TORONTO, Sept. 29 /CNW/ - At an appearance today before the Ontario Legislative Standing Committee on Social Policy, Ontario's doctors will stress the importance of health care professionals working together to enhance and strengthen the delivery of safe and quality care to patients. The Standing Committee is listening to oral submissions from stakeholders as the government moves ahead with proposed legislation that would expand the scope of practice of some health care providers.
"Ontario's doctors firmly believe that collaboration between health care professionals is the best way to strengthen and enhance the delivery of safe, high quality care to patients," said Dr. Suzanne Strasberg, President of the Ontario Medical Association (OMA). "We know that when physicians, nurse practitioners, pharmacists, dieticians and other health professionals work together we can and often do, deliver a more comprehensive level of care to our patients."
The OMA applauded several aspects of the proposed legislation including:
- Requiring all regulated health professionals to have professional
liability protection;
- Creating an independent expert drug committee that will streamline
regulatory processes, support colleges in developing their drug
lists while keeping pace with the changing health care landscape;
and
- Setting parameters for HPRAC to make recommendations regarding
changes to health professions statutes.
However, Dr. Mark MacLeod, President-Elect of the OMA will raise some concerns at the hearing about several proposals within the legislation. Specifically, with respect to pharmacists being granted the ability to 'adjust, adapt or extend' a prescription, Dr. MacLeod pointed out that this may create separate practice silos between a prescribing physician and a pharmacist and this type of fragmented treatment may diminish the quality of patient care.
Dr. MacLeod reiterated the OMAs long standing position that collaboration among health professionals results in a more comprehensive level of care being delivered to patients. The OMA strongly believes that if nurse practitioners are able to prescribe, dispense, sell, or compound drugs, then their prescribing power must be carefully regulated. More importantly, all drugs should be vetted and approved by the proposed independent expert drug committee rather than the College of Nurses of Ontario.
"The number one priority for Ontario's doctors throughout this entire process has been and remains patient safety because the level and quality of care that a doctor can provide should not be substituted for expediency," said Dr. MacLeod. "Ontario's doctors have offered constructive recommendations that we believe will protect patient safety by ensuring that all health care professionals maintain collaborative relationships with physicians."
Wednesday, September 30, 2009
Ontario government's lawsuit against the tobacco industry
TORONTO, Sept. 29 /CNW/ - The Canadian Cancer Society is pleased the Ontario government is suing tobacco companies to recover tobacco-related health care costs.
"The lawsuit filed today will begin the process of holding the industry accountable for the harm they have done to the health of Ontarians," says Rowena Pinto, Senior Director, Public Affairs, Ontario Division, Canadian Cancer Society. "The tobacco industry's addictive products are responsible for 30% of cancer deaths."
Cost-recovery litigation could significantly benefit public health. In other jurisdictions, litigation has resulted in restrictions on the marketing practices of the tobacco industry.
Benefits of litigation:
- Justice: lawsuit against the tobacco industry will hold them accountable for their destructive behaviour.
- Truth: through the court process, tobacco industry documents will become public. Documents released through the court process, will shed light on the many deceptive and destructive practices pursued by the industry for decades. The public will finally understand that this is an industry that operates outside the rules of normal
business.
- Compensation: potentially billions of dollars could be recovered as compensation for health care and other costs.
- Health: the process of litigation could result in greater restrictions on tobacco industry marketing and sales practices. For example, more restrictions on tobacco advertising.
Background:
- 13,000 people die of tobacco related illness every year in Ontario.
- Tobacco use is responsible for 30% of cancer deaths.
- Tobacco-related health care costs currently total more than $1.6 billion per year in Ontario.
- British Columbia, Saskatchewan, Manitoba, New Brunswick, Newfoundland, and Nova Scotia have already passed similar legislation.
- British Columbia and New Brunswick have begun the process of suing the tobacco industry.
The Canadian Cancer Society is a national community-based organization of volunteers whose mission is the eradication of cancer and the improvement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.
