Health Innovation Challenge winners announced!

Today we announced the winners for the third annual Health Innovation Challenge.
When the Challenge launched in September, we asked college and university students to find innovative policies or practices in Canadian health care, tell us why the innovations were working, and how they could be applied to the rest of the country.

Winners in the Health Policy category from Western University and the University of Toronto wrote about the use of automated remote drug dispensing technology to improve medication access in rural communities, and strategies in Ontario for removing financial and employment-related barriers to organ donation.

Winners in the Health Practice category from McMaster University and St. Francis Xavier University addressed strategies to curb emergency department admissions from long term care facilities, and a program to appoint case managers to help ensure patients with osteoporosis are identified and receive appropriate treatment to prevent osteoporotic fractures.

“These students represent the future of health care in Canada. We think it’s extremely important to engage youth in health care renewal and encourage them to learn from innovative practices and policies that are working,” said John G. Abbott, CEO, Health Council of Canada. “This year’s winning entries are outstanding, thoughtful examples of innovations in health care.”

Over 220 students across Canada submitted essays explaining what they think could change the future of health care in Canada. Several professors incorporated the Challenge into their class curricula, and as a result, entries came from a range of programs including nursing, medicine, pharmacy and many others.

Each winner receives $1,000 and the chance to apply for a summer internship at the Health Council of Canada office in Toronto, Ontario. Winners will also be invited to accept their award at a ceremony in June in Toronto.

To read their full entries, head to www.facebook.com/healthinnovation.

Here they are, and again, congratulations!

Health Policy

 

Group Winner:

· University of Western Ontario(London, ON)– Alvin Li, Sonia Thomas, Organ donation strategy: Reimbursement and job-protection policy

Individual Winner:

·         University of Toronto (Toronto, ON) – Galina Gheihman, Ontario’s remote drug dispensing policy as an innovation to improve prescription medication access in remote, rural and Northern communities

Health Practice

Group Winner:

·         McMaster University (Hamilton, ON) – Aaron Lau, Yi Ki Tse, NPSTAT - A novel nurse practitioner acute care model in the community for Canada's current and future aging population

Individual Winner:

·         St. Francis Xavier University (Antigonish, NS) – Elizabeth Gallivan, Bridging the osteoporosis treatment gap

Key Words: Health Innovation, Health Innovation Challenge 

Student video for Health Innovation Challenge submission

Laura Stymiest, from Dalhousie University (Halifax, NS), entered the Health Innovation Challenge in the health policy category with an entry called People Assessing Their Health (PATH) & Community Driven Health Impact Assessment (CDHIA): an innovative public policy initiative. She also submitted a video about the project. Check out the video below, as well as the abstract for her entry.

The video:
"The PATH/CDHIA video was filmed at the Coady International Institute in Antigonish, Nova Scotia. Several people involved in founding and facilitating the project were interviewed along with community members who had participated in the process. The interviewees reflected on their experiences, the impact of the project and how they envision PATH/CDHIA affecting health and healthcare policy in the future. We hope the video captures for the 2011-2012 Health Innovation Challenge the innovative potential of PATH/CDHIA and the amazing work of those who are involved. "
- Laura Stymiest

Entry Abstract:
There has been an increasing recognition that the social determinants of health must be considered as critically important in health policy and, in turn, in structuring healthcare services and programs. Historically, empowered and educated communities and civil society organizations that give “political expression to their needs” have driven major policy action on the social determinants (Irwin & Scali, 2010, 252). This submission explores how People Assessing Their Health (PATH) and Community Driven Health Impact Assessment (CDHIA) as a public policy initiative provides an innovative way to teach, empower and work with communities to change perceptions, practices and outcomes of healthcare. PATH/CDHIA can assist policy makers in developing healthcare policies and programs that are locally relevant, supportive of the social determinants of health, and fully representative of the needs of all community members.

Key Words: Social Determinants of Health, Health Promotion, Innovative Practices

Social Pediatrics in Saskatoon: More than Medicine

It is no secret that, in recent years, health care costs have been spiraling out of control, yet the state of Canadians’ health is not keeping pace. At a time when necessity is prompting more open discussion around health innovation and governments are demanding lower costs, a call can be heard for investment in preventive care. Today, an emerging initiative in Saskatoon—social pediatrics—offers a glimpse of the potential return on that investment.

Social pediatrics is an innovative medical approach that falls outside the boundaries of traditional medicine or social services.  It provides multidimensional, targeted care to children and their families who are likely to develop chronic illness. “These are children who do not get the care they need in busy clinics, the ‘problem’ children who are frequently abandoned by the system,” wrote Canadian pediatrician Dr. Gilles Julien in his flagship book A Different Kind of Care: The Social Pediatrics Approach.

