Filming video primer on clinical practice guidelines

For the past few weeks, we have been filming experts in clinical practice guidelines from across the country for our upcoming video series on CPGs. We are producing (with the help of Storymasters, our video experts) 4 videos to explain the Canadian landscape of CPGs, as well as challenges and opportunities for the future. We will be highlighting some key examples of CPG development, dissemination and implementation, and getting the experts’ take on what is working, and what needs more attention.

Here are some photos from the interview shoots taking place in our office this week – stay tuned for the video release late in November!

Our boardroom, transformed

Storymasters shoots our "researchers" hard at work

Randy from Storymasters directs our "researchers"

Preparing for the interviews

Interviews with the experts

The 2012 Media Awards for Health Reporting

Last week, we attended the Canadian Medical Association’s 2012 Media Awards for Health Reporting in Ottawa. The awards honour quality health-related journalism that “enhances understanding of health, the health care system, and the role of health professionals.”

This year’s winners wrote about and reported on a broad spectrum of health issues – from end-of-life care, to asbestos health risks and government cover-ups, to dental care in the north.

We’re big fans of the Maclean’s blog from Julia Belluz, Science-ish, which won in the Digital Reporting category for reporting on evidence-based health policies. Science-ish puts science and health care issues into plain language and does an excellent job explaining complex health topics. See for yourself!

The CMA also introduced four new categories this year: digital media, emerging health issues and multicultural and international health reporting. Of particular interest to us was the winner in the emerging health issues category – Jennifer Tryon of Global National News for her reporting on the Attaawapiskat housing crisis. The CMA chose determinants of health as this year’s issue, and Jennifer’s series represented the profound affect determinants like poverty and housing can have on the health of individuals and a community.

We’d like to offer our congratulations to all the winners and hope they will continue their important work reporting on the evidence and bringing to light Canada’s health care issues.

Winners: 

The Michelle Lang Award for Excellence in Print Reporting - In-depth feature article sponsored by The College of Family Physicians of Canada Lisa Priest, Globe and Mail - End of life
Special mention: Janet French, The StarPhoenix - The lost children; dental issues plague northern families 

Excellence in Health Reporting - Print (Large market) Sharon Kirkey, Postmedia News - Who will stop the pain? Canada's silent epidemic of suffering

Excellence in Health Reporting - Print (Mid-size market) Louisa Taylor, Ottawa Citizen - Unhealthy welcome: Why Canada is hazardous to their health

Excellence in Health Reporting - Television news Dany Croussette, Michel Rochon, Patrick André Perron, Gilles Turcotte, Ronald jr Roy, Normand Bourget, Radio-Canada - L'état d'urgence
Special mention: Kelly Crowe, Melanie Glanz, David MacIntosh, CBC News - Frozen eggs trade 

Excellence in Health Reporting - Television in-depth reporting Joseph Loiero, Terence McKenna, Gil Shochat, Alex Shprintsen, CBC News, The National - Fatal deception
Special mention: Lucy Van Oldenbarneveld, Jennifer Beard, CBC News - Kathleen Petty interview 

Excellence in Health Reporting - Radio Alison Motluk, Jim Handman, Bob McDonald , CBC Radio, Quirks & Quarks - Cheating the clock
Special mention: Carol Off, Jeff Douglas, Kevin Robertson, David McDougall, CBC Radio, As it Happens - Refugee health changes 

Excellence in Local Health Reporting - Print and broadcast Sonja Koenig, Kate Kyle, Sara Minogue, Joanne Stassen, CBC North - Cancer: A northern journey
Special mention: Heather Rivers, Woodstock Sentinel Review - The sad truth : Prescription drug use 

Excellence in Emerging Health Care Issue - Print and broadcast Jennifer Tryon, Global National News - Attawapiskat housing crisis
Special mention: Jennifer Tryon, Global National News - Refugee health cuts 

Excellence in Multicultural Health Reporting - Print and broadcast Sudha Krishnan, OMNI Television - Diabetes - Fighting a leading killer in the South Asian community

The Norman Bethune Award for Excellence in International Health Reporting - Print and broadcast Tanya Springer, Joan Webber, Pam Bertrand CBC Radio 1, The Current - Of mothers and merchants
Special mention: Dominique Forget, L'actualité - La peste blanche est de retour 

Excellence in Digital Health Reporting Julia Belluz, Macleans.ca - Science-ish on evidence-based health policies

My internship at the Health Council of Canada

Yvonne Tse was a 2011-2012 winner of the Health Innovation Challenge. As part of her prize, she had the chance to intern at the Health Council of Canada. Read her winning entry here. 
Working at the Health Council of Canada was a wonderful learning experience that offered an incredible exposure to current health care issues. Working in a national organization was initially overwhelming. However, the staff were incredibly supportive and approachable and eased my transition into my role as an intern for the past four months. As a result, I was able to participate and provide research support for a number of high quality reports. These projects refined my research skills and expanded my knowledge and perspective about Canada's current health care system.

