Out of province, out of sight

[The authors respond:]

The 3 major outcomes measured by the PEI blood notification program were identification of patients as tested for the hepatitis C virus, dead or "out of province." The most reliable and widely used outcome available in all health information systems is death. However, John Tallon makes a good point that "out of province" is not a desirable health outcome, and certainly not part of the vision of a comprehensive national health information system. The "out of province" outcome is the result of using provincial information systems established for administration, not for health outcomes. PEI requested follow-up from 8 provinces; there was no record of blood recipients moving to Saskatchewan or the territories. Only British Columbia was able to respond (the 2 recipients had died). In most provinces, notification for hepatitis C virus testing is just beginning, with completion expected by 2004.

The imperfect nature of the information systems currently available will require studies to account for people whose status is unknown with descriptors such as "out of province" for the foreseeable future.