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Digital health: Transforming care and adding value

By Lee Fairclough

This week is Digital Health Week, a yearly acknowledgement of the transformative power of digital health technologies to support the delivery of health care.

That such a transformation is desired by patients and caregivers is not in doubt. Canada Health Infoway notes that 80% of patients want access to their own records and other digital health solutions. This enthusiasm was confirmed recently in a survey commissioned by the Canadian Medical Association which found:

  • Three-quarters of Canadians would like to see more technology as part of the health care system
  • 7 in 10 Canadians would take advantage of virtual physician visits and many believe that it would lead to more timely care, convenience and overall care.
  • Over half (56%) would likely wear a mobile device that monitored their health continuously.

Despite these figures, digital care has been relatively slow in coming to Ontario and the rest of Canada for a variety of reasons related to the challenges of putting the proper infrastructure in place, privacy and security concerns and some resistance from health care providers and patients.

Everything I learned about quality…

by Dr. Joshua Tepper

I am rapidly completing my five-year tenure as President and CEO of Health Quality Ontario (HQO). I am probably a bit nostalgic and reflective by nature and so this transition time has led me to think about what I have learned in the last five years about quality improvement (QI).

It is helpful for context to know that while I probably brought a certain set of useful skills and knowledge to the role of CEO, I did not have a strong background or formal training in QI. These reflections then are not about a lifetime (or decades) of thinking about QI, but rather just the last few years.

To be clear, this is not a reflection or effort at summation of the good work that HQO and its partners have done in the last five years. Rather, this is a personal look at what I see as key themes in the still emerging and rapidly evolving space of quality improvement in health care.

I acknowledge that I have written about some of these ideas in other blogs. Also a recent set of comments (not really a speech) at the graduation class of an IDEAS cohort also touched on some of these themes. However I can also safely say that I have never put all of these ideas down in one place and further that this is by far the longest blog I have ever written. In fact, Pat Rich who helped me edit this said I should call this piece “The Long Goodbye”.

As a simple literary device I will bucket these ideas as “8 P’s”.

 

Challenges and opportunities: HQT 2018

by Dr. Joshua Tepper

It is only appropriate that the biggest conference in Canada, and one of the biggest in the world focused exclusively on health quality, should look with blunt honesty at the challenges of providing quality health care in 2018.

It is equally clear from listening and talking to the frontline health care professionals, patients, family members and others who made up the 3,000 delegates attending our Health Quality Transformation conference, that those present are willing to meet these challenges and uphold the six principles upon which quality care should be based - efficiency, timeliness, safety, effectiveness, patient-centredness and equity.

Quality Care: From Good to Great

Everybody wants quality health care. Why wouldn’t they?

This belief, which underpins the work of Health Quality Ontario, was recently endorsed by no less than the World Health Organization, World Bank and Organization for Economic Co-operation and Development Countries in a major report on global health care. They stated “even with essential health coverage and financial protection, health outcomes would still be poor if services were low-quality and unsafe”.

In a recent commentary in the CMAJ, we summarized data demonstrating that the quality of health care in Canada is good but not great. We also made several suggestions for improvement. In the article, we focused not on the things that individual clinicians could do differently, but rather on decisions that managers, administrators and policy makers can make. While most quality improvement initiatives are necessarily local, we feel certain key steps could be taken across the whole country.

Osteoarthritis: Be aware of a better care option

by Dr. Joshua Tepper

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability.

With an estimated 5.6 million Canadians suffering from osteoarthritis and that number expected to increase significantly as the population ages, the condition still has no cure and can be difficult to manage effectively. In Ontario, people with osteoarthritis report a quality of life 10% to 25% lower than those without osteoarthritis, and they incur health care costs two to three times higher. Despite the seriousness of this situation, osteoarthritis is often underdiagnosed and undertreated.

Osteoarthritis is just one of several musculoskeletal conditions that affects one in three Ontario adults. Recently released wait-time data that can be found on the Health Quality Ontario website shows that patients with these conditions spend the most time waiting to access health-care services, like magnetic resonance imaging (MRI) even though that may not be the best treatment option. In addition, uncontrolled knee, hip and back pain has been associated with inappropriate use of opioids.

To address this, an approach to redesign and innovate the current model of care in Ontario will help people access the right treatment faster, starting with osteoarthritis and other conditions causing hip, knee and low-back pain.

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