I have conducted environmental scans for topics like integrated care and clinical practice guidelines, focusing particularly on activities in each jurisdiction across Canada. This was an opportunity to build on the research skills I’ve learned throughout my nursing degree thus far. It is easy to simply collect and summarize information, however, the more interesting and difficult part is learning how to critically analyse the collected information to determine its strength and applicability.

The privilege of sitting in on some of the meetings with the Health Council of Canada Councillors was another unique experience I had this summer. Being able to listen to the conversations and discussion about ongoing projects and hearing their perspectives on various health policy topics was very different and definitely contributed to my understanding of the policy-making processes happening behind the scenes on a national level. The amount of dedication, time and effort spent on discussion of health care issues and projects was very impressive.

Currently, I'm entering into my third year of the Nursing program at McMaster University and I'm hoping to transfer the new knowledge I've obtained at the Health Council of Canada into my clinical placements and other aspects of my nursing career. My experience at the Health Council helped me realize that I still have much to learn and I'm encouraged to seek opportunities in the future to enrich my understanding of the health care system. I hope my experience will encourage other students to apply! 

Yvonne with fellow Health Innovation Challenge winner and intern
Galina Gheihman. Read Galina's blog here. 

The importance of patient engagement

Recently, doctors at three hospitals in the U.S. made their medical notes available to patients. This included test results as well as detailed descriptions of the doctors’ diagnosis and treatment plans.

Why make the notes available? At the end of the year, Dr. Joann Elmore (the study’s author) said patients said it made them feel more competent in taking care of themselves, and that they better understood their medical issues and how to take medication appropriately.

Of the 5,390 patients who responded, 77-87% said they felt more in control of their care, and 60-78% reported increased adherence to medications.

We at the Health Council recognize the importance of engaging patients in their own care. In 2011, we reported that engaged patients perceived themselves to be healthier, and made better use of the health services and resources in the system.

Unfortunately, we found that only 48% of Canadians reported feeling involved and engaged in their own health care. Since engaged patients are more likely to actively participate in disease prevention, screening and health promotion activities – this is worrisome.

We hosted a National Symposium on Patient Engagement last year in Toronto, as well as a town hall on this topic in Vancouver. We are continually confronted with the importance of patient engagement and the need to include patient voices when designing and delivering health services in Canada. Read our full report on patient engagement in Canada here.

My internship at the Health Council of Canada

Galina Gheihman was a 2011-2012 winner of the Health Innovation Challenge. As part of her prize, she had the chance to intern at the Health Council of Canada. Read her winning entry here. 

The Health Innovation Challenge’s summer internship program has been an exceptional, well-rounded experience. Not only was it a unique learning opportunity centred on the Canadian health care system, but it was also a chance for me to test the waters of the working world in a supportive environment. From the very first day, I tackled small parts of several projects, allowing me to explore what I found most interesting. Speaking out was encouraged and new ideas welcomed, making me feel that I made valuable contributions to the work. Best of all were the relationships I formed this summer. The Health Council is home to many enthusiastic, knowledgeable staff eager to teach and to collaborate. 

One of my most memorable experiences from this summer was participating in the June Council meeting. As it was held in Toronto, we were invited to sit in on a live meeting and observe the proceedings. To top the day off, the Health Innovation Challenge Awards Ceremony occurred that same evening. Held in the prestigious Faculty Club at the University of Toronto, the event was a unique opportunity to make a personal acquaintance with some of the Councillors we had observed earlier in the day and to meet the other Challenge winners.

This fall I will be entering my third year at the University of Toronto, studying Neuroscience and Physiology. Although my work with the Health Council may at first seem removed from my current studies, I have no doubt that the insights I've gained this summer about health policy and the Canadian health system will continue to inform my studies and career.

Reflecting upon this whirlwind of a summer, I cannot believe this all started with an essay submission to the Health Innovation Challenge, but am I ever glad I did it! I encourage all students across the country to consider applying this year—not only is it a fantastic way to share what innovative health practices might be working in your community, but it might just be your first step on an incredible journey!

By: Galina Gheihman, Health Innovation Challenge winner, Health Council of Canada intern

Interest in integration – Health Council symposium a success

Murray Ramsden, Councillor,
Health Council of Canada

Integration. Along with sustainability, it’s a common buzzword for discussion and debate in health care circles. But what, exactly, do we mean by integration? And more importantly, how do we do it?

