primary healthcare innovations in canada are we heading in the right direction? marie-dominique...

Primary Healthcare Innovations in Canada

Are we heading in the right direction?

Marie-Dominique Beaulieu, M.D., MSc, FCMFPresident, College of Family Physicians of Canada

Objectives

• A realistic vision: highly performing primary care organizations

• A diagnosis: the current situation• Some actions: continuing the reforms

Highly performing primary care organizations

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The 10 pillars of the Patient’s Medical Home

• Patient-centered• Personal family

physician• Team-based care • Timely access• Comprehensive

care

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The 10 pillars of the Patient’s Medical Home

• Continuity• Electronic records

and health information

• Education and training

• System supports• Evaluation

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Overview of Canadian initiatives

CPGsAffiliation

GP Divisions

Primary CareNetworks

Physicians IntegratedNetworks

FHNFHGFHT

GMFCSSSCRI

Summary of reported outcomes• Patient-centered– More individuals

affiliated to a family physician

– Mixed impact on timely access

– Improved users’ satisfaction

• Efficiency– Positive impact on

quality for some chronic diseases

– More individuals receiving team-based care

– Improved work satisfaction

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Same-day or next-day access (Health Council of Canada, January 2013)

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Discharge summary of visits to ERs within 48 hrs (Health Council of Canada, January 2013)

New models: do they have the characteristics of highly performing PC systems? (CFHI, December 2012)

Characteristics of highly performing PC systems AlignmentPolicy orientation explicitly based on patient-centered care +++

Provincial/territorial/locoregional governance mechanisms +

Rostering of patients +

Interprofessional teams +++

Involvement of patients -

Funding and compensation modes aligned with objectives ++

Information Technologies and DME ++

Ongoing performance measurement -

Training and support for quality improvement +

Leadership development -

Coordination and integration +

Systematic evaluation of innovation +

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Some actions: continuing the reforms

• Vision of quality: commitment to access• Patients and care-givers involvement• Supporting quality– Information systems– Creating a culture of quality

• Leadership and regional/local governance

• Integration and coordination