A hard look at Ontario's health system


TORONTO, Oct. 23, 2017 /CNW/ - Measuring Up 2017 – Health Quality Ontario's 11th yearly report on the health of Ontarians and how the health system is performing – shows that people in the province are living longer and are losing fewer years of their lives to premature death.

The report contains other positive findings that show many parts of Ontario's health system are working well or better than before:

  • More patients are receiving cancer surgery within maximum wait time targets.
  • More people are getting high-priority MRI and CT diagnostic scans within maximum wait time targets.
  • Care for residents in long-term care homes is improving.
  • More people are being screened for colorectal cancer.
  • People are receiving primary care consistently from the same doctor.

However, Measuring Up 2017 also shows Ontario's health system still faces significant challenges, such as people having to wait too long for certain forms of care, not getting the care they need as they transition between parts of the system, or not having equitable access to care. The report identifies several areas where improvements in access, transitions and equity are needed:

  • More hospitals beds are occupied by patients waiting for care elsewhere.
  • Patients are experiencing longer delays when they need to be moved from the emergency department to an inpatient hospital bed.
  • People with a mental illness or addiction continue to face difficulties in accessing mental health care.
  • People who live in certain regions or have lower incomes sometimes have poorer access to health care.
  • Informal caregivers of home care patients are increasingly distressed.
  • Fewer patients are having surgery within target wait times for hip and knee replacements.

Compared to other provinces and countries, Ontario's performance is mixed. Ontario has the lowest rate of premature mortality of any province in Canada, and performs best or second-best in key aspects of long-term care. However, compared to 10 socioeconomically similar countries, Ontario ranks last in access to primary care appointments on the same day or next day when patients are sick, and in the middle of the pack when it comes to patients' ability to pay medical expenses not covered through private or provincial insurance plans.

"This year's Measuring Up report shows that the work done in Ontario to improve health system performance in key areas such as wait times for cancer patients and resident care in long-term care homes has clearly brought positive results," says Joshua Tepper, president and CEO of Health Quality Ontario. "The report also shows many challenges remain that need to be the focus of ongoing efforts to provide the best health care for all Ontarians."

Measuring Up 2017 also includes stories detailing the personal experiences of patients, caregivers and health care providers to illustrate the real-life impact of the health system on real people.

Quick facts

Findings in areas that are doing well or improving

  • The rate of potential years of life lost (in deaths before age 75) improved by 17.6% in Ontario between 2003 and 2013, to 4,221 years per 100,000 people, from 5,120. Ontario has the lowest rate of potential years of life lost among Canadian provinces.
  • The proportion of cancer surgeries completed within provincial maximum wait time targets increased overall between 2008/09 and 2016/17. Depending on the priority level of the surgery, the number of cancer patients who had surgery performed within target ranged from 78% to 93%.
  • Between 2012/13 and 2016/17, the proportion of patients who had their diagnostic scan completed within the provincial maximum wait time target increased to 82% from 79% for Priority 2 MRI scans, and to 96% from 92% for Priority 2 CT scans.
  • The proportion of long-term care home residents without psychosis who were given antipsychotic medication fell to 22.9% from 35.0% between 2010/11 and 2015/16, while the proportion physically restrained on a daily basis declined to 6.0% from 16.1%, and the proportion who experienced moderate pain daily or any severe pain fell to 6.1% from 11.9%.
  • The proportion of Ontarians overdue for colorectal cancer screening decreased to 38.7% in 2015 from 43.6% in 2011.
  • Among Ontarians who had at least three primary care visits to a physician within the previous two years, 57.3% had high continuity of care from the same doctor, 27.4% had medium continuity, and 15.2% had low continuity, in 2015/16.

