Change Day Ontario: Celebrating Health System Change Through Patient Stories

Contributed by Michael Savage 

When I joined the OntarioMD team in June 2017, I was excited to be part of an organization that has both a start-up vibe and a true commitment to building a more seamless and connected Ontario health care system. Nearly six months later, that feeling has yet to wear off, because I’ve come to understand that everyone here lives and breathes health care and digital health innovation. As a result, it should come as no surprise that the OntarioMD team has rallied behind the introduction of the international Change Day movement into Ontario this year.

Change Day Ontario is a celebration of the awesome power that individuals committed to change – with a particular emphasis on the health care system – can have collectively. Whether joining a collective pledge to drive a policy shift, or pledging individually to spare some change for every homeless person we walk past, we’re all proving that committing to change creates change. As I write this, more than 3,500 Ontarians have posted a Change Day pledge at changedayontario.ca. That’s 3,500 people who are not just celebrating change as a concept, but acting on their vision for what a better, healthier, more compassionate world can look like.

My pledge for Change Day Ontario is to promote the voices of patients and their families – and to encourage others in the health care sector to do the same. Whether we work on the front lines in direct health care, or in a tech-focused organization tasked with designing the next generation of connected and intelligent health software solutions, we all have an opportunity to listen to the stories of patients and their families, and to bring them to the table to shape our work. OntarioMD’s ongoing ability to offer valuable advice and solutions that optimize practice efficiency and patient care depends on our ability to understand the needs of health care consumers.

To demonstrate both my passion and commitment to patient and family engagement, I’ve pledged to engage in more than 150 conversations with Ontario patients about their experiences with their health information by New Year’s Eve of this year. I’ve already had a handful of eye-opening discussions with Ontarians who are current or former patients. Some of the stories I’ve heard have demonstrated the importance of accessible and transparent patient/family portal systems, which provide patients with access to their health information. One patient I spoke with called their exposure to this innovation “the first time that I truly felt like my providers and I were on the same team.” Conversely, the stories have revealed that, while digital health is helping us collect important patient data, we still have work to do to make patients understand what that data means in clear terms that make sense to them. One patient explained that “I kept being told I needed to get my oxygen levels up to get better. What does that even mean? How does a person get their oxygen levels up? I think I could have gotten a lot better a lot faster if they had just used real-life terms, and just told me I needed to walk around more.”

My Change Day Ontario pledge is just one of the many great pledges made by my OntarioMD colleagues. While Change Day itself is celebrated on November 17, the range of provocative and game-changing commitments made by us at OntarioMD and by others across the province should remind us all that every day is Change Day if we’re committed to a better future.

Celebrating Digital Health Week

This week (Nov. 13 to 19) is Digital Health Week. OntarioMD is proud to support this initiative celebrating the important work being done in digital health, and to sponsor the Infoway Partnership Conference in Calgary on November 14 and 15, which will feature a breakfast seminar led by our CEO, Sarah Hutchison.

Read the following press release for more info on Digital Health Week events and participants.

November 9, 2017 (Toronto) – Health care organizations from across the country are coming together to celebrate the positive impact that digital health is making for Canadians during Digital Health Week, November 13-19, 2017.

“Digital health is transforming health care delivery in Canada,” said Michael Green, president and CEO, Canada Health Infoway. “There are countless stories about how digital health is making a difference for clinicians and Canadians. It better enables clinicians to access the information they need to make decisions more quickly and empowers patients to better manage their health through online portals and other digital tools and services. This is a week dedicated to celebrating these advancements.”

Digital Health Week was created as a way to raise awareness about the important work going on to advance health technology and evolve health care in Canada.

With dozens of participating organizations involved, there are many activities, announcements and events planned. A few include:

Partnership Conference Webcast – The opening keynote presentations on November 14 and 15 will be webcast live from Calgary.

#HCLDR TweetChat – Join the conversation on Tuesday, November 14 at 8:30 p.m. ET using #HCLDR and #ThinkDigitalHealth.

Women Leaders in Digital Health Award – This award, sponsored by COACH: Canada’s Health Informatics Association, will be announced during the week.

#OnesToFollow – A list of digital health leaders one “must follow” on Twitter will be released on November 14.

Digital Health Week Fête – Connect with people who are passionate about digital health on Monday, November 13 in Calgary.

