Patients across Ontario should expect to receive excellent care from our health system. And it usually delivers. But in too many instances, the quality of care people receive can vary depending on where they live.
For example, people with a diagnosis of heavy menstrual bleeding living in the northeast are more than ten times as likely to receive a hysterectomy as people living in Toronto. Similarly, people hospitalized with a hip fracture have a likelihood of dying within 30 days of admission that varies from 3% to 16% across the 50 highest volume hospitals in the province.
Some variation in care is always to be expected because of differences in patients’ underlying health conditions or in their treatment preferences. However, wide unwarranted regional variations in practices and outcomes are often a symptom of a system that lacks focus. Several decades ago, renowned health services researcher Dr. John E. Wennberg and colleagues at the Dartmouth Institute of Health Policy and Clinical Practice in the US determined that such regional variations point to a lack of “evidence-based standards of practice”.
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.
On Friday, March 9, 1:30 pm ET, join Health Quality Ontario CEO Dr. Joshua Tepper, and VP of Evidence Development and Standards Dr. Irfan Dhalla, for a tweet chat to discuss the opioid crisis and pain management.
Relationships are the bedrock upon which our health care system is built.
Nowhere was this described with more eloquence than at the recent Health Quality Transformation (HQT) conference in Toronto, where keynote speakers Dr. Don Berwick and Kim Katrin Milan both addressed this issue from very different perspectives.
Variations in care received by Ontario residents, based on where they live or certain demographic factors, can indicate a lack of quality in a health care system.
The recent report prepared for Health Quality Ontario titled Quality Matters: Realizing Excellent Care for All acknowledges the existence of unwarranted variations in care and the negative impact they can have on patients. This was also a key theme in last year’s Measuring Up report from Health Quality Ontario which noted that, while Ontario was generally doing a good job of providing care to all who needed it, “unacceptable variation” still existed by geography and population groups.