For further information: Christine Koserski, Ontario Provincial Office, Canadian Cancer Society: (416) 323-7030, ckoserski@ontario.cancer.ca
"The lawsuit filed today will begin the process of holding the industry accountable for the harm they have done to the health of Ontarians," says Rowena Pinto, Senior Director, Public Affairs, Ontario Division, Canadian Cancer Society. "The tobacco industry's addictive products are responsible for 30% of cancer deaths."
Cost-recovery litigation could significantly benefit public health. In other jurisdictions, litigation has resulted in restrictions on the marketing practices of the tobacco industry.
Benefits of litigation:
- Justice: lawsuit against the tobacco industry will hold them accountable for their destructive behaviour.
- Truth: through the court process, tobacco industry documents will become public. Documents released through the court process, will shed light on the many deceptive and destructive practices pursued by the industry for decades. The public will finally understand that this is an industry that operates outside the rules of normal
business.
- Compensation: potentially billions of dollars could be recovered as compensation for health care and other costs.
- Health: the process of litigation could result in greater restrictions on tobacco industry marketing and sales practices. For example, more restrictions on tobacco advertising.
Background:
- 13,000 people die of tobacco related illness every year in Ontario.
- Tobacco use is responsible for 30% of cancer deaths.
- Tobacco-related health care costs currently total more than $1.6 billion per year in Ontario.
- British Columbia, Saskatchewan, Manitoba, New Brunswick, Newfoundland, and Nova Scotia have already passed similar legislation.
- British Columbia and New Brunswick have begun the process of suing the tobacco industry.
The Canadian Cancer Society is a national community-based organization of volunteers whose mission is the eradication of cancer and the improvement of the quality of life of people living with cancer. When you want to know more about cancer, visit our website www.cancer.ca or call our toll-free, bilingual Cancer Information Service at 1 888 939-3333.
For further information: Christine Koserski, Ontario Provincial Office, Canadian Cancer Society: (416) 323-7030, ckoserski@ontario.cancer.ca
Monday, September 28, 2009
In a pandemic more than twice as many hospital patients will require intensive care, with less than half the staff
When the Hamilton Health Sciences (HHS) Pandemic Influenza Planning Committee contemplated how the triage process would be enacted at its hospitals, numerous gaps were identified:
- How is critical care triage operationalized in different care settings within the hospital (e.g., emergency department, hospital wards, ICU)?
- Who can function as a "triage officer"? What skills are required? If there is a single triage officer in each institution, what happens when these officers are needed in two places at once?
- Should these life and death decisions, made under extremely stressful circumstances, rest on the shoulders of single individuals? What are the risks of this model for triage officers and healthcare organizations? What supports do triage officers require?
- What procedural and institutional structures ensure triage decisions are of high quality, consistent (across time, triage officers and different hospitals), efficient, ethical and evidence-based? How should decisions be documented?
- What happens if the demand for critical care is so great that it cannot be managed using the Ontario Health Plan for an Influenza Pandemic process? How should choices be made between patients with the same clinical priority for critical care (i.e., SOFA score)?
Hamilton Health Sciences is the first hospital in Canada to develop a detailed critical care triage protocol for bedside application. In this article, we present (1) the rationale and process HHS undertook to create this protocol, (2) highlights and key innovations of the protocol and (3) issues arising from preliminary testing of the protocol.
Copies of the paper can be downloaded at http://www.longwoods.com/home.php?cat=609
Friday, September 25, 2009
Tom Talks: Maintaining Trust and Confidence in Ontario's Hospitals - September 25, 2009
Currently not available.
Thursday, September 24, 2009
Health Record Errors "above the fold"
September 2009. I have been a patient at my primary-care clinic for over 20 years. Finally the physicians have the benefit of electronic health records -- making them pioneers in Ontario. But the news is not necessarily good. My physician is young, articulate and totally computer literate. So that gives me a reasonable level of confidence. Still my record was full of errors to just the basics and that's cause for concern. This may well reflect the front office but what about the rest of the information that I don't fully understand? You decide.
