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This study was formulated by KPMG as a way to assess the transparency of healthcare systems around the world. It is generally accepted that more transparent health systems should promote higher quality care, as it can lead to a greater level of accountability in the system. This needs to be balanced with appropriate privacy and security controls to keep personal health information safe and secure. We identified a number of key metrics across six dimensions to identify how transparent health systems were. All health systems were scored against the same criteria to identify an overall transparency score.

Canada’s overall score of 61 percent put it in the second tier of healthcare systems alongside the UK, Australia and Singapore. The first tier was dominated by Scandinavian countries — Denmark, Finland and Sweden.Canada scored highest on our assessment in the dimensions of ‘Governance’ and ‘Communication of Healthcare Data’. In relation to ‘Governance’, key factors contributing to the high score included the freedom of information legislation in each province, the availability of procurement activity to the public, and engagement with communities and stakeholders to oversee care and set strategic directions.

For the ‘Communication of Healthcare Data’ we found a vast amount of data relating to quality of care publicly available through the Canadian Institute for Health Information (CIHI) which demonstrated quality of care by individual provider, regionally and by province. Scores relating to ‘Patient Experience’, ‘Finance’ and ‘Personal Healthcare Data’ were the lowest for Canada. Patient experience measures are not routinely collected across regions, provinces or nationally to allow for comparison, although plans are in place for CIHI to collect more data to be able to report in this area.

The score for ‘Finance’ was lower due to the limited reporting around costs of healthcare available to the public. Personal healthcare data scored lower due to the fact that health systems in Canada have grappled with providing the public with access to their patient records. Efforts continue in this area and some progress is being made.

More generally we found that healthcare organizations generally do not publish as much information on their websites as counterparts in other countries. There could be opportunities for these organizations to provide more information around quality of care shortcomings in order to demonstrate the impact this has had on the organization and more importantly to demonstrate the actions taken to improve care. There could also be opportunities for healthcare organizations to consider how they are assured over the quality of the data being used in day-to-day decision-making and externally reported. Other countries have taken great strides in improving the quality of data. 

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