Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 87
indicators measuring ICT access, use and skills, the ICT Development Index,
or IDI as it is known, was developed by the United Nations’ International
Telecommunication Union. In 2010, Canada was ranked in 26th position on
this index, considerably lower than Australia, France, Sweden, the United
Kingdom and the United States. Moreover, it is the only country in this group
to experience a decline in its IDI ranking between 2008 and 2010 (see Table 4.5).
It is also worth noting that there was a larger rural–urban gap in terms of
individual use of the Internet in Canada than in Australia or the United States
(ITU, 2011).
Table 4.5
ICT Development Index (IDI) based on 11 indicators, rank and level, in Canada and
selected countries, 2008 and 2010
IDI level in 2008 IDI rank in 2008 IDI level in 2010 IDI rank in 2010
Australia 6.78 14 7.36 14
Canada 6.42 20 6.69 26
France 6.55 18 7.09 18
Sweden 7.53 2 8.23 2
United Kingdom 7.03 10 7.60 10
United States 6.55 17 7.09 17
Source: ITU (2011).
Canada’s performance in the use of ICT for health delivery is also poor
relative to a number of other developed countries. In a 2009 survey of
high-income countries that included Australia, France, Sweden, the United
Kingdom and the United States, the Commonwealth Fund found that Canadian
family doctors scored the lowest in terms of using EHRs and had the lowest
electronic information functionality based on 14 categories among family
doctors in the 11-country comparison (Schoen, et al., 2009). These results, some
of which are summarized in Table 4.6, are consistent with a different survey of
primary care physicians that included Germany, New Zealand, the Netherlands,
Canada, Australia, the United Kingdom and the United States. In that study,
Canadian physicians were again at the bottom of the league, with only 16%
using some form of EHRs (Jha et al., 2008). However, based on the 2010 results
of a national physician survey showing that 34% of Canadian physicians use
a combination of paper and electronic records (and 16% use only electronic
records), it appears that this take-up rate is improving (CIHI, 2011f).