Questioning the Minister of Health in Estimates on progress on digital health, home care and on health prevention.

 On Wednesday May 25th, I asked questions of the Minister of Health in Estimates on health information and medical records systems across the province, on the Shared Health strategic plan and on the Minister's actions with respect to preventing sickness.  My questions and the Minister's responses are below.  

Hon. Jon Gerrard (River Heights): Okay, yes. My question to the minister is this: What is the situation with regard to electronic medical records across the province? I know there was a wide variety of systems that, when Southern Health was formed, there were two different systems being used.

      What is the situation and what is the minister's plan?

Ms. Gordon: I thank the hon­our­able member for River Heights for the question with regard to elec­tronic medical records across the province with the change in the movement of Digital Health from eHealth under the Winnipeg Regional Health Authority to Shared Health. We–this has allowed us to plan prov­incially. So we use the term, planning prov­incially, delivering locally.

      Of course, individual physicians will–may decide to use other records. One of the examples I use quite often is that, right now, the Diag­nos­tic and Surgical Recovery Task Force, in terms of gathering infor­ma­tion on various surgeries, is having to go individually to surgeons' offices because some are using different systems. And so they do have ability to make choices about which systems they want to use.

      But, certainly, as a gov­ern­ment, as a Province, we're using the expertise of Shared Health now that we've transferred Digital Health to Shared Health to try to encourage those physicians to work with us in terms of planning prov­incially.

      So some examples of how that has been done is with the Emergency De­part­ment Infor­ma­tion System, and as well the surgical infor­ma­tion system that is being worked on or developed under the Diag­nos­tic and Surgical Recovery Task Force, is being done on a prov­incial scale. So, as well, during the COVID‑19 pandemic, there were op­por­tun­ities to allow for access to emergency medical records prov­incially so that we could plan, we could roll out our vaccine campaign not just regionally but across the province and really monitor the number of vaccines that were going into arms during that time.

      So the plan is–to address, spe­cific­ally, the mem­ber's question–is to continue to support the work of Shared Health and Digital Health, that now comes under Shared Health, to plan prov­incially, ensure that we have con­sistent medical records that can be accessed at various levels of the health system.

      Thank you, Mr. Chairperson.

Mr. Gerrard:  I notice in the Shared Health strategic plan, there is a plan for a home-care hub. Is that up and running, operational? How many people are staffed there and what is the plan for what the home-care hub will do?

Ms. Gordon: Can I ask for clari­fi­ca­tion or for the member to repeat the question, please? I didn't hear–his voice kind of trailed off at the end, so I didn't hear all of that.

      Thank you.

Mr. Gerrard: On page 15 of the Shared Health plan–or strategic plan, there's a reference there to a home-care hub. And I'm asking, what is the–is the hub up and running or not? How many staff are in it or will be in it? And what is the plan for what the home-care hub for the province will do?

Ms. Gordon: I do want to go back to a previous ques­tion that the hon­our­able member for River Heights had asked, and we had run out of time during Committee of Supply, and I do want to respond to it. It was a question about who provides primary pre­ven­tion for diabetes and who provides secondary care for diabetes.

      And I want the member to know that primary pre­ven­tion is done under the Min­is­try of Mental Health and Com­mu­nity Wellness. Secondary pre­ven­tion in diabetes care involves reducing further complications related to diabetes, which means that once someone is diagnosed with diabetes they are at a higher risk of developing renal, ophthalmological, neurological and cardiovascular complications.

      So secondary pre­ven­tion in diabetes care may include, and which might fall under the Min­is­try of Health: early diagnosis; edu­ca­tion on diabetes manage­­­ment and care, including monitoring glucose levels and ongoing support for lifestyle modifications including diet, exercise and weight loss; smoking ces­sation therapy and medi­cations; managing choles­terol, blood pressure and blood sugars; using lifestyle modifications and medi­cations; use of preventive medi­ca­tions to assist in preventing vascular complica­tions; as well as vac­cina­tion, including COVID‑19, in­fluenza and pneumococcal vaccine; as well as regular eye exams; regular foot care; including assessment for neuropathy.