Findings in areas that need improvement

  • An average of 3,961 Ontario hospital beds per day were occupied by patients waiting to receive care elsewhere in 2015/16. Those 3,961 beds were the equivalent of 10 large hospitals.
  • For patients who were admitted to hospital, the average length of stay in emergency increased 10.9% to 15.2 hours in 2016/17 from 13.7 hours in 2015/16.
  • Between 2006 and 2015, about a third of people who went to the emergency department for a mental health condition had not received mental health care from a primary care doctor or psychiatrist over the previous two years.
  • The rate of potential years of life lost was nearly 2.5 times higher in the area of the province with the highest rate – the North West Local Health Integration Network (LHIN) region – at 7,647 years per 100,000 people, than in the region with the lowest rate – the Central LHIN region – at 3,026 years per 100,000 population, during the 2010-2012 period.
  • Among urban residents, those who lived in the lowest-income neighbourhoods had the highest rate of being overdue for colorectal cancer screening in 2015, at 46.5%, while those who lived in the highest-income neighbourhoods had the lowest rate of being overdue, at 32.7%.
  • In the first half of 2016/17, among long-stay home care patients with at least one informal caregiver, 24.3% had caregivers who experienced continued distress, anger or depression in relation to their caregiving role, compared to 21.2% in the first half of 2012/13. That was a 14.6% increase over a four-year period.
  • In 2016/17, the proportion of patients who had Priority 4 knee replacement surgery within the wait target fell to 80% from 85%, so that 1 in 5 had to wait longer than the maximum wait target of six months. Priority 4 is the category of knee replacement with the greatest number of surgeries.

To read the full report visit: www.hqontario.ca/MeasuringUp2017

About Measuring Up
Measuring Up 2017 is Health Quality Ontario's 11th yearly report to Ontarians on health system performance. Its findings are based on data from a set of about 50 health system indicators, called the Common Quality Agenda, developed in association with health care experts and health system partners such as doctors, nurses, hospitals, local health integration networks and home care providers, as well as patients and their families and caregivers. This year's report highlights findings from 28 indicators.

About Health Quality Ontario
Health Quality Ontario is the provincial advisor on the quality of health care. With the goal of excellent care for all Ontarians, Health Quality Ontario reports to the public on how the system is performing, develops standards for what quality care looks like, evaluates the effectiveness of new health care technologies and services, and promotes quality improvement aimed at sustainable positive change. Visit www.hqontario.ca for more information.

SOURCE Health Quality Ontario

Digital Health Market Update: Entering a Next-Generation of Digital Transformation in Healthcare

Frost & Sullivan hosts a complimentary briefing discussing innovations in the digitization of healthcare

SANTA CLARA, Calif. August 8, 2017

Tuesday, 29th August 2017 at 1:00 pm EDT
On-line, with Complimentary Registration



Daniel Ruppar, Global Program Director, Digital Health, Frost & Sullivan

Digital health brings a diverse range of growth opportunities for vendors across the value chain. As the space evolves we have experienced a multitude of stepwise successes and stellar failures, yet funding continues to flood the sector. Major moves continue to come into the industry from the broader vendor environment, underlining the importance of health in everyone’s lives and progressively in strategic interests of the C-Suite across the ecosystem, from provider to payer to vendor organizations.

To attend the webinar, please click here or email Mariana Fernandez, Corporate Communications: mariana.fernandez@frost.com

“What is exciting about digital health is the continued progression of investment, innovation, the change in conversation, and the understanding of old and new stakeholders’ needs. The road for digital transformation in healthcare will be a long one, yet it is one where all kinds of great companies, innovators, payers, providers, and consumers want to be a part of, which shows the promise of this market,” explained Daniel Ruppar, Digital Health Global Program Director, at Frost & Sullivan.

Healthcare delivery is evolving throughout the continuum of care, creating both new drivers and challenges. Stakeholders must overcome the data and information hurdles leveraging progressive improvements in health IT to form the backbone of collaborative and unified patient care, across all environments and points of experience in the patient journey. New models, digital tools, data driven treatment decisions, and learnings from global markets all present opportunities to solve challenges currently faced in healthcare. The progression of topics like artificial intelligence (AI) in areas from hard analytics usage to consumer platforms, or extensive market discussions about the telehealth value in mental health, demonstrate that this transformation is in progress.

