Webinar - March 7: How do Canadian primary care physicians rate the health care system?

Register for our upcoming webinar, How do Canadian primary care physicians rate the health care system?

The Health Council recently released the latest bulletin in the Canadian Health Care Matters Series with survey results from the 2012 Commonwealth Fund International Health Policy Survey of primary care doctors.

We found that adoption of electronic medical records has more than doubled nationally since 2006, with over half (57%) of primary care physicians now using computerized patient charts. However, this number varies widely across provinces (from 26% in New Brunswick to 74% in Alberta), and overall we still rank second last among the 10 countries surveyed.

For this webinar, we’re bringing together three expert panelists to talk about care coordination among health care providers and the use of information technology in health care settings;
Dr. Michael Moffatt, Executive Director of Research and Applied Learning for the Winnipeg Regional Health Authority and Health Council of Canada councillor
Dr. Jennifer Zelmer, Senior Vice President, Clinical Adoption and Innovation at Canada Health Infoway
Robert Salois, Quebec Health and Welfare Commissioner

Join us and add your voice to the conversation with your questions.

• Date: Thursday, March 7, 2013
• Time: 12:00PM EST (GMT – 5:00)

Click here to register for the online event.

Welcome our newest Councillor, Dr. Cy Frank

This week we welcomed Dr. Cy Frank as our newest Councillor. Dr. Frank is the first Councillor appointed by the province of Alberta, after the Alberta government announced it would join the Health Council in November 2011, and did so formally in January 2012.

Dr. Frank is currently Professor in the Section of Orthopaedics, Department of Surgery, University of Calgary, Alberta Health Services, Calgary; the McCaig Professor of Joint Injury and Arthritis Research; Executive Director of the provincial Alberta Bone and Joint Health Institute; and VP, Research Strategy, Alberta Health Services. Effective, April 1, 2013 he assumes the role of CEO/President of Alberta Innovates-Health Solutions, where he is currently Senior Scientist. Dr. Frank is also one of 350 members elected to the Canadian Academy of Health Sciences based on achievement in the academic health sciences in Canada.

His first duty as Councillor was to attend a quarterly Council meeting, the latest held this past weekend in Edmonton. Dr. Frank was introduced and his role on Council endorsed by The Honourable Fred Horne, Minister of Alberta Health and Wellness. Presentations followed by Dr. Frank’s Alberta colleagues: Dr. Tom Noseworthy, Associate Chief Medical Officer, Strategic Clinical Networks & Clinical Care Pathways, Alberta Health Services; Dr. Axel Meisen, Chair of Foresight at Alberta Innovates – Technology Futures; and Dr. John Cowell, CEO of the Health Quality Council of Alberta. Our other Councillors and Health Council staff came together to discuss Council business and to meet Alberta health system representatives at a well-attended evening stakeholder event.

The British Columbia Innovation and Change Agenda

By Nick Grant, Executive Director, Planning and Innovation Division, BC Ministry of Health 

In British Columbia, the Ministry of Health works with health authorities, health care providers, agencies and other organizations to guide and deliver health services for British Columbians. The province’s six health authorities are the organizations primarily responsible for health service delivery. Five regional health authorities deliver a full range of health services to meet the needs of the population within their respective geographic regions. A sixth health authority, the Provincial Health Services Authority, is responsible for managing the quality, coordination and accessibility of province-wide health programs.

Working with these system partners and other health care providers, British Columbia has introduced a province-wide strategic agenda to fundamentally change the health care system – the Innovation and Change Agenda. This transformative plan will position the health sector to better meet changing population needs and continue to deliver quality health services to British Columbians in ways that can be sustained into the future. The strategy is based on the Triple Aim Approach: improving population health; enhancing the patient and provider experiences of care; and reducing the costs of health care.

The goals of the Innovation and Change Agenda are to help people stay healthy and live active lives, to provide networks of services in communities that best manage changing health needs and to ensure high quality hospital care for those who need it. These goals are underpinned by a culture of innovation and efficiency in designing and delivering services.