Chronic health problems such as HIV/AIDS, type 2 diabetes, and mental illness are endemic to modern cities, and their etiology for most begins in childhood – practically at birth. Statistics reveal that residents of Saskatoon’s six poorest neighbourhoods are nearly 15 times more likely to commit suicide and nearly 20 times more likely to use illegal drugs than their more affluent counterparts. Further, their infant mortality rates parallel those of developing nations. Yet, the consequences of failing to care for at-risk youth do not lie solely within the realm of health outcomes. These same individuals are also at increased risk for dropping out of school, detention in the juvenile justice system, addictions, and chronic unemployment—social problems that exacerbate a cycle of poverty and disease. To envision and then promote a healthy population rising from these circumstances requires unusual insight and dedication.

In 2007, a partnership between the University of Saskatchewan Department of Pediatrics, the Saskatoon Tribal Council, and the Greater Saskatoon Catholic School Division precipitated a social pediatrics clinic at St. Mary Community School. There are now three such school-based clinics (St. Mary, St. Mark, and W.P. Bate), all focused on improving access to care for inner-city youth and tending to both their medical and psychosocial health needs. A pediatrician is directly available to all families without the need for referral from a family physician. To date, over 1000 children and adolescents have accessed these clinics, and most continue to follow-up. A fourth clinic will open at E.D. Feehan High School later this year.

One of the main goals of the social pediatrics approach, says Dr. Maryam Mehtar, a Saskatoon pediatrician involved with the clinics, is the creation of social capital. “When you or I get sick, we have no limit to the places we can go or the people who can help us. Intergenerational poverty simply doesn’t afford people the necessary resources to cope, and social exclusion compounds the problem.”

By immersing herself in the environment of her patients, Dr. Mehtar takes an essential step toward understanding their needs. She believes that neglect due to poverty creates an environment that adversely affects childhood development and carries considerable weight in establishing chronic disease in future adults. This lies at the heart of improving the standard of medical and social care for Saskatoon children and adolescents.

Now is the time for innovation to shape the future of health care in Canada. The success of our health care system depends less on our challenges than on our response to them. Thanks to an imaginative partnership that established school-based health clinics in Saskatoon, our city can take some credit for the development of an economical and effective medical advancement – the social pediatrics approach. It is an example of what preventive medical care can look like for young people across the country. Those with an eye to the future of primary health care, take note.

Alexander Dyck and Ingrid Wirth are medical students at the University of Saskatchewan who were shortlisted in our Health Innovation Challenge. This op-ed was also featured on the StarPhoenix.

Key Words: Health Innovation Challenge, Primary Health Care

Shortlisted students create video for Health Innovation Challenge submission

Two of our Health Innovation Challenge winning students, Sonia Thomas and Alvin Li of Western University, created a video to go along with their submission. Check out their video and description below, as well as the abstract for their submission.

"For this video we interviewed Dr. Amit Garg, a clinician scientist and director of the Kidney Clinical Research Unit at the London Health Sciences Centre. Dr. Garg discussed the importance of living kidney donation in Canada, some of the barriers faced by living kidney donors, and Ontario's reimbursement program - the 'Program for Reimbursing Living Organ Donors' (PRELOD). We hope that this video highlights how changing reimbursement policy can help promote living kidney donation, which is the preferred treatment option for the growing number of Canadians with end-stage renal disease."

- Alvin Li and Sonia Thomas, Western University (London, ON)

Entry Abstract:

Organ Donation Strategy: Reimbursement and Job-Protection Policy

With a growing number of Canadians on the waiting list for a life-saving organ transplant, the importance of facilitating living organ donation is clear. Donation-related expenses are an economic barrier that may discourage or prevent potential donors from coming forward. This report highlights two Ontario initiatives from its Organ Donation Strategy Project to address this barrier: (1) a policy permitting reimbursement for donation-related expenses, and (2) the introduction of Bill 154 which provides unpaid job-protected leave for employees who choose to become an organ donor. These initiatives focused on changing policy to permit donor reimbursement and protect employment. This will serve to promote living organ donation and allow those from low-income families to consider living donation as a feasible option.

Key Words: Health Innovation Challenge, Access and Wait Times

OP-ED: Turning what we know into action

The below is an op-ed by Dr. Jack Kitts, Chair of the Health Council of Canada and CEO of the Ottawa Hospital. It was published last week in several local papers.

Looking beyond 2014, it’s time to start thinking about the new direction the Canadian health care system could take, and to take advantage of the rare opportunity to be able to decide what kind of health care system we want. The conversations already underway are too important to not include the very people who benefit most from health care: the patient. To transform the health care system, and for the good of Canadians, patients need to be involved in the design, planning, and delivery of their own health care.