Here's the story.
I had some lab tests scheduled for today and was provided with a printed requisition produced by my physician using the new EHR. I didn't read it until this morning - - -
On this, the appointed day, I called the clinic early to see what time the lab opens. I was hoping to be first in line. The clinic's office number was answered by an office unrelated to my clinic. When I pointed this out to admin staff, the office administrator was baffled and was keen on fixing it immediately. The phone number was in a header and, presumably, was wrong on every record in the office.
My name had two spelling errors. (What does the provincial insurer do with that?) On correction by the office administrator only one spelling error remained.
My phone number was changed some 5 years ago. Now its correct.
That's four errors and we are only just "above the fold" of my requisition.
This doesn't give me much confidence in the rest of the information. Just because the doctor's order was electronically requisitioned gives me no reason to believe its right. The lab technician did take a vial of blood as expected. I hope it will be used for the right tests.
Questions: Did the clinic follow a "change" protocol? Was anyone trained by the vendor? Are patients asked to check information about themselves? Is this a global problem? How serious are the patient safety implications? Will we now see wide spread errors caused by one wrong key stroke?
Landmark BC study shows value of good primary care to health care system
Promoting greater attachment to family doctors could save millions of health care dollars
People with chronic diseases who are regularly served by the same full-service family practice cost the health care system significantly less money than those patients not closely attached to a family doctor, a landmark study in British Columbia has found.
Most of the savings result from patients not needing to be admitted to hospital or not needing to be seen so often by specialists, the study found.
The study, conducted by Victoria-based Hollander Analytical Services Ltd., examined usage data from more than 98,000 high-needs patients in B.C. in 2007-08. The study focused on two common chronic diseases, diabetes and congestive heart failure (CHF).
“Our study found that the more patients go to the same family practice, the lower the overall annual costs are to the health care system,” said Marcus Hollander, the study’s chief author. “It appears that as little as a 5% increase in attachment to a family, or primary care, practice, for high care needs diabetes and CHF patients, could result in savings of some $85 million annually in BC alone.”
The study, which is now available on the web, is reported in the fall issue of Healthcare Quarterly, a leading Canadian health care journal covering health care policy, administration and practice.
While other studies have shown there is a direct correlation between better health outcomes and regular service by full-service family physicians, Hollander’s study is the most detailed examination yet of the impact family physicians have on direct health care costs. And the impact is considerable.
The study found that the average annual hospital costs for high-needs diabetes patients who were not attached to family practices were almost $17,000 annually. That compares, on average, to just $5,900 for similar patients attached to a family practice. The highest needs patients with CHF cost the overall health system almost $30,000 if they were not attached to a family doctor, but just $12,000 if they were. “The difference in costs can be attributed in large part to the fact that patients without family doctors spend more days in hospital which greatly adds to the cost of the health care they receive,” Hollander said.
Hollander noted that other studies have found that “continuity of care”, particularly the personal relationship that develops between a patient and a family doctor, tends to keep patients healthier and out of hospital. This relationship is not forged in walk-in clinics, in emergency departments or through specialist visits.
A number of international studies have shown the stronger the system of primary care in a region, state, or country, the better the population’s health outcomes. “We know that good primary care is better for the patient’s health but now we know that it is better use of our health care dollars too,” said Dr. William Cavers, a Victoria-based family physician and the co-chair of the committee that commissioned the research.
Hollander’s study is also being hailed by US physician and academic Dr. Barbara Starfield, one of the world’s leading experts on the link between family physicians and better health outcomes. “Although it might be hypothesized that the sickest individuals would benefit the most from frequent visits to specialists, this is not the case,” said Starfield. “Policy makers must realize that it is ongoing primary care, not specialist care, that has the most to offer in the care of ill individuals regardless of their age,” Starfield said.
In fact, Hollander’s study found that attachment to a family practice was the best predictor of the patient’s overall health care costs and was more related to costs than other variables such as age.
