The Institute for Clinical Evaluative Sciences: 20 years and counting.

The Beginning In the early 1990s, as the quality and efficiency of healthcare in Ontario were coming under increased scrutiny, provincial officials saw the value of a new type of research institute that would provide evidence-based insights on system performance. But before the government could give its full support to the Institute for Clinical Evaluative Sciences (ICES), there were two hurdles to overcome: First, ICES scientists needed to explain precisely what kind of data they were seeking, and why. Second, the new organization had to formulate a set of privacy protective ground rules – at a time when jurisdictions around the globe were taking the first steps toward creating regulatory frameworks to safeguard personal data. The proposal from the original ICES team – led by Dr. David Naylor and his colleague (and successor) Dr. Jack Williams – was that the Ontario Ministry of Health could gain these kinds of population-based findings from the administrative data routinely collected in providing health services to Ontarians. Strengthening their case was the fact that the Ontario Health Insurance Plan (OHIP) had recently begun issuing individual cards to every eligible resident, replacing the earlier family cards. This would vastly enhance researchers’ ability to study specific types of patients – pinpointing, for instance, users of cholesterol medications or children in a particular age range for a pediatric study. After considering the implications of redirecting personal health information for a secondary purpose, government officials agreed that the benefits to Ontarians far outweighed the potential risks – a tremendous achievement for Dr. Naylor, and a great show of faith by the ministry, which was understandably concerned about disclosing data outside its walls. In April 1992, ICES opened its doors in A-Wing on the campus of Sunnybrook Hospital in North Toronto. Dr. Naylor was the institute’s first CEO. Dr. John Evans chaired a fourmember board of directors. The following year, ICES moved into the newly renovated G-Wing—where it remains today.