DIGITAL HEALTH One small, silver-lining from Covid-19 has been a heightened impetus for digital innovation in health care. Unfortunately, much of the technological underpinnings of Canadian health governance are evermore antiquated, heightening risks and costs accordingly. Such is the stark message from many quarters, notably provincial and federal Privacy and Information Commissioners. As first reported in IT World Canada last September, the Commissioners passed a resolution urging governments at all levels to collectively: i) ‘develop a strategic plan and provide appropriate supports, funding, or other incentives to phase out the use of traditional fax and unencrypted email and reBY JEFFREY ROY GOVERNING DIGITALLY 22 / Canadian Government Executive // Spring 2023 A SHARED NATIONAL IMPERATIVE place them with more modern, secure and interoperable digital alternatives in a coordinated fashion; and ii) ensure that all digital health information sharing infrastructure… are equitably available and accessible to all Canadians’. While this need has been longstanding, the pandemic further exposed major challenges with data collection and sharing across jurisdictions, which inhibited a truly national response. The federal government’s own Expert Advisory Group, established in fall 2020 to explore the makings of a ‘pan-Canadian Data Health Strategy’ exhaustively exposed these shortcomings, calling for urgent action. The Panel recommended that governments establish ‘federated data governance, clear standards for interoperability, an effective policy environment and meaningful engagement with the public to facilitate this change.’ Despite such sound advice, this federal body lacked formal ties to the Provinces and the Panel’s’ sharply one-sided critique of Provincial data efforts during the pandemic did little to establish mutual trust. Nevertheless, the views of both the Privacy Commissioners and the Expert Advisory Group have helped to contextualize recent federal-provincial discussions around health care data (a theme returned to further below). Political federalism versus federated architectures: The current reality is that a truly national approach to digital health requires shared
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