Digital Health Canada

In Canada, most health information systems are unable to capture gender, sex and sexual orientation data beyond a single sex or gender field. Consultations with the provinces and territories, as well as with major Hospital Information System (HIS) and Electronic Medical Record (EMR) vendors, revealed that there are no commonly agreed upon data standards for gender, sex and sexual orientation concepts. Data collection is therefore fragmented and incomplete and gender diverse individuals are largely invisible within the health care system, which subsequently impacts the quality of care that they receive, as well as their accurate representation within health system analytics. To address these challenges, the Canadian Institute for Health Information (CIHI) is establishing the first pan-Canadian gender, sex and sexual orientation (GSSO) data standards that are fit for purpose across all health information needs, including clinical care, care organization operations, health system planning and population and public health. These standards are based on British Columbia’s Gender, Sex and Sexual Orientation Health Information Standard and align with those produced by Canadian and international partners, including Statistics Canada and Health Level 7 International (HL7). The implementation of these standards will be a transformative step towards building a more patient-centered, inclusive, and interoperable health care system for Canadians. Presented by: Shannon O’Connor is a Program Lead in Data Standards at the Canadian Institute for Health Information. She has over a decade of experience in digital health, health data analytics and data standards development, including in the areas of mental health, opioid-related harms and gender, sex and sexual orientation. Shannon is passionate about using data standards to help advance interoperability and developing standards that contribute to a safe, equitable and inclusive health care system. She is a member of the HL7 Canada Council and a co-chair of Canada Health Infoway’s Sex and Gender Working Group. Dan Simic is the Manager of the Health Information Standards unit with the Conformance, Integration & Standards team at the BC Ministry of Health. Dan's current focus is around standards development, governance, and implementation and he gained experience in health care during his eighteen years at the ministry working in PharmaCare, and the Medical Services Plan, and recently in standards development at the clinical and administrative level. The GSSO standard represents an important step forward to how the health sector collects and uses gender and sex data, both to provide healthcare services and create policies for a more inclusive reflection of the diversity of people who live in British Columbia.

The COVID-19 pandemic prompted a rapid shift towards digital health solutions to address healthcare challenges, offering virtual access to a range of services including contact tracing, public health updates, virtual care, mental health support, and vaccine booking. While digital technologies helped mitigate virus spread, their unintended impact on health equity, particularly for marginalized racialized low-income communities, emerged as a parallel concern. This research investigates the influence of digital health adoption on pre-existing inequities among racialized Ontarians, utilizing a qualitative literature review. The study examines healthcare structures, socio-economic factors, and assesses the 2019 Digital First for Health Strategy's impact on health equity. COVID-19 policies and digital tools are analyzed for their effect on racialized populations, revealing existing gaps. Despite public funding, Ontario's healthcare system remains unequal, disproportionately affecting racialized communities during the pandemic due to discriminatory policies and inaccessible digital solutions. Pre-pandemic analysis confirms long-standing health inequities, with socio-economic factors driving 50% of health outcomes. Low income's domino effect worsens health outcomes for vulnerable individuals, including hindrances to accessing virtual care. Addressing this, the study advocates for evidence-based policies, among other recommendations that are rooted in equity. Presented by: Ishaw Sharma is an Indo-Canadian healthcare professional residing in Toronto with over a decade of experience in clinical research, public health, and digital health. With a background encompassing a BSc in Life Sciences and an MBA, her commitment extends to shaping an inclusive digital healthcare system in Ontario and beyond. Ishaw also dedicates herself to advancing her academic research on current digital health and its implications on pre-existing health disparities in Ontario for racialized population. She actively advocates for equitable policies through public forums and documentary photography.