Most Canadians view our healthcare system as a safety net for support when they get sick or injured – “the ‘system’ will make you better and you don’t have to pay out of pocket to have this security blanket!” – has been the prevailing line of thinking. One of the realities discussed frequently in the media is that the current acute care/hospital centric approach to healthcare funding is unsustainable. Its no wonder that people are concerned when healthcare costs currently absorb about 11 per cent* of Canada’s gross domestic product and almost half of our provincial budgets. The pressure placed on the healthcare system will continue to increase given Canada’s aging population, the worldwide transmission of communicable diseases and the year-over-year increase in the number of people with chronic diseases.
Shifting the Focus: Treatment to Prevention
So, if the model isn’t sustainable what are we doing about it? Today’s clinicians, public policymakers, politicians and administrators of publically funded health care organizations have already begun to shift financial resources from treatingcomplex cases to preventing them in the first place. The shift is focused on emphasizing programs to control the risk factors associated with chronic diseases, dealing with the social determinants effecting health, such as homelessness and poverty and actively promoting wellness initiatives.
A key part of the vision is to empower individuals with information and support through primary care to prevent the need to be treated acutely. Prevention and early intervention through primary care will reduce, or at least slow down, the requirement to fund the most expensive form of healthcare that exists, acute hospital based care.
Over the last 15 -20 years many studies have documented the need to increase support for primary healthcare to ensure a sustainable, funded healthcare system. There is clear evidence that patient centred primary healthcare increases the quality of care received, lowers costs, improves access, reduces waiting times and enhances the patient experience. However, it really wasn’t until the last 5 -10 years that technology has made it possible to truly support a model where a care team is centred on the individual in the community instead of the provider.
Making it a Reality: Secure Data
A cornerstone to patient centred preventative healthcare is the availability of data that was controlled by health care providers. Traditionally, all patient identifiable health information was kept in a paper chart at the doctor’s office or with the health information management group within a hospital. With the maturation of Electronic Medical Records (EMR), lab systems, diagnostic imaging systems and other clinical information systems much of the data is now stored electronically. The evolution in the last several years has seen the ability of these systems to securely share that data interactively based on common repositories.
The access to secure health data is the game changer that empowers individuals with information and support and we are seeing a shift occur across the country where health data is starting to be accessed by the individual.
What is Next?
The traditional government funded, large scale, costly hospital based initiatives will stop – except in situations where the systems are at end of life, or there is not a system in place already. In those cases how those new systems share the data, to ensure there is “one patient, one record” across the continuum of care, will be paramount.
Patient-centred, comprehensive, coordinated, accessible care in the community will grow and create new complexities in the administration of these services.
To support this, innovations in delivery will evolve. For instance:
- The EMR and Personal Health Record (PHR) will become more accessible and provide context-oriented information appropriate for each actor including the patient. Cloud-based services will become the norm to support this and the key challenge is accessibility to the cloud while maintaining stringent privacy and security requirements to support health information standards legislation.
- A change to a more service oriented culture that is reflective of high performing retail service organizations. Support for individuals through interdisciplinary teams with more capability for online and remote care delivery will be provided. Select areas of services can be addressed through online access, telehealth and secure messaging.
- Smart device monitoring – from smartphone apps to unique biometric devices to support home monitoring. Some key challenges include in-home high speed connectivity, integration with data repositories and availability through a PHR to all care team members in context to their role.
As a team Online has been working with frontline healthcare providers as these changes begin to be realized. We have had the privilege of working on transformational projects that make ‘one patient – one record’ thinking a reality and are also actively working in primary care on solutions that deliver administration efficiencies to shift resources to front line care. We are proud to be a Canadian-owned company and even more proud to be part, even in a small way, of helping to improve the Canadian healthcare system.
On a personal level, if you want to contribute to making our health care system more sustainable just remember “sitting is the new smoking”. Look it up and then get up and find something fun to do!
* In 2015, total health expenditure in Canada is expected to reach $219.1 billion, or $6,105 per person. It is anticipated that, overall, health spending will represent 10.9% of Canada’s gross domestic product (GDP).