The Innovation and Change Agenda is delivered through a set of medium to long-term strategies. These strategies are organized into four areas:

1. Providing effective health promotion, prevention and self-management to improve the health and wellness of British Columbians. 
2. Meeting the majority of health needs with high quality primary- and community-based health care and support services. 
3. Ensuring high quality hospital care services are available when needed. 
4. Improving innovation, productivity and efficiency in the delivery of health services. 

Under these four headings are several ‘Key Result Areas’ identifying specific areas of focus and desired changes guided by best practices - from tools for healthy living, to standardized guidelines for delivery of care, to improved procurement of medical supplies. It’s a multi-year plan and implementation rests on effective collaboration and alignment of efforts with regional health authorities and health care providers.

Progress has been made across the plan and a number of initiatives have been implemented. Examples include:

• As part of the healthy living focus, an Informed Dining program has been introduced in participating restaurants to provide diners with nutritional information on menus. 
• The ministry, physicians and health authorities have formally organized structures to coordinate care for target priority populations – frail seniors and people with chronic conditions or mental health needs. 
• Clinical care guidelines have been implemented in partnership with health care providers and the BC Patient Safety and Quality Council, to improve quality and consistency in the delivery of key health care services. 
• Lean design has been used by all health authorities to improve efficiency, save resources and improve patient care. 

More information about BC’s health sector transformation, including videos and discussions, can be found at ThinkHealthBC.ca

Health Innovation: A National Imperative

Gabriela Prada, Director, Health Innovation, Policy and Evaluation at The Conference Board of Canada

‘Innovation’ has become a buzz word and a priority for governments and health care systems and organizations. However, innovation is not an easy concept to grasp. Innovation is not about creating a new device or drug, or a new process or idea. Innovation is about putting these new ideas, processes, or products into practice and extracting value from them. Therefore, innovation takes place only when value is created, which can take many years after inventing the products or processes.

Why does innovation matter? At the health and health-care system levels, innovation can improve the quality and efficiency of health services, thus contributing to improved population health (social value). For example, innovation can decrease waiting times, length of hospital stays, morbidity, and mortality. In addition to these obvious social benefits, innovation can also contribute to the affordability of health and health care services (economic value), a major challenge in our health-care systems.

But we believe that the benefits of greater innovation in health go well beyond health and health care systems. Health care systems do not exist on their own, disconnected from the rest of the economy. On the contrary, as one of the biggest recipients of public revenues, health care plays an integral role in national economic performance. The health care sector represented 10.1 per cent of the national GDP in 2011 and supported 2.1 million jobs and while most people are generally aware of the costs of health care, the argument for its economic benefits is rarely made. Innovation in health and health care systems can directly and indirectly improve Canada’s productivity and economy. For example, eliminating long waits to access health care services and/or redesigning health and health care services to lead to optimal health outcomes can avoid work-time productivity losses that cost billions to our economy. Furthermore, Canada has a strong health and life sciences industry sector, which despite tremendous global opportunities, has captured only a small share of this global market. Concerted efforts to increase Canada’s share of this global market could result in significant economic development and job creation.

The Health Innovation, Policy and Evaluation team at The Conference Board of Canada is committed to raise awareness of the main issues and opportunities linked to greater innovation in Canada’s health and health care systems. Through our Centre for the Advancement of Health Innovations and our Council for Innovation Procurement in Health Care we are conducting and facilitating independent, objective, leading-edge policy research and dialogue to foster systemic innovation in health and health care in Canada. We are teaming up with government, academia, health-care leaders, and industry, to examine the various elements of Canada’s health innovation system, to identify best practices, and to articulate sound policy recommendations to improve our health innovation performance. We believe that if Canada embraces health science, technology, and innovation as national imperatives, Canadians will have not only better health and health care systems, but also a brighter future.

