Abstract

Information about the interactions between those who provide products and services and their customers is the sine qua non of every successful business. Such information is essential both to operate the business efficiently and to govern it and plan effectively for its future.
Most Canadians would not believe that in 1998, in this technologically and educationally advanced country, we do not yet have in place a well-developed health information system to support the effective operation of our most highly treasured and single most expensive social program. But it is a simple fact that, in one day, a busy customer can visit one or more physicians, a community health centre, a chiropractor, a hospital emergency room, a rehabilitation centre, an immunization clinic in a public health unit, and attend several pharmacies to fill prescriptions. No single provider of service would know anything about the visits elsewhere unless told by the patient. It is also a simple fact that while we have good, comparable data on patients treated in hospital beds, we have very sketchy data on the far greater number who visit hospitals as ambulatory patients and very little or none at all on those who receive services elsewhere in the community. Hospital records are not available to the home care organizations or physicians or nursing homes or community health centers that look after the same patients when they leave hospital or vice versa.