The paper is being hailed by doctors in Canada and BC because at the present time, a shortage of family physicians poses a serious challenge to health care systems in Canada and the US.
“This paper presents compelling evidence of the cost-effectiveness of comprehensive primary medical care for higher needs patients,” said Dr. Anne Doig, president of the Canadian Medical Association. “It is remarkable for the rigour and robustness of the analysis. This landmark study should stimulate the drive to ensure that every Canadian has a primary care physician. “
"This study shows that a well designed, collaboratively developed program between physicians and government that has been effectively implemented will work in an area otherwise fraught with setbacks," said Dr. Brian Brodie, president of the BC Medical Association. "In the past, many different programs and models have attempted to renew primary care - all with little results. These are results from a program designed for all family practitioners that provides better care to patients and saves the system money. This is the kind of program that makes being a family doctor a rewarding career choice because one can see the benefits every day."
Since 2002, in an unprecedented collaboration, the BC Ministry of Health and the BC Medical Association agreed to support family physicians in the province. The resulting General Practices Services Committee (GPSC) has the mandate to “find solutions to support and sustain full service family practice,” said Cavers. Some of the GPSC actions include: incentive payments that compensate doctors for the extra time, care and effort good full-service family practice entails; physician recruitment initiatives; funding for training modules for family physicians; and other financial and practical supports.
The Hollander study was an evaluation project of the GPSC to examine the basic question of whether or not full-service family practice was a wise investment of funds in British Columbia. “Our study would suggest that the more we support family doctors to provide good primary care to their patients, the lower the costs to the health care system overall,” said Hollander.
Copies of the full paper are available for free download at:
http://www.longwoods.com/product.php?productid=21050
-30-
Media Inquiries
For comments about the research aspects of the study please contact:
Dr. Marcus Hollander, President, Hollander Analytical Services Ltd., at marcus@hollanderanalytical.com
For comments about the policy and program implications of the study please contact:
Dr. William Cavers, Co-Chairperson, General Practice Services Committee, at wcavers@shaw.ca (for Canada)
Dr. Barbara Starfield, University Distinguished Professor, Johns Hopkins School of Public Health, at
410-955-3737 or at bstarfie@jhsph.edu (for the USA)
To speak to someone in person, for more information, or for assistance in contacting any of the above individuals, please call 250-389-0123.
People with chronic diseases who are regularly served by the same full-service family practice cost the health care system significantly less money than those patients not closely attached to a family doctor, a landmark study in British Columbia has found.
Most of the savings result from patients not needing to be admitted to hospital or not needing to be seen so often by specialists, the study found.
The study, conducted by Victoria-based Hollander Analytical Services Ltd., examined usage data from more than 98,000 high-needs patients in B.C. in 2007-08. The study focused on two common chronic diseases, diabetes and congestive heart failure (CHF).
“Our study found that the more patients go to the same family practice, the lower the overall annual costs are to the health care system,” said Marcus Hollander, the study’s chief author. “It appears that as little as a 5% increase in attachment to a family, or primary care, practice, for high care needs diabetes and CHF patients, could result in savings of some $85 million annually in BC alone.”
The study, which is now available on the web, is reported in the fall issue of Healthcare Quarterly, a leading Canadian health care journal covering health care policy, administration and practice.
While other studies have shown there is a direct correlation between better health outcomes and regular service by full-service family physicians, Hollander’s study is the most detailed examination yet of the impact family physicians have on direct health care costs. And the impact is considerable.
The study found that the average annual hospital costs for high-needs diabetes patients who were not attached to family practices were almost $17,000 annually. That compares, on average, to just $5,900 for similar patients attached to a family practice. The highest needs patients with CHF cost the overall health system almost $30,000 if they were not attached to a family doctor, but just $12,000 if they were. “The difference in costs can be attributed in large part to the fact that patients without family doctors spend more days in hospital which greatly adds to the cost of the health care they receive,” Hollander said.
