By Ruth Whittington (

Many of us in health economics and outcomes research look at Canada as one of the leaders in the field; along with Australia , Canada was one of the first countries to demand evidence of cost-effectiveness as a prerequisite for drug approval.

To those of us not intimately acquainted with its healthcare system, the recent presentation by Richard Alvarez, President and CEO of Canada Health Infoway, may have come as a bit of a shock. He described a system almost wholly reliant on paper records – a system where 37–43% of recommended treatment is never delivered, of 30–40% of women at risk of cervical cancer not being screened, of 32% of patients presenting at emergency rooms with vital pieces of their healthcare information missing.A country where it is estimated one in nine patients receives the wrong medication, and where over 24,000 patients die annually from preventable adverse events from treatment. Small wonder, then, that he is attempting to drag the ten provinces, three territories and numerous health regions into the 21st century by instituting electronic patient healthcare records.

Canada Health Infoway is a primarily government-funded organisation working with the provinces (which provide 25% of its funding) to integrate and coordinate healthcare, and Alvarez firmly believes that electronic record keeping will help solve several of their major issues. Information technology, he believes, will improve access, quality and productivity in healthcare provision, and although it may cost $CAN10 billion to institute it, ultimately all Canadian citizens will benefit from a better healthcare service.