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| March 2006 COMMUNIQUE - 42 First Nations utilizing the First Nation and Inuit Health Information System (FNIHIS) will have funding cut, effective April 1st, 2006. |
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| On February 14th, FNIHB Ontario Region distributed
letters to 42 First Nations indicating the termination of FNIHIS
data entry funding effective April 1st, 2006. Citing budgetary realignments,
and the need to reallocate e-Health funding in order to sustain telehealth
initiatives in remote Northern Ontario communities, all First Nations
lost financial support except the First Nations currently serviced
by the Sioux Lookout First Nations Health Authority, within the Nishnawbe-Aski
Nation. How this cut was determined was a unilateral decision by
FNIHB with no input from COO or any First Nations. The FNIHIS is an information management system which is co-owned, by FNIHB (then Medical Services Branch) and the Chiefs of Ontario (COO) and dates back to 1993 . While comprised of 13 subsystems, First Nations have primarily utilized the Immunization and Reportable Diseases components of FNIHIS. Since its inception FNIHIS has been a non-mandatory program but for First Nations who have chosen to utilize the system, in many instances, they have come to rely greatly upon it. In addition to access, Data Entry resources were also provided to First Nations to assist with client file management. Contribution agreements were established and amounts varied from community to community based on population sizes. In 2002, while development was underway for an updated Version 2 of FNIHIS, FNIHB announced cutbacks to the Data Entry dollars. Through effective lobbying efforts, COO and the FNIHB Ontario Region were able to protect the existing allocations. However, in 2004, a further reduction in CA dollars was experienced and FNIHB made an initial round of cuts. Again, this was an arbitrary decision by FNIHB with no input from COO or First Nation communities. It was explained that funding was rescinded to communities where the FNIHIS system was inactive and/or any given "transaction" (event utilization) was calculated at greater than $50 per client transaction. In the last Budget Announcement, the government indicated that FNIHIS (now housed within the e-Health Solutions Unit) budget would be reduced from $17M to $5M with the FNIHIS application to be phased out by March 2007. These cuts were indicated to the Chiefs in the last AOCC briefing materials. It should be noted that; FNIHB has indicated that First Nations and health agencies will continue to have access to FNIHIS but no associated funding. The Regional Office will resume responsibility for inputting data with First Nations have "Read Only" and "Reports" capabilities. The new Regional Public Health group further indicated that an additional catalyst for the cuts was due to the number of errors in the existing FNIHIS system. Although work had commenced in 1999 for the development of an updated, Version 2 of FNIHIS, collaboration ceased in 2003 when FNIHB Headquarters stated that they were redefining themselves as an e-Health solutions group, no longer FNIHIS, and with greater emphasis to be placed on broader e-Health initiatives and not application development. Public Health and pandemic planning continue to be a cited priority of both the Federal and Provincial governments. But without adequate data collection, management, and analysis at the First Nation level, our members continue to be at a potentially very high risk of pandemic outbreak either infectious and/or environmental. FNIHB must recognize that threat and provide adequate resourcing for our communities to contend with it from both a planning and contingency perspective. The increased use of information technology for enhanced health care service delivery and records management is imminent. As all health care providers, First Nation and non-First Nation, move towards record keeping (i.e. electronic health records), additional resources will be required by First Nations to assist in that transition. Moreover, additional training and support will be necessary so that our health care providers can focus on providing services and not record keeping and data entry. We encourage First Nation representatives to contact FNIHB Ontario Region, in writing, about how these cuts will negatively impact our First Nation membership and health service delivery capability! (e-Health Program Manager, Richard Leikkari @ 613-952-0161 or email: richard_leikkari@hc-sc.gc.ca) In the meantime, staff at the Chiefs of Ontario Office are in the process of coordinating a meeting between our leadership and senior FNIHB officials about how these cuts should be remediated and future information management/knowledge management MUST proceed. For further information, please contact: Lily Menominee-Batise Health Information Coordinator Chiefs of Ontario Office (705) 268-8713 menominee@personainternet.com |
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