Provincial Health Indicators Work Group (PHIWG)
Meeting of January 25, 2001

Record of Decisions
Ministry of Health and Long-Term Care
5700 Yonge Street, Room M4, Toronto, Ontario

Mary-Anne Pietrusiak, Durham Region Health Department
Eng-Soon Chan, Ministry of Health
Carla Troy, Centre for Surveillance Coordination, Health Canada
Elizabeth Rael, Public Health Branch, MOHLTC
Anne Marie Parkinson, Durham Region Health Unit
Ruth Diaz, Public Health Branch, MOHLTC
Andrea Smith, Peel Health Department
Hyewon Lee-Han, Peel Health Department
Brenda Guarda, Simcoe County District Health Unit
Sherri Ennis, Central East Health Information Partnership
Carol Paul, Health Planning Branch, MOHLTC
Jessie Wong, Health Planning Branch, MOHLTC
Doug Manuel, Institute for Clinical Evaluative Sciences
Chee Wong, Public Health Branch, MOHLTC
Evelyn Crosse, Perth District Health Unit
Brenda Coleman, Elgin-St. Thomas Health Unit

Indra Pulcins, CIHI
Jason Gilmore, Statistics Canada

Patrick Seliske, Wellington-Dufferin Guelph Health Unit
Nam Bains, Health Information Partnership, Eastern Ontario Region
Vic Sahai, Northern Health Information Partnership

1. Introduction:
Members were welcomed to the Provincial Health Indicators Work Group.

2. Review history and current status of Indicators Project: Mary-Anne provided a brief history (Round 1) of the Indicators initiative and the formation of the work group. Round 2 will review all current indicators and incorporate additional indicators to reflect new data sources.
The work groups terms of reference were reviewed. It was suggested that the purpose be revisited and more clearly defined; under Reporting, expand to include Astatus reports in applicable organizations represented@.


ACTION: Mary-Anne Pietrusiak to revise

Health unit membership representation was reviewed. Representatives from City of Toronto, the North, East and Central South are not represented. In the Northern region, travel costs are a barrier. Mary-Anne will approach heath units where representatives are needed. Elizabeth Rael indicated that the Ministry of Health may be able to help with these costs.


ACTION: Mary-Anne Pietrusiak to approach appropriate health units & advise E. Rael re: support needed for northern units.

3. Statistics Canada and CIHI Indicators Project
Presentations were made by Jason Gilmore from Statistics Canada and Indira Pulcins from the Canadian Institute for Health Information (CIHI). Jason will identify who in each of the health units was sent the Health Regions EA Boundaries 2000 - CD-ROM product.


  ACTION: Jason Gilmore will provide the distribution list upon request

4. PHIWG=s Mandate: Revision, Addition, Coordination, Promotion:

4.1 Role of the Ministry: Elizabeth Rael expressed Ministry support of the indicator project. She requested that meeting cost estimates be sent to her prior to each meeting to assess for MOH support (re: travel and refreshments). She reviewed the ACommunity Health Centres (CHC) Indicators Project@ (handout provided). Feedback and input from the PHIWG into the CHC project is welcomed to help ensure overlap and relevance and build communication. Elizabeth reported the release of the Canadian Perinatal Surveillance System 2000, Health Canada Report. A Steering committee has been formed to address issues with the Office of the Registrar General. The concerns related to the quality of Vital Statistics birth data were expressed. Concerns expressed on access to Office of Registry General data. Elizabeth stressed need to prioritize list of priorities and concerns.
Issues identified by the PHIWG will be taken forward by Elizabeth. 

  ACTION: Mary-Anne to provide Elizabeth with meeting cost estimates.

ACTION: PHIWG to provide concerns/feedback to Elizabeth re: issues related to data provided by the Office of the Registrar General. 

ACTION: APHEO to establish subgroup to provide feedback to Statistics Canada and MOHLTC.

ACTION: PHIWG Mortality working group to provide feedback to APHEO subgroup.

ACTION: APHEO to provide list of Office of Registry General data priorities to Elizabeth.

4.1.1 Revised Mandatory program: Elizabeth requested working group to review and identify, define indicators that are not measurable.

  ACTION: Specific committee working groups review new draft Mandatory programs.

4.1.2 Mandatory Program Indicator Questionnaire: Elizabeth reported that a Technical Review Process is underway. Concerns and challenges include: accountability; what is measurable? what is reasonable? 

