Implementing a Provincial Cancer Performance Measurement Program in Saskatchewan, Canada 4 th International Cancer Control Congress November 2011 Riaz Alvi & Dr. Jon Tonita Population Health Division

Saskatchewan - Canada 1 of 10 provinces in Canada Population 1 Million – 33% over 50 Publicly funded health care 2 major cities comprise half of population Major producer of wheat, lentils, potash, oil

Saskatchewan Cancer Agency Responsible for provision of: cancer treatment (radiation, chemotherapy), prevention, early detection (breast, cervical, colorectal programs), research, and education services to entire Saskatchewan population One of the oldest cancer registries in the world (1932) Currently implementing an electronic health record across the Agency

Saskatchewan Cancer Agency Numerous databases: Internal  Registry, Early Detection databases, electronic clinical chart, paper clinical chart, pharmacy database, financial database, human resources database External  Ministry of Health (government) databases – surgical procedures, hospitalization, pharmaceutical, vital statistics Difficult to make databases “talk to each other” No central point to access integrated data “data rich, information poor”

Need for System Performance Information Monitor our investments better Track outcomes in a systematic manner Performance information for key stakeholders (board, funder (Ministry of Health), CPAC, etc.) Ongoing evaluation of our programs Commissioned “Outcomes Model Report”

Outcomes Model Report Gather information necessary to make an informed decision regarding an outcomes model for the Agency Extensive information gathering and analysis Nearly 60 managers and staff across Agency interviewed Interviewed Board of Directors, Ministry of Health Inventory of existing databases Current state of information management (data quality, availability, organizational capacity, technical expertise) Inventory of performance measurement initiatives in other provinces (lessons learned) Key recommendations made

Outcomes Model Report Key Recommendations Agency establish performance measurement program Extend Epidemiology Department to include performance measurement Establish steering committee to provide direction and oversight for performance measurement program Indicator development process Two levels indicators, public and internal Information management strategy Look for opportunities to add external data

Monitoring progress/next steps Two positions created initially Hire new lead Hire data specialist Process for decision making Begin process of: Data linkage/warehousing Indicator development Start small – insure success Manage expectations Monitor organizational structure

Summary Comprehensive environmental scan Assess databases Assess readiness of organization Dedicate appropriate resources Manage expectations Expect a bumpy road

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