Roy Romanow, 'Building on Values'

          The Royal Commission on the Future of Health Care in Canada , also known as the Romanow Report, is a committee study led by Roy Romanow on the future of health care in Canada. It was delivered in December 2002.
          Mr. Romanow recommended sweeping changes to ensure the long-term sustainability of Canada's health care system. The proposed changes were outlined in the Commission's Final Report, Building on Values: The Future of Health Care in Canada.

  • Canadians want and need a more comprehensive health care system.

         The Canadian health care “system” must transform from one in which a multitude of participants working in silos, focus primarily in managing illness, to one in which they work collaboratively to deliver seamless, integrated array of services to Canadians, from prevention and promotion to primary care, to hospital, community, mental health, home and end-of-life care.

         There is a need for a clear and decisive action to modernize the system and make it more durable and responsive.

  • Canadians want and need a more accountable health care system.

         Information is a key ingredient. Better information will facilitate evidence-based decision making. There is a need for a better information sharing system so that all governments and all providers can be held accountable to Canadians.

         Currently, much of the clinical and administrative information in the health system is contained in files of paper records. In most cases, health care providers and their organizations decide what information is relevant for their purposes and what form the information should take. As a result, the current health record system can be described as an assortment of non-standardized patient information stored in isolated patient records.

         Currently, problems in the health care system related to patient safety are not well monitored or identified for a host of reasons including the lack of information technology to monitor and track errors and also the fear of blame and litigation.

         While a number of electronic health record initiatives are underway across the country, progress on the major provincial initiatives has been slow and costs have been high. Greater collaboration among governments could both speed up development and save costs for all Canadians.

  •  A personal electronic health record for each Canadian that builds upon the work currently underway in previous and territories.
  • Canada Health Infoway should initiate to take the lead on this initiative and be responsible for developing a pan-Canadian electronic health record framework built upon provincial systems, including ensuring the interoperability of current electronic health information systems and addressing issues such as security standards and harmonizing privacy policies.
  • Good information systems are essential to a high quality health care system. They allow health care providers, managers and policymakers to share information and use the best available evidence to guide their decisions. They can also forge a strong link between quality on the one hand and accountability on the other.
  • Electronic health records are one of the keys to modernizing Canada’s health system and improving access and outcomes for Canadians.
  • With an electronic health record, information from a variety of health care providers is collected and stored on a single record, providing a more complete and more accurate record of an individual’s personal health history.
  • Increased use of information technology in health care can also have important benefits for patients. It can provide them with better access to their own health information as well as to relevant health knowledge, which in turn allows them to play a more active role in maintaining their health and making decisions about their medical care.
  • Health care providers would have access to clinical decision support tools to assist them in making decisions based on the best available evidence. Health care providers would be able to access patient records at the point of a clinical encounter. It would help manage the massive amounts of complex health information and ensure that health care providers have complete and accurate information about patients’ health and health care histories. It also would improve physicians’ ability to access the latest information, select the best course of action, and use evidence to guide their decisions.
  • The electronic health record system would enhance the ability of health care managers and researchers to identify and respond to medical errors or problems that occur in the health care system, and improve patient safety and quality of care.

Romanow, J. R. (2002). Building on Values: The Future of Health Care in Canada. Retrieved October 26, 2010 from