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Thursday, October 20, 2011

Congratulations to B.C. on landmark agreement improving on health services for First Nations

We want to commend the B.C. First Nations Health Society, B.C. First Nations Health Council, and the federal and provincial ministries of health on the landmark agreement transferring responsibility for First Nations health care in British Columbia to a new agency.
The agreement indicates the new agency will be responsible for on-reserve programs like primary care, mental health, maternal and child health services and addiction services. The agency will work with established health authorities in B.C. to ensure First Nations’ cultural knowledge and practices are incorporated into their care.

We’re happy to see that the agreement echoes some findings and recommendations from our recent report on Aboriginal health. The report talked about how funding policies for Aboriginal health lack focus on prevention and community health, and that Western medicine tends to look at health issues in isolation rather than as a balance of physical, spiritual and emotional health. As a result, it is important for Aboriginal communities, who know what they need and what programs are working, to be able to take responsibility for their own health.

Check out this video from the signing of the agreement in Squamish territory, West Vancouver, B.C.:

Congratulations again to all parties involved, we look forward to seeing the results of this agreement.

Tuesday, October 11, 2011

Patient Engagement in Primary Care: What Are the Next Steps?

Kathryn Nicholson is completing her Masters of Science in Epidemiology and Biostatistics at the University of Western Ontario, in particular, looking at primary care encounters among fatigue patients. Next, she plans to complete a PhD focusing on patient-centered care, electronic medical records, and how these factors will combine to influence the long-term sustainability of the Canadian health care system. After that, she hopes to combine this research with medical practice. Kathryn won first place in the Council’s Health Innovation Awards in the individual category in 2010 and last year was a student ambassador for the awards.

Achieving a patient-centred health care system is a dynamic interplay of expectations, enablers, and desirable outcomes, many of which have been identified in the Health Council’s recent report, “How Engaged are Canadians in their Primary Care?" The changes or components required for patient-centred health care delivery (from both the patient and provider perspective, as listed within the Health Council report) seem to be fairly reasonable, especially given the dividends these actions promise.  Successfully integrating a patient-centred approach into our current system will not only be beneficial for the professionals and the consumers of health care, but ultimately its long-term sustainability.  However, as a current consumer of health care and as a hopeful future family physician, ensuring that patient engagement becomes entirely enshrined in the culture of primary care practice does not seem to be straightforward. 

The doctrine of a patient-centred family physician must be complete and encompassing of all practitioners to fully shift from administering health care “to” a submissive, agreeable patient, to delivering this care with the active partnership of an engaged consumer.  Shared decision-making has been shown to be an essential component of what patients view as effective “patient-centred care,” but this process is a significantly delicate balance between the clinical expertise of the family physician and the personal views and desires of the individual patient.  Moreover, each patient must be “practiced” or literate in being engaged at each visit, and ensuring that each primary care visit is productive in meeting their needs, is tailored to their current goals, and results in a meaningful next step to improving or caring for their health.  Undoubtedly, this culture change must occur at both the physician level and patient level, in order to achieve the most sustained effects and the most positive outcomes. 

Young future family physicians are trying to establish how we can translate what we have learned from the research into innovative action.  I, for one, would be inspired by the “rolling out” of best practices currently being undertaken and applying the most appropriate approaches to each primary care practice throughout the country.  However, until this action is possible or plausible, perhaps the most practical and effective approach is to be found in some of the actions listed by the report, such as simply giving patients the opportunity to ask questions or helping coordinate patients’ care with specialist services.  There seems to be some question as to what the next steps will be in “rolling out” patient-centredness in a unified way throughout Canadian primary care centres, but whether it is that many small steps are required or one gigantic leap, a whole-hearted culture shift toward successful patient engagement is what excites me about the future of primary care practice in Canada.

Key Words: Health Innovation Challenge, Patient Engagement, Primary Care

Friday, October 7, 2011

The Canadian Academy of Health Sciences discusses the direction of health system reform in Canada

We were at the Canadian Academy of Health Sciences annual forum in Ottawa on September 15, called “Smarter Caring for a Healthier Canada: Embracing System Innovation.”  The keynote address was delivered by Brian Golden (Rotman School of Management), who presented his thoughts on the direction of health system reform in Canada. This was followed by four panel sessions covering the topics of Equity, Efficiency, Sustainability and Community. 

The Equity panel discussed how current inequities in health, health care access and outcomes can be overcome with system reforms.
Presenters: Nancy Edwards (University of Ottawa), Margo Greenwood (National Collaborating Centre for Aboriginal Health), Louise Nasmith (University of British Columbia)

The Efficiency panel presented their thoughts on how the health care system can become more efficient through strategic planning and the use of health information technologies, and how personal privacy can be protected in light of these new information technologies. 
Presenters: Dr. Jack Kitts (CEO, Ottawa Hospital and Chair if the Health Council of Canada), Patricia Kosseim (Office of the Privacy Commissioner of Canada), Bartha Knoppers (McGill University), Robyn Tamblyn (McGill University)

The Sustainability panel conveyed the collective message that sustainability goes beyond financial dimensions and that smarter policies are needed to contain costs.
Presenters: Don Drummond (formerly Chief Economist, TD Financial Group), Jeremiah Hurley (McMaster University), Kevin McNamara (Deputy Minister of Health and Wellness, Nova Scotia), Pierre-Gerlier Forest (formerly Chief Scientist, Health Canada)

Finally, the Community panel presented their thoughts on the day’s discussion and highlighted aspects of health system reform that may have been missed by the other panels. 
Presenters: Cindy Blackstock (First Nations Child and Family Caring Society of Canada), Sharon Soholzberg-Gray (former president of the Canadian Healthcare Association), Anne Snowdon (Ivey Centre for Health Innovation) and Andre Picard (Globe and Mail)

Dr. Jeff Turnbull (Past President, Canadian Medical Association) presented his thoughts on a new health system that gives universal access to quality and patient-centred care that is adequately resourced and delivered to all Canadians. He wrapped up by calling for meaningful accountability and a national framework for reporting on health system performance. 

Slides of the presentations are available on the CAHS website:

Susan Brien, Policy Lead, Health Council of Canada

Key Words: Sustainability, Health Innovation

Thursday, October 6, 2011

Photos from our celebratory event in Eskasoni, NS

On September 7, 2011, the Health Council of Canada held a celebratory event in Eskasoni to show how one program, the Unama’ki Maternal Child Health Program, is making a real difference in the lives of Aboriginal mothers and children, and to release our video on the program called Culture is Good Medicine ( Here are some photos from the event: