Promoting patient-centred healthcare around the world

PATIENT CENTRED
HEALTHCARE AROUND
THE WORLD
In association with

Primary Congress Sponsors

Patient-Centred Healthcare in Canada

2nd Global Patients Congress

Barcelona, Spain
February 22 24, 2006
Katharina Kovacs Burns MSc, MHSA, PhD

@Kovacs Burns, K Faculty of Nursing

Overview

Patient-Centred Healthcare in the Canadian

Context

Issue-driven Patient-Centred Healthcare What

needs to change; what is being proposed

Identifying Some Outcomes of change towards

Patient and Consumer Centred Healthcare

Identifying Ongoing and Future Needs

@Kovacs Burns, K Faculty of Nursing

Patient-Centred Healthcare in the Canadian

Context Some Legislative History

The Canada Health Act (1962); and 10 provincial

Health Acts, and three territorial Acts.
Patient/consumer Rights Canadian Charter of
Rights and Freedoms (Constitution Act, 1982) &
The Human Rights Act;
Achieving Health for All (Epp, 1986)
Romanow Commission on The Future of
HealthCare; & Kirby Commission (2004)
Health Protection Legislation (revised 2005)
@Kovacs Burns, K Faculty of Nursing

Canadian Context
Personal

patient level
Patient-physician level
Local/regional health care
Provincial health care
Federal health care

@Kovacs Burns, K Faculty of Nursing

WHO
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@Kovacs Burns, K Faculty of Nursing

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Connecting the Patient to all levels of Health

Care:
What Pt. Needs? Who provides it?

Physician

Private
Services

Federal/National
System

Regional Health Authority

Provincial System

@Kovacs Burns, K Faculty of Nursing

Main Issues For Patient-Centred Healthcare

in Canada Impacts at all levels:
1.
2.
3.
4.
5.

Access
Ensure capacity
Timely availability
for self-care &
Safety and surveillance
management
Costs and coverage
Patient and consumer engagement in decisions

@Kovacs Burns, K Faculty of Nursing

Issues regarding
Capacity of Self-Management of Disease

Move from patients being penalized to being center

of the Chronic Disease Care Model

Majority of Pts. are not empowered to make

choices based on traditional Medical Model

Medical Model to Primary Healthcare Model

emphasizes different early access points in health
care system patient initiates self-care

@Kovacs Burns, K Faculty of Nursing

Access Issue for Patient-Centred Healthcare

Reality : many pts. do not have access to all aspects

of healthcare system:
~ 6-10 million Canadians do not have access to
physicians
Doctors prescribe by what is available
20 different formulary listings across Canada
Lengthy wait times
Movement is towards
Primary Health Care Model
National Pharmaceuticals Strategy
Mixed public and private system to address waits
@Kovacs Burns, K Faculty of Nursing

Availability Issue for Pt.-Centred Health care:

Availability of safe approved drugs and other

medical products needs to be timely
Availability of healthcare services and hospital
beds needs to increase
Publicly funded services must always be there
(Canada Health Act)
Privately funded services are being
acknowledged

@Kovacs Burns, K Faculty of Nursing

Safety and Surveillance Issues Accountability &

Transparency in Patient-Centred Health care:

Surveillance system is disjointed

Different standards and definitions for
patient safety and surveillance
Accountability for patient safety who is
responsible for reporting any problems?
Need for broad transparency at all levels
Need broad education program at all levels

@Kovacs Burns, K Faculty of Nursing

Costs and Coverage Issues - Affordability

Issues:
20 different drug plans & coverage in Canada
public, private, out-of-pocket, combinations
6 million pts. have inadequate or no drug coverage
insurance (2000 data)
Canadians feel they are entitled to public drug
coverage
Catastrophic Drug coverage provincial formula
Being discussed within the National Pharmaceuticals
Strategy

@Kovacs Burns, K Faculty of Nursing

Patient Involvement/Engagement Issues

Patients/Citizens rights to be part of the

decision dialogues on health care policies

Smart Regulation (Privy Council of Canada)

Canadians to be involved in discussions
Office of Consumer & Public Involvement (Health
Canada, HPFB) Public Involvement Framework
(2005) work continues on this

Make no decisions without us voice of

patient and consumer groups
@Kovacs Burns, K Faculty of Nursing

Health Canada,2005

Health Canada, 2005

Outcomes
Development & implementation of a patient,
stakeholder, and public engagement
framework (Health Canada)
recognition for Transparency &
Accountability
Patient & citizen representation on Health
Canada advisory committees, strategic
planning discussions, others.
Improved communications amongst groups.

@Kovacs Burns, K Faculty of Nursing

Conclusion on Pt-Centred Healthcare In Canada

GOOD FIRST STEPS

PARTNERSHIP (Patient, stakeholder,

government, citizen groups)

FRAMEWORK for meaningful engagement &

discussion of health and health care policies

MORE NEEDS TO HAPPEN FOR EFFECTIVE

PATIENT-CENTRED HEALTHCARE & OUTCOMES

@Kovacs Burns, K Faculty of Nursing

CONTACT INFORMATION
Katharina Kovacs Burns, MSc, MHSA, PhD
Director, Research
Faculty of Nursing
CSB 3-114
University of Alberta
Edmonton, AB T6G 2G3
Ph.
(780) 492 3769
Email: kathy.kovacsburns@ualberta.ca

@Kovacs Burns, K Faculty of Nursing