How we can improve on Care Outcomes for People with Multiple Chronic Conditions?

The Health Council of Canada’s has just released the third bulletin in their Canadian Health Care Matters series and this report deals with patient-provider interactions in chronic illness care. Some of the report’s findings are very interesting: people with chronic health conditions are more likely to rate their care as “excellent” if their doctor knows their history and helps to coordinate their care. Of all the countries surveyed, Canada had the highest rate (69%) of respondents with a primary care provider who knew their history and offered care coordination. On the whole, Canadians with this type of care arrangement were more likely to get recommended routine test to monitor their conditions, were more likely to have assistance in managing their situation, were more likely to have their medications reviewed and to have a nurse practitioner involved in their care. It is no surprise that the report showed team-based care to be particularly effective for people with chronic conditions. A supportive and coordinated team of doctors, nurses, pharmacists and other professionals such as social workers and dietitians makes it easier for patients to get the services they need and increases opportunities for providers to focus on wellness, prevention, and patient education. In May 2009 the Health Council of Canada released a report on healthcare teams (HCTs) that attempted to evaluate how far we had progressed towards the goal outlined in the 2003 Health Accord to have 50% of Canadians treated by HCTs by 2011.

We decided to take the public pulse by administering our own detailed poll. CARP members answered in droves; over 5800 of you responded. Despite this excitement, respondents had little faith this goal would be accomplished: only 9% of respondents thought the 2011 target would be met. The Health Council Report found that 34% of Canadians were already using primary HCTs but our polling revealed that only 17% of CARP members had access to such care.

To read a detailed analysis of the CARP Health Care Team Poll, please click here

Perhaps the reason behind the slow progress in this area can partially be blamed on our slow adoption of electronic health records. These records are recognized as an essential tool to coordinate care, particularly for patients with chronic conditions who may see a number of professionals (as would be the case with Canadians using primary HCTs). In this area Canadians need improve: of the eleven countries surveyed we were dead last in electronic medical record use (only 37% of family doctors use electronic medical records). Leaders in this area included the Netherlands, New Zealand, Norway, the UK. Australia, Italy and Sweden who all had 90%+ adoption rates. This demonstrates that despite the E-Health debacle, governments must press onward and make e-health a reality.

Electronic Health Records Use

The report concludes with some helpful questions you can ask yourself if you are a Canadian with a chronic condition:

Does my doctor always know important things about my medical history?
Does someone in my regular family practice help to coordinate other aspects of my care?
Does my doctor work with other professionals in a primary health care team? Should I be getting team-based care?
Should I ask my doctor about these things on my next visit?
Am I missing out on the benefits of these and other elements of patient-centered care?

A full PDF copy of the report is available here here.

Keywords: healthcare, caregivers, doctors