Federal government withholds entire annual budget of digital health agency following collapse of $300-million PrescribeIT program
Health Minister Marjorie Michel has put $50-million in federal funding for Canada Health Infoway on hold, citing unresolved governance concerns at the organization responsible for the failed PrescribeIT electronic prescribing program, which consumed nearly $300-million in public money before being shut down across most of the country last month.
The funding freeze represents the organization’s entire federal budget for the current fiscal year, which began April 1. Michel’s office confirmed Tuesday that the minister has not yet signed the contribution agreements required to release the funds.
A Program That Reached Almost No One
Canada Health Infoway is a federally funded non-profit that administers digital health initiatives on behalf of the federal government. It launched PrescribeIT in 2017 as part of so-called “axe the fax” efforts to replace outdated fax-based prescription systems with digital alternatives.
Despite nearly eight years of operation and close to $300-million in federal investment, the program was wound down in most provinces last month after fewer than five per cent of prescriptions were processed through it.
The organization’s board dismissed its long-serving chief executive officer in late April following a damaging committee appearance and a series of media reports highlighting the program’s poor performance and high expenses — including the departing CEO’s annual compensation of nearly $900,000.
Governance Under Scrutiny
During Monday’s Question Period, Michel acknowledged “governance issues” at the organization and said corrective steps were underway.
“The CEO has left, and we have an acting director right now,” Michel said. “The people involved are currently reviewing the mandates together to see how we can do a better job of solving the governance issues.”
She said the board would report back to her by the end of the summer. Canada Health Infoway announced last week that executive vice-president Abhinav (Abhi) Kalra had been named interim CEO and president.
Parliament Threatens Contempt Finding
Separately, the chair of the House of Commons health committee issued a formal warning to Canada Health Infoway on Tuesday, urging it to comply with an April request for documents or risk being found in contempt of Parliament.
Liberal MP Sukh Dhaliwal, who chairs the committee, wrote that the organization is weeks overdue in producing contracts and agreements with technology vendors, including Telus Health, as well as details of spending on consultants.
Telus Health, the program’s primary technology vendor, has disclosed it received $98-million of the total $298-million in federal funds spent on PrescribeIT.
“The power to send for persons, papers and records is rooted in the Constitution and is constitutional in nature,” Dhaliwal wrote. “It is not subject to statutory and contractual restrictions and supersedes other privileges, such as commercial and third-party contractual agreements.”
The letter warned that failure to comply “could result in the committee reporting the situation to the House of Commons, which in turn, could lead the House to find Canada Health Infoway in contempt of Parliament.”
Canada Health Infoway told The Globe and Mail last week it was working through a large volume of records and had concerns about the secure transmission of files. The organization did not respond to requests for comment Tuesday.
Political Friction Stalls Committee Work
The health committee’s investigation has been largely paralyzed over the past month due to procedural clashes. Conservative and Bloc Québécois MPs have repeatedly moved to compel Minister Michel to testify before the committee — motions that Liberal MPs have blocked.
Conservative health critic Dan Mazier said the lack of transparency undermined any case for continued public investment in the organization.
“If this organization cannot be transparent about where taxpayers’ money went, Canadians should have no confidence in its ability to oversee another dollar of public funding until the Health Minister answers for the mismanagement,” Mazier said.
Uncertain Future for Digital Health Standards Work
Despite the collapse of PrescribeIT, Canada Health Infoway has been involved in developing national standards for electronic health records and has contributed to the development of Bill S-5, federal legislation introduced earlier this year to improve the sharing of health data between patients and providers — a concept known in the industry as interoperability.
Alexandre Bergeron, spokesperson for Minister Michel, said the organization’s future role has not yet been determined.
“While its work on interoperability has informed the development of S-5, the development of the regulations associated with the bill will be determined once the bill has been adopted,” Bergeron said.
