Musings on Canada Health Infoway, PR and “Dave”

Michael Martineau and I are having a difference of opinion over Canada Health Infoway’s proposed PR campaign. Michael, who I know and respect very much, recently posted on his blog, eHealth Musings, about his attendance at the 10th annual eHealth Summit and a presentation by Kirk Ferguson of Canada Health Infoway (“Infoway” or “CHI”). While this isn’t a topic that I usually blog about, it being the 21st century, Michael asked me to respond via my blog to help foster a public dialogue on the subject. This is my response.

For my purposes, the relevant portions of Michael’s blog post are as follows (you can read the whole post here):

“.… it does not appear that we have quite the same level of public recognition of the benefits of digitizing our health system in Canada.   To address this lack of awareness, Canada Health Infoway plans to launch a public awareness campaign this fall that includes both print and television advertising along with a dedicated web site to which people can go to get more information…

The Infoway public relations campaign …demonstrates some much needed leadership in raising public awareness about the benefits of investing public funds in eHealth related projects…

My reaction to this bit of news was simply: why? As in “why do I have to pay for you to make me feel better about your plans for my EHR”?

Infoway’s mandate is, according to its annual report, is “to foster and accelerate the building of a pan-Canadian electronic health record (EHR) network, which will manage Canadians’ health information from coast to coast to coast.”

I’m not suggesting that CHI isn’t fulfilling that mandate or that it hasn’t performed well during the course of its existence since 2001 in channeling federal funding to provincial eHealth initiatives. One need only read the Auditor-General’s November 2009 audit report to have an impartial view of how well it has done. But, in this time of government fiscal restraint, do we really need a public relations campaign to promote awareness of the benefits of electronic health records?

The news reminded me of the “budget scene” from the 1993 movie “Dave” (a very enjoyable comedy). Here’s the relevant portion of the screenplay:

DAVE (from a card): You’re spending forty-three million dollars on an ad campaign to…(reading)’Boost consumer confidence in the American auto industry.’

SECRETARY OF COMMERCE: And it’s proving quite effective…

DAVE: Does it make the cars any better?

SECRETARY OF COMMERCE: No, sir.  It’s more of a perceptual issue.

DAVE (beat): Perceptual?

SECRETARY OF COMMERCE: Yes, it’s designed to bolster individual confidence in a previous domestic automotive purchase.

DAVE (beat) : Why?

SECRETARY OF COMMERCE: Well… to shore up product identification and preserve market share.

DAVE: So we’re spending forty-three million dollars to make people feel better about a car they’ve already bought?

SECRETARY OF COMMERCE: Yes, but I wouldn’t…

DAVE (indignant): Well I’m sure that’s really important, but I don’t want to tell some eight-year-old kid he has to sleep in the street because we want people to feel better about their cars. (beat) Do you want to tell him that?

He gestures toward the TV cameras in the room.

SECRETARY OF COMMERCE: Me? Uh, no sir… I sure don’t.

Infoway’s current web site has several “success” stories about EHRs as well as a lot of detail about what is planned for the future so it’s not as if CHI hasn’t been sensitive to the need to communicate the benefits of EHRs. However, the Auditor-General in her 2009 audit recommended:

To ensure Parliament and Canadians properly understand Infoway’s goal, the Corporation should further explain in its public reports what is meant by having an electronic health record available to authorized health care professionals.

While Infoway’s response to the 2009 Auditor-General’s report makes no mention of a public relations campaign, it may be that CHI believes it necessary to undertake such a campaign to extend its commitment to “further explain”.  Though it does make one wonder if the Auditor-General would consider such a campaign (with television advertising) a good “value-for-money” exercise when the recommendation was limited to “public reports”.

Admittedly there are no details as to what this public relations campaign entails or is designed to do but some nagging questions come up.

Who is the target audience? The public, who have been exposed to a steady diet of “eHealth scandals” over the last year? The healthcare community who are expected to embrace EHRs? Provincial governments who are the recipients of the funds and who are moving to implement EHR systems?

What is the purpose of the campaign? Is it really to raise public awareness of the benefits of EHRs? Arguably the benefits should be self-evident because hundreds of millions have already been expended over the last decade. And with major deployment of EHR component systems still years away in some provinces, it can’t be to say that the end of CHI’s mandate is, at last, in sight.

All in all, as a taxpayer, I’m left with “why?”

Or, to paraphrase Dave, “we’re spending dollars to make people feel better about an EHR they’ve already bought?”

9 Responses to “Musings on Canada Health Infoway, PR and “Dave””

  1. Here, here!

    The taxpayers have already spent more than enough money on EHRs.

    CHI should just quietly get on with the job. That money is health care money, not IT money. CHI should figure out how much money they plan to spend on their self-promotion and compare it to how much treatment for autistic kids it would otherwise purchase. Against that comparator, is it worth it?

    Mark Johnson

  2. Having followed the opinion polls on EHR over the years, Im certain that the public is convinced of the value of EHRs in theory. What I think is missing is any kind of public understanding of what will happen in the big black box of secondary use.
    I don’t think a PR campaign of any kind is going to sort that one out or put anyone’s mind at ease.
    In short, not what I want my tax dollars being used for.

  3. Hello Michael,

    An interesting question.

    The largest (non-cynical) part of me suspects that the effort is primarily designed to counter the growing number of breach-related stories that the public sees in the media every day, before our (ie. – the tax-payers) collective awareness shifts too far in a direction that is unrecoverably contrary to CHI’s mission.

    Or on a more concrete level, to provide some/any level of visible response to groups like BC’s Big Opt-out. But then we tread the fine line between reasoned debate and a high-tech, healthcare version of Monty Python’s “argument clinic” sketch 🙂

    EHR’s are bad. No they aren’t! Yes they are! That wasn’t $43 million just now…


  4. I guess I am just one of those that do not want or need a system like this. My medical stuff is private for me and my doc. I do not want my stuff in `SECURE` places that eventually will end up in USA – everything else does, per our government looking after us.

  5. Check out my response at

    Michael Martineau

  6. Good peice Michael and I agree, it is a completw waste of their funding, given that money should be going to funding the mandate of additional EMR adoption, not promoting their own success!

    If they want to spend, spend some money on shoring up thier certification processes to include proper security and privacy objectives. For that matter, find a solution to the current certification processes that are in conflict of interest, given they are the funder and certification body!

  7. […] the merits of an Infoway sponsored public awareness campaign.  Check out Michael’s views here and my views here.  What are your views on this campaign?  Is it worthwhile?  What do you think […]

  8. Canada Health Infoway’s “Knowing is Better” PR campaign is an absolute pointless waste of taxpayer dollars. What is the purpose of promoting Electronic Health Records? Canadians do not have a choice whether or not to participate and certainly don’t have a choice as to whether their tax dollars are spent on this initiative. This project is already costing far too much without blowing tens of millions of dollars on a needless PR campaign to talk about it. Where is the cost accountability here? How can the federal and provincial governments possibly stand by and see taxpayer money blown to the wind for this? I hope there is a major public and media backlash to this campaign.

  9. I just saw the commercial! My husband looked at me and said, so what information did that provide? Maybe the issues that Infoway needs to address should be highlighted-we are stuck moving forward with electronic medical record sharing to remote parts of the provinces. We’ve determined that telehealth initiatives can replace health professionals in your community as long as we have your record, high speed internet, computers, and specialists that are paid to do it. We need you to accept this.

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