In our review of the current health accords, the Health Council of Canada has found that where specific objectives and concrete targets were set, governments and the health system made the most progress. The patient experience is measurable, and in future, should inform the establishment of key system performance objectives. This sends a signal that the time has come for those at all levels of the health care system, including service delivery and policy settings, to recognize patients as partners. And moreso now than ever, Canadians expect to be involved. Too often, decisions are made for patients, rather than with patients. In a recent report, we found that less than half of Canadians feel involved and are actively participating in their health care. We also found that patients who are engaged are happier with their care, and feel better about their health. So why wouldn’t we encourage more patient engagement?

Patient engagement is a continuum of involvement. On one end, the provider merely informs patients of what will happen and how they will be cared for. That’s all too often where we are today, and where we have been in the past. But the role of the patient should not be to passively receive care. The relationship needs to get onto the other end of the spectrum, where there is a two-way exchange of information, patients are empowered, providers are willing to listen to them, and decisions are made as a team. We have evidence that shows engaged patients tend to have better health outcomes, and we believe that the health care system could have better results if patients were actively involved in its design and continuous improvement.

To raise awareness about the potential of patient engagement, and to spark a national dialogue to build support for patient engagement in health system transformation, the Health Council of Canada hosted a symposium in October, 2011. The over 160 people who attended collectively represented the Canadian health care system: patients, federal and provincial government representatives, regional health authorities, local health integration networks, health system administrators, health care providers, and researchers. We heard many perspectives. Patients told us what it is like to navigate the often intimidating and confusing Canadian health care system. Health care providers gave us an insider’s view on this same system, and planners and administrators told us how they’re working to make patient-centred care a reality.

We also heard  of many examples where patient engagement is being done well across Canada. For example, the Patients as Partners program is both a policy and a philosophy of the British Columbia Ministry of Health. Their unofficial motto is “nothing about me without me.” For the health care system to change, we must learn from one another, share what others are doing well, and, more importantly, not be afraid to ask them how they did it. The ideas for change are out there. By sharing what we learn from others who are also actively involved in health care, and putting that knowledge into practice, we can start to turn ideas and experience into action, and a better reality.

For the Health Council of Canada, our work didn’t end with the symposium. We recently released Turning what we know into action, our commentary on what we heard throughout the symposium. The proceedings report is also available online at healthcouncilcanada.ca. We will keep what we learned in October fresh in our minds, and embed it into all that we do. Patient engagement at all levels happens when we ask ourselves, “Is this the right thing to do so that patients and their caregivers have a voice?” We hope governments and health care providers take that message to heart. And we also hope that patients take it upon themselves to be more involved in their own care.

Dr. Jack Kitts

Dr. Kitts is the Chair of the Health Council of Canada and is the CEO of the Ottawa Hospital.


Key Words: Patient Engagement, National Symposium, Patients as Partners

“Million-dollar patients” face unacceptable barriers to care

A recent Globe and Mail column highlights the need to pay more attention to “million-dollar patients.” These individuals have complex needs, and frequently use health services and resources – a key example being patients with multiple chronic conditions.

As discussed in our report on sicker Canadians with chronic conditions, these patients are more likely to be hospitalized, have surgery, use the ER, and take prescription medication. In fact, 90% take at least one prescription drug, and 54% take four or more for conditions like diabetes, arthritis, and heart disease.

An important finding in our report is that these patients are experiencing serious barriers to accessing the care they need. Almost one quarter (23%) of patients who were surveyed had skipped a dose of medication or did not fill a prescription due to cost. In addition, they experience barriers to co-ordinated care, with only 51% receiving help from their regular doctor’s office in coordinating their visits with specialists.

These are significant issues that need to be resolved if we hope to help our  “million-dollar patients” maintain better health and use the system less. Eliminating cost barriers that affect these patients will be key to improving their access to the system. Alternatives to face-to-face visits – like telemedicine, email and phone consultations – could help save costs on travel time and resources. To improve coordination of care, electronic medical records can be an important tool, and are long overdue on an expanded scale in Canada.

Doctors, policy-makers and patients need to work together to find solutions to barriers in the system. In this article, Mr. Picard discusses the importance of sharing innovations across the country and highlights a few that are already working. There are innovative practices producing benefits in all provinces and territories, and we can accelerate change by sharing knowledge and experiences that have worked. Through our work, we strive to inform decision-makers throughout the health system about innovative practices, in order that they may learn from one another and ensure the system’s most frequent – and vulnerable – patients do not slip between the cracks.

Key Words: Innovative Practices, Health Promotion, Million-Dollar Patients, Chronic Disease