4.2 Rapid Risk Factor Surveillance System (RRFSS): Presentation made by Brenda Guarda. The first RRFSS was conducted in 1999 in Durham Region with a focus primarily to collect lifestyle data. There is growing health unit interest and participation. A data dictionary is being developed to help identify how questions will be analyzed. Input is needed on issues related to data analysis.

4.3 Canadian Community Health Survey (CCHS): Presentation made by Carol Paul on the current status, upcoming surveys (handout), role of Ministry to obtain health unit data and means to obtain data raw (Statistics Canada website).

4.4 Revisions to the draft 1999 indicators: Mary-Anne reported that limited feedback was obtained from Round 1. Sherri Ennis to review website for feedback obtained. Subgroups to review the draft indicators to be established. 

5. Coordination with other projects:

5.1 Statistics Canada/CIHI: Jason Gilmore will be the Working Groups Statistics Canada contact to address questions related to health surveys and census data. Jason reported that data are available on the Stats Canada website. Indira Pulcins identified herself as the CIHI contact for health care utilization data.

5.2 Others: Manitoba Health: Mary-Anne reported that Manitoba Health is also developing health indicators. She will contact Manitoba Health for a status update and circulate appropriate material if appropriate.

  ACTION: Mary-Anne will contact Manitoba Health.

Sherri Ennis reported that the Ontario Hospital Association is developing clinical health indicators. Also, the District Health Councils are also interested in developing health indicators. The importance of coordinating and liaising with the DHCs was stressed.

  ACTION: Mary-Anne to lead to ensure coordination

6. Promotion of indicators project: Members discussed ways to promote the project. Target audiences identified included: health unit program staff, DHCs, HIUs, Health Canada, Statistics Canada, CIHI.

Short articles to familiarize readers with the project and use of the indicators and regular updates was recommended. As well, the value of conducting workshops on use of the indicators was discussed. Conducting workshops at the Branch educational days was suggested as a means to reach the public health unit audience. 

  ACTION: Mary-Anne to provide a short update to Elizabeth for PHERO.

ACTION: Elizabeth to explore possibility of PHIWG workshop at Ministry Education Days.

7. Work Assignments:

Mary-Anne will oversee and direct the project. Individuals were identified to review and provide recommendations for revisions to the 1999 November draft indicators as follows. Working sub-group to provide Mary-Anne with a realistic time frame to review and identify changes by February 28, 2001. 

  ACTION: Sub-groups to provide time line feedback by February 28th. 

ACTION: Sub-groups: ongoing work to review and identify recommended changes


Working group members are as follows: 
1. Introduction: Mary-Anne Pietrusiak
2. Population: Sherri Ennis, Brenda Guarda, Carol Paul
3. Environment and Health

  3A. Social Environment and Health: Sherri Ennis, Brenda Guarda, Carol Paul
3B. Physical Environment and Health: Vic Sahai with input from the Health promotion and Environmental Protection Office, Toronto Public Health
4. Leading Causes of Mortality and Hospitalization
  4A. Mortality: Sherri Ennis
4B. Hospitalization: Sherri Ennis
5. Health-Related Quality of Life: Doug Manuel, Brian Laundry, Richard Alverez
6. Chronic Disease and Injuries
  6A. Chronic Diseases: Jane Hohenadel 
6B. Cancer Incidence and Early Detection of Cancer: TBA
6C. Injury Prevention and Substance Abuse Prevention: TBA
7. Behaviour and Health
  7A. Smoking: Brenda Guarda, Carol Paul, Jessie Wong, Susan Bondy, Anne Marie Parkinson
7B. Alcohol: Brenda Guarda, Carol Paul, Jessie Wong, Susan Bondy, Anne Marie Parkinson
7C. Physical Activity: Brenda Guarda, Carol Paul, Jessie Wong, Susan Bondy, Anne Marie Parkinson
7D. Nutrition: Brenda Guarda, Carol Paul, Jessie Wong, Susan Bondy, Anne Marie Parkinson
8. Family Health: Brenda Coleman, Evelyn Crosse, Ruth Sanderson, Ruth Diaz
  8A. Sexual Health: Evelyn Crosse
8B. Reproductive Health: Brenda Coleman
8C. Child and Adolescent Health: Ruth Sanderson
8D. Seniors Health: Ruth Diaz
9. Mental Health: Jessie Wong
10. Infectious Diseases: Julie Stratton, Carla Troy
11. Use of Health Services and Medications: Nam Bains
  Direct and Indirect Standardization
Standard population
PYLL Calculation
Age-Standardizing the OHS
Calculating a moving average