Hollander noted that other studies have found that “continuity of care”, particularly the personal relationship that develops between a patient and a family doctor, tends to keep patients healthier and out of hospital. This relationship is not forged in walk-in clinics, in emergency departments or through specialist visits.
A number of international studies have shown the stronger the system of primary care in a region, state, or country, the better the population’s health outcomes. “We know that good primary care is better for the patient’s health but now we know that it is better use of our health care dollars too,” said Dr. William Cavers, a Victoria-based family physician and the co-chair of the committee that commissioned the research.
Hollander’s study is also being hailed by US physician and academic Dr. Barbara Starfield, one of the world’s leading experts on the link between family physicians and better health outcomes. “Although it might be hypothesized that the sickest individuals would benefit the most from frequent visits to specialists, this is not the case,” said Starfield. “Policy makers must realize that it is ongoing primary care, not specialist care, that has the most to offer in the care of ill individuals regardless of their age,” Starfield said.
In fact, Hollander’s study found that attachment to a family practice was the best predictor of the patient’s overall health care costs and was more related to costs than other variables such as age.
The paper is being hailed by doctors in Canada and BC because at the present time, a shortage of family physicians poses a serious challenge to health care systems in Canada and the US.
“This paper presents compelling evidence of the cost-effectiveness of comprehensive primary medical care for higher needs patients,” said Dr. Anne Doig, president of the Canadian Medical Association. “It is remarkable for the rigour and robustness of the analysis. This landmark study should stimulate the drive to ensure that every Canadian has a primary care physician. “
"This study shows that a well designed, collaboratively developed program between physicians and government that has been effectively implemented will work in an area otherwise fraught with setbacks," said Dr. Brian Brodie, president of the BC Medical Association. "In the past, many different programs and models have attempted to renew primary care - all with little results. These are results from a program designed for all family practitioners that provides better care to patients and saves the system money. This is the kind of program that makes being a family doctor a rewarding career choice because one can see the benefits every day."
Since 2002, in an unprecedented collaboration, the BC Ministry of Health and the BC Medical Association agreed to support family physicians in the province. The resulting General Practices Services Committee (GPSC) has the mandate to “find solutions to support and sustain full service family practice,” said Cavers. Some of the GPSC actions include: incentive payments that compensate doctors for the extra time, care and effort good full-service family practice entails; physician recruitment initiatives; funding for training modules for family physicians; and other financial and practical supports.
The Hollander study was an evaluation project of the GPSC to examine the basic question of whether or not full-service family practice was a wise investment of funds in British Columbia. “Our study would suggest that the more we support family doctors to provide good primary care to their patients, the lower the costs to the health care system overall,” said Hollander.
Copies of the full paper are available for free download at:
http://www.longwoods.com/product.php?productid=21050
-30-
Media Inquiries
For comments about the research aspects of the study please contact:
Dr. Marcus Hollander, President, Hollander Analytical Services Ltd., at marcus@hollanderanalytical.com
For comments about the policy and program implications of the study please contact:
Dr. William Cavers, Co-Chairperson, General Practice Services Committee, at wcavers@shaw.ca (for Canada)
Dr. Barbara Starfield, University Distinguished Professor, Johns Hopkins School of Public Health, at
410-955-3737 or at bstarfie@jhsph.edu (for the USA)
To speak to someone in person, for more information, or for assistance in contacting any of the above individuals, please call 250-389-0123.
Wednesday, September 16, 2009
The Most Interesting Health Consultant In the World
A message from The Most Interesting Health Consultant In the World about universal health care in the United States and the truth about Canadian publicly funded health care.
Monday, September 14, 2009
Knowledge Translaton and Transfer. In teaching . . .
In teaching, you must simply work your pupil into such a state of interest in what you are going to teach him that every other object of attention is banished from his mind; then reveal it to him so impressively that he will remember the occasion to his dying day; and finally fill him with devouring curiosity to know what the next steps in connection with the subject are.
Source: James on Psychology and The Teaching Art
Source: James on Psychology and The Teaching Art
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