We have examined timely and relevant health innovation issues including the value of conducting and engaging in medical research, the opportunities and benefits of engaging citizens in health innovation processes, and the potential of using procurement as a tool to encourage and support innovation. Our current project focuses on measuring innovation readiness of health care organizations. Our 2012 Health Innovation Survey, which was responded by over 80 acute, long-term, and home care organizations across Canada, is quantifying health innovation performance; identifying the factors that contribute to health innovation; and determining benchmarks from which improvements could be assessed over time. Stay tuned for more on this project!

Interested in knowing more about us? Please visit our web site where you’ll find more information about who we are and what we do as well as links to our blogs. You can also follow us on Twitter or through LinkedIn. We would love to hear from you!

Dr. Anne Snowdon on Innovatexchange

Dr. Anne Snowdon, Professor and Chair, International Centre for Health Innovation, Richard Ivey School of Business

In my travels across the country and around the globe as Academic Chair of the Ivey International Centre for Health Innovation, it has become clear that there are many impressive innovations emerging in every health system. However, it is also clear that there is no easy way for health professionals, policy makers or administrators to learn about innovations making an impact across the country, across the ocean or even across the street. This health system myopia is stifling our progress in achieving system transformation.

To overcome this challenge, the students and staff at the Centre reached out to stakeholders across sectors to acquire input into what an effective sharing platform might look like. The result was the creation of Innovatexchange, an interactive, user-generated map of innovations in health care across Canada and from around the world. This tool was designed to give health care stakeholders a snapshot of projects, trends and achievements in health systems innovation from across the country and around the world, and to provide an open forum for discussion.

Once an idea is populated to Innovatexchange, there is room for comments, suggestions, conversation and collaboration. The platform is designed to accommodate ideas that span the innovation life cycle, from ideas, to research, to deployment, to impact. Innovatexchange already houses more than 100 examples of innovations, and the momentum continues to build as health care stakeholders visit the site to contribute new projects and ideas, and learn from others.

Canada’s health care system is vast, and arriving at widespread innovation sharing among stakeholders requires more than one approach. The creation of multiple new tools that advance the sharing and adoption of innovation in Canada’s health system is something to be celebrated, which is why we are pleased to also be supporting the Health Council of Canada’s recently launched Health Innovation Portal. Our two complementary tools take different approaches, but have the same goal – to facilitate the sharing of innovation and improve Canada’s health care system.

To ensure sustainability, we must innovate by re-designing health services to achieve greater quality and efficacy. However, it is also essential that we do more than just innovate; we need to measure the impact of innovation at the health system level, and disseminate our findings broadly. At the International Centre for Health Innovation, it is our hope that through the creation of new knowledge sharing platforms, such as Innovatexchange and the Health Innovation Portal, we will create opportunities to connect with others and to encourage dialogue and potential partnerships between groups.

To submit an innovation or learn more about achievements already on the platform, visit: www.innovatexhchange.ca

Social Media in Health Care

Wayne Leung, Digital Communications Specialist, Health Council of Canada

Recently, I attended the Social Media in Health Care conference organized by the Ontario Hospital Association. This event provided an opportunity for people working in the health care sector to come together and share ideas about ways we can leverage social media to improve health care.

The day started off with an overview by Colleen Young who founded Health Care Social Media Canada (#HCSMCA), a group that holds weekly Twitter chats on a variety of health-related topics using the hashtag #HCSMCA every Wednesday at 1PM EST. The group is a great place to start engaging with others who have an interest in health care and social media.

Throughout the day, organizations presented some of their best examples to illustrate the power of social media in health care.

The Trillium Life Network recently digitized the database of organ donors in Ontario and widely uses social sharing throughout their web properties. As soon as you finish signing up to be an organ donor at beadonor.ca you can send messages to your Twitter and Facebook networks directly from the confirmation page to encourage your friends and followers to sign up as well.

The Canadian Patient Safety Institute recently hosted Med Safety Goes Viral 2012, a medication safety video competition where different organizations submitted short, engaging and often funny videos to raise awareness of issues in medication safety. The videos were uploaded to CPSI’s YouTube channel and the video that received the most views won the contest. The 14 submitted videos generated over 20,000 views by the end of the first week!