Social Media – There will be plenty of social media activity happening using #ThinkDigitalHealth.

Visit www.betterhealthtogether.ca/digital-health-week for more information and to see what else is planned.

Digital Health Week Participating Organizations

Federal, provincial and territorial health ministries, along with the following health care organizations from across Canada are supporting Digital Health Week:

  • Alberta Health Services
  • Brightguide
  • CADTH
  • Canada Health Infoway
  • Canadian Association of Radiologists
  • Canadian College of Health Leaders
  • Canadian Foundation for Healthcare Improvement
  • Canadian Home Care Association
  • Canadian Medical Association
  • Canadian Nurses Association
  • Canadian Ophthalmological Society
  • Canadian Patient Safety Institute
  • Canadian Pharmacists Association
  • Canadian Physiotherapy Association
  • Canadian Society of Hospital Pharmacists
  • CEFRIO
  • CIUSS West-Central Montreal
  • COACH: Canada’s Health Informatics Association
  • Densitas Inc.
  • Diabetes Canada
  • Equinoxe Virtual Clinic
  • Gene42
  • Health Arrows
  • Health Sciences North
  • Healthcare Information Management & Communications Canada
  • Heart and Stroke Foundation
  • HIMSS
  • Hypercare
  • IMAGINE Citizens Collaborating for Health
  • Institute for Safe Medication Practices Canada (ISMP Canada)
  • International Medical Informatics Association (IMIA)
  • ITAC Health
  • Mackenzie Health
  • Mackenzie Innovation Institute (MI2)
  • Made by Uppercut
  • mdBriefCase Group Inc.
  • MEDEC
  • Mental Health Commission of Canada
  • Molecular You
  • Neighbourhood Pharmacy Association of Canada
  • Ontario Telemedicine Network
  • Patient Critical Co-op
  • QHR Technologies
  • Registered Nurses Association of Ontario
  • Rick Hansen Foundation
  • St. Joseph’s Health Centre
  • Strata Health
  • The Arthritis Society
  • The eHealth Centre of Excellence
  • The Scarborough Hospital
  • Waterloo Wellington Local Health IntegrationNetwork
  • Women’s College Hospital

Friends of Digital Health Week 2017

Infoway Partnership Conference sponsors are recognized as Friends of Digital Health Week:

  • Brightsquid Secure Communications Corp.
  • Canadian Institute for Health Information (CIHI)
  • HAnalytics Solutions Inc.
  • Harris Healthcare
  • HITS eHealth Office at Hamilton Health Sciences
  • IBM Canada
  • IMO-Intelligent Medical Objects
  • Iron Mountain Canada
  • McKesson Canada
  • Mikata Health
  • Novari Health
  • Cerner Canada
  • Chronometriq
  • Forcare Canada Inc.
  • Gevity
  • OntarioMD
  • Oracle
  • Passport Health
  • Red Hat Canada
  • SNOMED International
  • TELUS Health
  • Think Research
  • Think Tank Innovations Ltd. (ShareSmart)
  • Wolters Kluwer

 

Change Day Pledge

Change Day is a grassroots movement that is being adopted around the world to improve quality compassionate care. In Canada, the British Columbia, Alberta, and Saskatchewan Health Councils have all championed successful Change Days over the last two years.

Change Day Ontario has been designed to empower people within the health system to make positive changes through making pledges and taking actions, big or small, to improve compassionate quality care. The campaign is about people engaging with one another through their ideas and stories; sharing them online and through social media; overcoming barriers; and ultimately, helping to improve the experience of health care for patients and providers alike.

To make your own pledge, please visit http://www.changedayontario.ca/

 

Measuring the System’s Fault Lines

Contributed by Dr. Joshua Tepper, President and CEO of Health Quality Ontario

A quality health care system seamlessly delivers care across a broad spectrum of care settings and patient populations. Unfortunately, even a good health care system can have fault lines into which patients can fall and where quality care is deficient.

Measuring Up, Health Quality Ontario’s newly released 11th annual report on the performance of the province’s health system and on the health of Ontarians, documents those fault lines as well as other areas where the provincial system can improve.  It takes the pulse of the system through measurement and through narratives from people like Gordon, Lilac and Elgin who share their experiences as patients and that of Shawn Dookie, a nurse practitioner.

