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Dr. Joshua Tepper

ARTIC: Bringing Innovation in from the Cold

“When it comes to moving health care practices forward efficiently, Canada is a country of perpetual pilot projects. We seldom move proven projects into stable, funded programs, and we rarely transfer the outcomes of pilot projects across jurisdictions. This approach is not serving our health care system well.”

Those words were published by the Honourable Monique Bégin, with co-authors Laura Eggertson and Dr. Noni Macdonald almost eight years ago in the Canadian Medical Association Journal when Bégin was professor emeritus, at the Telfer School of Management, University of Ottawa.

This inability of Canada to capitalize on and spread proven healthcare interventions is an enduring theme. Dr. David Naylor echoed this in his 2015 report on Innovation in Health Care when he said “Canadians working at all levels of healthcare observed that innovations of proven worth were not being scaled up and spread across the nation”.

More recently the problem has been raised again by Dr. Danielle Martin in her new book Better Now: Six Big Ideas to Improve Health Care for all Canadians: “Very few health care improvement projects get implemented in a sustainable way, and spread beyond that one area of the organization,” writes Martin, a family physician. “This is where we repeatedly fall down in Canadian health care.”

The good news is that efforts are underway to address this problem. ARTIC is a provincial partnership between the Council of Academic Hospitals of Ontario (CAHO) and Health Quality Ontario supported by funding by the Ministry of Health and Long-term Care.

Started by CAHO in 2010 to encourage the dissemination of good ideas across the research hospital sector, a partnership with Health Quality Ontario was formed in 2014 to move beyond these hospitals. ARTIC is one of the only Canadian programs that focuses exclusively on implementing evidence-based interventions across multiple parts of the health care system.

ARTIC is doing exactly what Bégin, Naylor, Martin and many others have been encouraging to foster widespread dissemination and implementation of healthcare innovations.

Since its start, ARTIC has successfully launched a number of projects which have been spread to hundreds of sites across the province and had a collective impact on more than 18,000 patients.

For example, ARTIC has supported a program that ensures patients with both a major depressive disorder (MDD) and alcohol dependence (AD) have access to a person-centered, evidence-based integrated care pathway, while another program integrates the alcohol or opioid addiction treatment provided by emergency department staff, addiction physicians, and primary care providers.

This week we are pleased to announce the latest project to be funded by ARTIC: expansion of primary care Memory Clinics to 14 rural, remote and underserviced communities across Ontario.

This innovative program provides training to allow family medicine teams to care directly for patients with memory problems associated with dementia. Already implemented at 85 clinics in the province, the model has reduced specialist referrals from up to 80% of patients with memory issues to fewer than 10% while also improving the patient and caregiver experience.

At Health Quality Ontario we are keen to continue our partnership with CAHO to support a model that is dispelling one of the enduring myths of the Canadian health care system – namely our inability to move from pilots to system-wide change.

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