      With regard to home care, we were pleased to include in Budget 2022's budget speech that $7.2 million more is being provided to support two home- and com­mu­nity-care modernization pilot pro­jects, the Priority Home and client-directed funding pilot and sup­port­ive housing pilot, Mr. Chairperson. This is to provide more safe spaces for seniors and to improve home- and com­mu­nity-based care.

      So we continue to work very, very closely with our Home Care program and support the work of the program. Shared Health is launching a number of initiatives to continue to support Home Care because we know that being able to allow Manitobans to return home when they're in an acute-care setting, if they've had surgery or a stay in hospital, is very im­por­tant in terms of their recovery and as well in terms of patient flow.

      So, yes, Home Care is working very closely with Shared Health, and they do have in their strategic plan several initiatives that they will be under­taking with the Home Care program.

      Thank you, Mr. Chairperson.

Mr. Gerrard: There are a number of im­por­tant pre­ven­tion initiatives, including what we talked about earlier: congenital syphilis and tuberculosis, which are infectious diseases and in–environ­mental issues, lead toxicity leading to behavioural and learning problems in kids and radon problems leading to lung cancer.

      Can the minister tell us, what is the respective role of the De­part­ment of Health in these–because, to some extent, it's shared between the De­part­ment of Health and the de­part­ment of mental health and wellness–and what her de­part­ment is doing?

Ms. Gordon: So, Public Health is the subject matter expert, and we seek advice from Public Health. We certainly don't duplicate, we col­lab­o­rate. And so, with regard to the member's question, the two de­part­ments work very, very closely together, but then we work, as well, with Public Health and many other de­part­ments on this very, very im­por­tant work.

      So again, agri­cul­ture–

Mr. Chairperson: The hour being 5 p.m., com­mit­tee rise.

On May 27th, the Minister of Health provided additional details in Estimates: 

Hon. Jon Gerrard (River Heights): To the minister: I have a limited amount of time and a number of questions. I wonder if she could keep her responses short or have them taken under ad­vise­ment so she could provide the answers later.

      First of all, as the minister knows, I've been a strong advocate for getting funding under medicare for the pro­ces­sors for the cochlear implants, and that was included in the budget, and for that I thank the minister.

      Is that funding now available for people who want pro­ces­sors or need a pro­ces­sor upgrade, or is that going to be starting at some later date?

Ms. Gordon: I–with regard to the member's question, more infor­ma­tion will follow after the Thompson by‑election blackout, but I do have a response to a previous question that the member for River Heights asked regarding the home-care hub. And so I'd like to provide that infor­ma­tion now.

      In col­lab­o­ration with the Canadian Home Care Association, a knowledge network hub with repre­sen­tation from each RHA was esta­blished to support the work under way to address the recom­men­dations con­tained in the OAG's report. The hub utilized the Canadian Home Care Association's expertise and the Home Care Knowledge Network to facilitate the imple­men­ta­tion of the recom­men­dations.

      The hub's first goal was to define core home-care services and to what extent they are available in the regions. This deter­min­ation was central in meeting many of the other OAG recom­men­dations. Con­sul­ta­tions were held in each RHA to identify gaps and explore potential solutions in meeting this goal.

      The hub then reviewed policies and standards in order to prioritize those that should be updated first, with a plan that, as policies are revised, performance measurement will be included to improve account­ability and provide for greater forecasting and analysis of future trends and current con­di­tions. The hub evalu­ated present performance measures used within each RHA with respect to service timelines and reliability.

      In the clinical and pre­ven­tative services plan this hub work was identified as a good initiative to start to  enable care planning across the province. Since the approval and release of the CPSP plan, an imple­menta­tion project on home- and com­mu­nity-care modernization has been advanced.

      The project has been working on modernized models and approaches for home care that will expand services to Manitobans. Initiatives will be intro­duced in stages over the coming months and years. The process will include con­sul­ta­tion with stake­holders and patients.

      So I'm pleased to respond to an earlier question from the–posed by the member of River Heights (Mr. Gerrard).

      Thank you, Mr. Chairperson.