Starting with initial entry into the system, Measuring Up this year identifies areas of concern. Compared to 10 other developed countries, Ontario scores as one of the worst when it comes to having access to a primary care provider the same or next day when someone is sick. More than half of Ontarians surveyed reported having this problem.

Then, when patients have to go to the emergency department they are spending on average of an hour-and-a-half longer in the emergency department before being admitted to a hospital bed than they were the previous year. This can, at least partially, be attributed to the fact that an average of 3,961 beds daily were occupied by patients waiting for care elsewhere in 2015/16 (known as Alternate Level of Care). For those of you who want to see a good Rick Mercer-type rant about Alternate Level of Care and its impact on the system, this video was filmed by the chair of Health Quality Ontario’s Quality Standards Committee, Dr. Chris Simpson, two years ago when he was president of the Canadian Medical Association.

Little progress was documented in reducing the number of people with a mental health or substance use issue who went to the emergency department without seeing a psychiatrist or other physician first (33.1% in 2015).

Some wait times also continue to be an issue in Ontario. Hip and knee replacements are increasingly common yet fewer patients are receiving surgery within the target time. For example, 5% fewer of those awaiting Priority 4 knee surgery in 2016/17 had their procedure within the target time, compared to in 2014/15

Furthermore, only 56.7% of home care patients felt strongly involved in the development of their own care plan. And caregiver distress among those caring informally for patients needing home care has increased from 21.2% in 2012/13 to 24.3% in the first part of 2016/17.

Health Quality Ontario always brings an equity lens to the delivery of care and here again Measuring Up identifies areas of concern.

  •  About 1 in 12 people in Ontario reported having trouble paying their medical bills
  •  Variations exist by region and by rural vs. urban in reported having ongoing consistent care over time with the same physician. For example, the proportion of people who had high continuity of care ranged from 66.5% in the South-East Local Health Integrated Health Network (LHIN) LHIN region to 49.8% in the Central West LHIN region.
  • The premature mortality rate shows striking variations across the province with the rate of potential years of life lost being 2.5 times higher in the North West LIHN region) at 7,647 potential years of life lost per 100,000 people compared with 3,026 potential years of life lost per 100,000 people in the Central LHIN region over the same time period.
  • Colorectal cancer screening has inequities by income. Urban residents in the lowest income neighbourhoods had the highest rate of being overdue for screening in 2015 at 46.5% compared to 32.7% of these in the highest income neighbourhoods.

The measures of involvement in home care and continuity of care referenced above are two of four new indicators added to Measuring Up this year. The other two indicators are:

  • The wait time from when a patient is assessed or registered in the emergency department to the time they are first seen by a physician. The average time patients waited to see a physician increased slightly this year from last year to 1.5 hours from 1.4 hours.
  • The wait time between when a cancer patients is referred by a primary care physician to a surgeon to the time of their first appointment with the surgeon. About 6 out of 7 Ontario patients who had cancer surgery had their first surgical appointment within target wait times in 2016/17.

In addition, findings are now available on the delivery of primary care in the LHIN sub-regions, smaller geographic planning areas within Local Health Integration Networks.

In Quality Matters: Realizing Excellent Care For All, our report on how to improve quality in the system, it is noted that measurement gaps exist in documenting transitions in care and that “safer and more efficient transitions for patients require appropriate accountabilities and hard data rather than anecdotes.”Measuring Up this year is an example of where we are bridging those gaps in knowledge, by producing numbers that shine a light on where we can do better.

The report also documents where Ontario is doing well and these findings are not insignificant as they show that overall Ontarians are living longer and losing fewer years of their lives to premature death. Measuring Up also shows long-term care residents are receiving better care on a number of parameters and more people are receiving colorectal cancer screening in a timely manner.

These statistics are also useful as they show improvement is possible and guidance on how that improvement might occur.

 

Toronto EMR: Every Step Conference Recap

Contributed by Revin Samuel

 

 

Thank you to all the attendees, speakers, exhibitors, peer leaders and staff who participating in the 2017 EMR: Every Step Conference this past September 28 in Toronto. The conference was a tremendous success!

If you’d liked to provide any feedback on the conference, feel free to do so by emailing omd.events@ontariomd.ca.

Stay tuned to OntarioMD.ca for details on future EMR: Every Step Conference and our brand new series, On the Road with OntarioMD.

We hope to see you again soon!