I participated in Wednesday’s symposium on integrated care in my role as vice-chair of the Health Council of Canada. But I also listened to the presentations – both from keynote speakers and front-line providers – with the perspective of someone who has operated a hospital and a health region.

I thought Dr. Dennis Kodner set the stage perfectly at the beginning of the day by providing his insight into the key success factors and potential pitfalls of integration. He made some pointed comments about the need for courage, which is all too true: there are many barriers for people who are trying to implement patient-centred integration, including inertia, professional and organizational “tribalism”, misaligned policies, regulation and financing, and the differences in the roles and clinical philosophies across providers and sectors. (And that’s just to start.)

One of Dr. Kodner’s quotes should be above the desk of every health manager (and health minister): It’s not about fitting people into the model – it’s about finding a model that meets the needs of the people. There were continuing conversations about this throughout the day, including the importance of patient and community input in developing integrated care models that work for them. We shouldn’t assume we know.

Dr. Kodner’s presentation was followed by a panel discussion on promising solutions for achieving integrated care, with presentations on interprofessional teams, increased patient and community engagement, and the role of case managers, a topic which seemed of particular interest to the audience. Dr. Charles Wright, the panel moderator and a fellow councillor, concluded the discussion by reminding us that some common components of successful integrated systems – such as interprofessional teams, expanding the scope of practice, and physician payment reform – require firm political action, which can be a challenge since some of these changes can be “politically distasteful”. I appreciated Dr. Wright’s frank comments. We need to speak more openly about these challenges and how to resolve them. We also need courageous action from politicians as well as providers.

Throughout the day, I particularly enjoyed the many presentations about integration by front-line providers. They told us about innovative programs and strategies that are making improvements in areas such as transitions of care, communication between providers, access to care, and patient engagement. But great front-line efforts in integration need more support from health leaders and governments. We need to be willing to tackle physician compensation and scope of practice issues, speed adoption of electronic health records, and revise policies that are blocking their progress. Jurisdictions that move quickly in these areas will be able to provide better care. Those that don’t will still be stuck in the same place 10 years from now.

Finally, the keynote presentation by The Honourable Fred Horne, Alberta’s Minister of Health, earned him accolades from the audience: “The best presentation I’ve ever heard from a Minister of Health.” Mr. Horne described the three provincial priorities for health –– primary health care, continuing care, and mental health ––adding that reforms are guided by an overarching philosophy: to stop doing things in the hospital that they know they can do in the community. In the question period, several participants asked about Alberta’s decision to eliminate regional health authorities in favour of one large organization, Alberta Health Services. Mr. Horne said the reasons for this included a desire to be able to uniformly implement any policy issue across the province, to standardize, and to achieve better cost savings. There appears to be significant interest in Alberta’s approach and how their reforms will unfold. We were pleased that the Minister was able to join us as this is Alberta’s first year as a member of the Health Council of Canada.

I was inspired by the ideas I heard at the symposium and only wish it had been possible to attend all the presentations. I encourage you to read the descriptions of the innovative practices in the symposium program, view the corresponding presentations, and bookmark the Health Council’s Health Innovation Portal as an ongoing source of ideas. We can avoid duplication and speed each other’s efforts by sharing what’s working.

By Murray Ramsden, Councillor, Health Council of Canada

Still overpaying for generic drugs

A new study this week from the UBC Centre for Health Services and Policy Research shows that by international comparison, Canadians are still overpaying for generic drugs. In fact, an editorial by report writer Michael Law draws an analogy between how inflated our generic drug prices are and paying $60 for a cup of Tim Horton’s coffee.

In 2010, our report Generic Drug Pricing and Access in Canada: What are the Implications? found international prices for generic drugs in 10 other developed countries to be 15-77% lower than average Canadian prices. Unfortunately, it appears little has changed.

The report does point out that most provinces are making progress and focusing on reducing generic drug prices for their residents. In June, the premiers agreed to use collective buying power to drive down prices, and last week they assembled to work out the details. This is a positive step and we look forward to the impact this may have.

It’s vitally important that we continue to work to bring prices down so that Canadians can access the medication(s) they need. In 2011, we reported that 23% of sicker Canadians with chronic conditions skipped a dose of medication due to costs (and 12% of the general population did the same). This is unacceptable and has significant repercussions on the well-being of patients, while further burdening the health system.

You can read the full report here.

For more on generic drugs, read these blog posts:

• Two new reports on generic drugs in Canada
• Canadian Generic Pharmaceutical Association responds to Council's 'Generics' Discussion Paper 
• The Actra Fraternal Society reponds to Council's 'Generics' Discussion Paper