out, there is
going to be a huge demand.

DW: How can industry help with this issue?

MF: I believe health care represents the last big vertical market to get into. In fact there
is a unique opportunity as the growth in health care needs converges with the bust in
other sectors. Furthermore, Canada represents a great environment in which to build IP
(intellectual property) and skills, and then sell them into higher priced markets such as
the US and Europe. Now I recognize that this is a bit of a chicken and an egg situation.
Until we are at full throttle, we don't have the full demand to warrant the capacity. Yet if
the marketplace doesn't prepare for it, you won't be able to meet the demand when it
hits. Maybe this can be a topic for an early industry workshop where we can put our
collective heads around the challenge?

DW: I appreciate your candour Myrna. If you had just one message for our
readers, what would it be?

MF: There have been many false starts in the automation of health care over the years. I
must stress that this time it's real. The plan is long term and everyone needs to hang in.
Now I agree we need to produce the evidence and results to prove the point, which we
will do over time.

                                 Queens School of Business
                                  Executive MBA Program

        Appendix X: ITAC and Potential Investment Opportunities

Ottawa, February 3, 2003 – The Information Technology Association of Canada believes
that information and communications technology (ICT) tools can contribute significantly
to enhanced patient safety and security, as well as to improved efficiency and
productivity in the health care sector. ITAC has called upon all governments to raise the
rate of Canadian investment in ICT.

"Across Canada, only $2 to $3 billion is spent annually on information and
communications technology. This represents less than 2 per cent of operating budgets in
health care. Organizations in the United States commit six per cent of their operating
budgets for health care on ICT and benefit from greater efficiencies," said Gaylen
Duncan, President and CEO of ITAC.

ITAC is calling upon Canadian governments to match U.S. investment in information and
communications technology by tripling their investment in ICT in the health sector, as
well as providing ongoing change management support for users.

The association is not alone in pointing out the potential gains to be made through more
intensive ICT investment. Commissioner Roy Romanow called for the Federal
Government to make substantial, ongoing national investments to improve the health of
Canadians and improve the efficiency of the health care system. The Senate Standing
Committee on Social Affairs, Science and Technology also noted that Canada needs to
invest more in health care technology and health information systems. And, in a recent
speech, Minister of Health Anne McLellan stated, "Improving the accessibility and quality
of information is critical to good patient care, safety and sustainability, particularly for
Canadians who live in rural and remote areas. Better use of information technology can
also result in better use of resources."

In a white paper it released today, ITAC outlined the role that technology such as the
Internet can play in reshaping health care delivery. "The Internet can make patient
records, test results and practice guidelines accessible from the examination room or the
bedside," Duncan said. "It can be used to modify home medical devices remotely. And it
can be used to streamline administrative practice and reduce overhead. Canada is one

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of the most connected nations on earth, yet we aren't even close to maximizing this
resource to improve health care delivery."

Another key technology is electronic health records. The vision for electronic health
records is to provide a collection of a patient's interactions with the health care system
that would be secure, private and available to health care professionals on a need-to-
know basis anywhere in the country. ITAC believes that the ICT industry can play a
pivotal role in overcoming the challenges of EHRs in a timely fashion. It has called upon
the Federal Government to ensure that pan-Canadian implementation of EHRs is
supported by a secure national infostructure and national standards, interoperable
among all provinces.

"Canada pioneered the convergence between health care and information technology
systems," Duncan said. "We already export our expertise in telemedicine. Careful
investment in ICT solutions in health care will not only help to ensure the viability of our
health care system. They will also spur Canadian innovation and enterprise. If we can
create solutions to issues like electronic record privacy, we can be world leaders in ICT
for health care. But we need to see more investment in our home market to make this

                    Queens School of Business
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             Appendix XI: Common Acronyms
ACHI     Advisory Committee on Health Infrastructure
ACIET    Advisory Committee on Information and Emerging Technologies
AMA      Alberta Medical Association
BCAS     The British Columbia Ambulance Service
BCMA     British Columbia Medical Association
CCAC     Community Care Access Centers
CCO      Cancer Care Ontario
CHA      Canadian Healthcare Association
CHI      Canada Health Infoway
CHIPP    Canada Health Infostructure Partnerships Program
CHITTA   Canada's Healthcare Information Technology Trade Association
CHN      Canadian Health Network
CHP      Canada Health Portal
CHST     Canada Health and Social Transfer
CIHI     Canadian Institute for Health Information
CMA      Canadian Medical Association
COACH    Canadian Organization for Advancement of Computers in Health
CPSO     College of Physicians and Services Ontario
EHR      Electronic Health Record
EHRWG    EHR Working Group (under Ontario Hospital e-Health Council)
EMPI     Enterprise Wide Master Person Index
EMS      Emergency Medical Services
ePP      E-Physician Project
ER       Electronic Records
FHN      Family Health Network
HCIOC    Health Chief Information Officer Council
HIA      Health Infostructure Atlantic
IACB     Information, Analysis, and Connectivity Branch
IHA      Interior Health Authority
IMIA     International Medical Informatics Association
ITAC     Information Technology Association of Canada
MOHLTC   Ministry of Health and Long Term Care
MPN      Managed Private Network
MSO      Medical Services Only
NHA      Northern Health Authority
OACCAC   Ontario Association of Community Care Access Centers
OEHC     Ontario e-HEALTH Council
OFHN     Ontario Family Heath Network
OHA      Ontario Hospital Association
OHIH     Office of Health and the Information Highway
OHISC    Ontario Health Informatics Standards Committee
OHPA     Ontario Health Providers Alliance
OMA      Ontario Medical Association
PACS     Picture Archiving and Communications System
PHAA     Provincial Health Authorities of Alberta
PHCTF    Primary Health Care Transition Fund
PIPEDA   Personal Information Protection and Electronic Documents Act
PKI      Public Key Infrastructure

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PRS    Provider Registry
PSIS   Professional Standards Information System
RHA    Regional Health Authorities
RNAO   Registered Nurses Association of Ontario
SMI    Secure Messaging Infrastructure
SSHA   Smart Systems for Health Agency
UPI    Unique Patient Identifier
VIHA   Vancouver Island Health Authority
WERC   Western EHR Regional Collaborative Electronic Health Records
WHIC   Western Health Information Collaborative


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