Dr. Amir Ginzburg of Trillium Health Partners was on hand to present his winning video entry entitled “BYOB – Bring Your Own Bottle.”

At the Health Council we regularly use Twitter to engage with Canadians including the live-tweeting of our recent National Symposium on Integrated care using the hashtag #HCCsymposium. We also use the Facebook page we created for our Health Innovation Challenge to engage with college and university students; reminding them of deadlines and answering any questions they might have about the challenge. We’re constantly looking for new ways to leverage social media tools to share and engage with others about health care renewal and innovative practices. In the meantime, please keep in touch; like us on Facebook, follow us on Twitter and LinkedIn, and subscribe to our YouTube channel.

Spreading innovation across Canada

Mark Dobrow, Director of Analysis and Reporting, Health Council of Canada

The CMAJ recently published a news article that reports on the Health Council of Canada’s new Health Innovation Portal. I was interviewed for the story, as was a family physician who was described as a specialist in medical information technology. As this physician/article makes several assumptions about the Health Innovation Portal, I wanted to provide more background on what motivated its development.

Health systems are complex, with many moving parts. This necessitates that good ideas and innovative solutions to the challenges faced come from a host of health system participants and stakeholders, including but not limited to physicians. The Health Innovation Portal was never intended or designed as a tool to inform physicians’ specific clinical practice decisions. In fact, one of our three inclusion criteria is that a practice for the Health Innovation Portal should not be a specific drug, surgical or medical intervention. The reason for this inclusion criterion is that there are well developed methods for evaluating these types of interventions and disseminating the findings. In addition to databases like Medline and Cochrane, there are an increasing number of databases that synthesize available evidence in the form of clinical practice guidelines (e.g., CMA’s Infobase).

While the Health Council clearly appreciates the importance of these evidence-based approaches to clinical decision-making, which we reported on in our recent video series on CPGs, the reality is that there are still a vast number of challenges facing our health systems that are not specific drug, surgical or medical interventions. These innovations often relate to decisions that organizations, regional health authorities and/or governments need to make to foster improvement. Yet, there are few places to go to get information on these types innovations. In large part, it was this gap, recognized by the federal/ provincial/ territorial ministers of health, which led them to specifically add the identification and sharing of health innovation to the Health Council’s mandate. The Health Innovation Portal is the beginning of a response to that request.

The CMAJ article suggests that the Health Innovation Portal is simply curating articles and that information is not ‘run through the evidentiary gamut.’ There are, in fact, very few peer-reviewed articles on the health innovations we profile on the Health Innovation Portal, and the critical appraisal tools appropriate for drug, surgical or medical interventions are not relevant to a broader set of health innovations. I agree with his note that there are ‘no accepted metrics.’ This is why our Council emphasized the need to develop an explicit and transparent approach to evaluate innovative practices, the Innovative Practices Evaluation Framework, before launching the Health Innovation Portal.

The article further states that ‘…physicians don’t make decisions to change their practices in a vacuum.’ We fully agree that physicians, and all other health system participants and stakeholders, must contextualize information as part of any strong decision-making process. That is why the Health Innovation Portal was specifically designed to assess the influence that contextual factors may have on the spread of an innovation. Two of the four evaluation criteria that make up the Innovative Practices Evaluation Framework focus on context, including the applicability and transferability of an innovation from one setting to another. While no information source can provide all necessary contextual information, an important focus for the Health Innovation Portal, in addition to information on applicability and transferability, is to provide direct links to individuals who led the development of the practice and are in position to provide insight into how best to interpret and adapt the given practice for another context/setting.

We are at an early stage in the development of the Health Innovation Portal, but the feedback we’ve received has been overwhelming and positive. Since we launched the Health Innovation Portal in November 2012, governments, organizations, and other health system stakeholders have contacted us, eager to share more innovative practices. We are hard at work adding new content to the Health Innovation Portal and look forward to more feedback. Send your thoughts to innovation@healthcouncilcanada.ca.