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TWO DECADES
OF CITIZEN & PATIENT
ENGAGEMENT
LOOKING BACK Matthew Mendelsohn
THE FUTURE Will Falk
September 21, 2011
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LOOKING BACK THE PAST TWO DECADES OF CITIZEN
& PATIENT ENGAGEMENT
MATTHEW MENDELSOHN Director, Mowat Centre
www.mowatcentre.ca
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HEALTH CARE CANADA’S NATIONAL TREASURE
Romanow Commission (2002)
•!Popularizes notion that health care is a national treasure
•!Regularizes the way we report on how Canadians feel about health care system
•! Links pride in health care to Canadian identity
•!Creates a baseline on citizen opinion on healthcare for Canadians
THE PAST | 1
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Alberta www.waittimes.alberta.ca
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Ontario www.waittimes.net
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TRANSPARENCY
ON QUALITY
A new emphasis on quality created an “alphabet soup”
of organizations that report and comment on quality
1998 2007 1995
CIHI
1992
ICES
MCHP
2001
CHI
HQC
2004
MIPS
HQCA
CPSI
HCC
HQO
CSBE
NBHC
BCPSQC
THE PAST | 3
First academics, then journalists and policy makers, and ultimately citizens and patients begin to receive health quality information
CHSRF
2010
LKSKI
CADTH (1990)
CIHR
ISMP
RCPSC (1929)
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REPORTING TO THE PUBLIC
As part of Access to Care, the Ontario government mandate public reporting starting in 2008
Ontario Patient Safety Indicators and Public Reporting:
!! Clostridium difficile (C. difficile)
!! Methicillin-resistant Staphylococcus aureus (MRSA)
!! Vancomycin-resistant Enterococci (VRE)
!! Hospital Standardized Mortality Ratio (HSMR) – mortality rates
!! Rates of ventilator-associated pneumonia
!! Rates of central line infections
!! Rates of surgical site infections
!! Hand hygiene compliance among health
care
THE PAST | 4
!! Surgical Safety Checklist Compliance
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QUALITY REPORTING TO
CITIZENS: ECFA INDICATORS
THE PAST | 5 THE PAST | 5
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BEYOND GOVERNMENT
Government and health sector advancements
happened behind a backdrop of ever-expanding
information about health and disease for patients
THE PAST | 6
•! headlice.org
•! adam.com
•! WebMD
•! Wikipedia
•! Google Flu Trends
•! cancer.ca
•! heartandstroke.com
•! Diabetes and Me
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TODAY’S CITIZEN
Today’s citizens have access to information and are
able to make informed decisions
VALUE
QUALITY •! 8 indicators •! ECFA in first year of implementation
•! Better access to disease information
COST •! Mass LBP Citizen Reference Panels
ACCESS •! Full transparency on institutional
wait times & acute care procedures
•! ER in implementation, physician-level forthcoming
THE PAST | 6
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THE FUTURE THE NEXT DECADE IN CITIZEN
& PATIENT ENGAGEMENT
WILL FALK Executive Fellow in Residence, Health Policy & Public Sector Transformation, Mowat Centre
www.mowatcentre.ca
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VIRTUALIZATION IN
INSTITUTIONS
Growing prevalence of virtualization in Ontario’s health
institutions is changing how patients engage
THE FUTURE | 1
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VIRTUALIZATION OF PATIENT
NETWORKS
Patients are increasingly using social networks to
share experiences
THE FUTURE | 2
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Patients Like Me is a data-
driven social networking
health site that enables its members to share
condition, treatment, and
symptom information in
order to monitor their
health over time and learn from real-world outcomes.
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“Social media in healthcare
holds substantial promise,
including the construction of valuable information sprung
from collaboration, patient-to-
patient social supports, and
more sustained and
collaborative patient-provider relationships across the
continuum of care.”
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VIRTUALIZATION OF HOME
THE FUTURE | 3
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LOW COST ALTERNATIVES TO
HEALTH SPECIFIC SYSTEMS
THE FUTURE | 4
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LOW COST ALTERNATIVES TO
HEALTH SPECIFIC SYSTEMS
Next generation of devices
•!75% of US doctors now own an Apple device 75% of US doctors now own an Apple device
THE FUTURE | 5
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26% Reduction in physical visits in first 18 months of adopting virtual visits (Kaiser Health Affairs, 2009)
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THE FUTURE | 6
DATA LIQUIDITY IS NOW POSSIBLE (AND LIKELY IN CANADA)
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EMERGENCY ROOM
WAIT TIMES
THE FUTURE | 7
Health networks are developing mobile applications to communicate emergency wait times in many US and now some Canadian cities (Ottawa, Baton Rouge, Detroit)
•! Next generation systems will see real time updating using 311 data
•! Patients will have the information and partner with the health system by choosing sites of care
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INTEGRATED SOLUTIONS
THE FUTURE | 8
While these solutions will emerge as point solutions,
patients and consumers will quickly bundle and
integrate them as they organize their care
Pharmacists �
Virtual RN�
Connected Home�
Virtual MD Visits�
Phone Calls �Quality Reporting�
Access Reporting�
P2P Counselling� Telepathology�
TeleDI