Does health system performance reporting stimulate change?

For numerous countries, including Canada, regular health system performance reporting has become increasingly routine if not mandated by legislation. In Canada, the health system performance reporting agenda includes multiple players at all levels from national organizations to provincial health (quality) councils and others. Canada, like many other countries, also participates in international health system performance reporting initiatives. Making sense of what all of these reporting initiatives are telling us about health system performance both within Canada and compared to other countries is becoming increasingly more challenging. For almost 20 years, the Canadian Institute for Health Information has worked with provinces, territories, and other key partners to develop comparable, standardized pan-Canadian performance indicators. Throughout this process, many lessons have been identified including the actionability one can reasonably expect from public reporting initiatives. This article outlines some of the key aspects of these lessons.