Join Frost & Sullivan in this webinar update showcasing a variety of different facets of the market and continue to learn why there’s something for everyone in digital health!

Attend this webinar to discover the latest trends on:

• Highlights in new findings on diverse digital health sectors, such as data analytics, patient engagement, hospital health IT including workforce management software, and sleep tech.

• Leading investment telehealth areas identified in Frost & Sullivan research in 2017, and the further value of telebehavioral health.

• Consumer digital health platform progressions and integration of artificial intelligence.

• Will Apple’s Activity and Watch changes truly make a difference?

• Future impact components, including the Internet of Medical Things (IoMT) and blockchain.

About Frost & Sullivan

Frost & Sullivan, the Growth Partnership Company, works in collaboration with clients to leverage visionary innovation that addresses the global challenges and related growth opportunities that will make or break today's market participants. For more than 50 years, we have been developing growth strategies for the global 1000, emerging businesses, the public sector and the investment community.

Physician leadership needed to transform health care

CSPL white paper calls for changes to increase physician involvement

Effective reform of the Canadian health care system cannot occur without the involvement and leadership of physicians.

That's the main conclusion of "Accepting our responsibility: a blueprint for physician leadership in transforming Canada's health care system", a white paper prepared by the Canadian Society of Physician Leaders (CSPL).

The document outlines actions that must be undertaken by individual physicians, the medical profession as a whole, health care organizations, and governments to bolster the role of physicians as leaders to help change the system.

"The current framework for creating and supporting physician leaders in Canada today is disorganized, episodic, and limited in scope," said CSPL past-president and study co-author, Dr. Johny Van Aerde.

"While there are examples of physicians being meaningfully involved in helping shape health care transformation and innovation in Canada, these examples are limited," said Dr. Van Aerde, who is also clinical professor of pediatrics at the universities of British Columbia and Alberta.

Findings in the paper are based in part on the first-ever survey of physician leaders in Canada conducted by the CSPL, in partnership with the Canadian Medical Association (CMA) and the Centre for Health Innovation at the University of Manitoba.

Among the findings from the survey of 689 physician leaders:

  • Many physicians take on a leadership role with no compensation or only a minimal stipend
  • Only 54% of physicians in formal leadership roles are compensated for pursuing leadership training or education
  • Only 39% said they were involved in innovative projects in their organization

"Organizational policies often exclude physicians from meaningful leadership roles, but the culture of medicine must change to acknowledge the responsibility of physicians to the system as a whole," said Dr. Van Aerde.

The white paper contains a number of recommendations to enhance physician leadership and improve physician participation in health care reforms, including the following:

What physicians should do

  • Explore and challenge their personal mental models and the world views that restrict them from engaging in the health care system and realizing their potential as leaders.
  • Be willing personally to participate in and champion efforts by colleagues to understand the reform agenda within their provincial health care system and the implications for their own area of responsibility.
  • Take steps to negotiate appropriate working conditions for physicians in a reformed health care system.

What health care service organizations should do

  • Make changes in organizational structure and design, jointly advocated by the organization and physician representatives, to alter policies and practices toward involving physicians in informal and formal leadership roles.
  • Use informal and formal communications approaches to ensure that physicians are aware of organizational issues and priorities and are able to respond and provide feedback on such issues.

What provinces and medical associations should do

  • Initiate negotiations to formalize and support regional and organizational efforts to realize effective physician leadership and engagement.
  • Work with universities and health research agencies, both provincially and nationally, to identify best practices; either conduct or gather research on the impact of various models of physician leadership and engagement; and share that knowledge widely with potential partners.
  • Provide financial support for physician leadership development and remuneration for physicians in leadership roles.

What Canada should do

  • The Government of Canada and Health Canada are encouraged to endorse the recommendations of the Advisory Panel on Healthcare Innovation and, in the spirit of human resource development, instill in the national innovation hub strong support for physician leadership development and engagement.
  • The Canadian Medical Association should develop a policy statement that recognizes the importance of physician leadership in health care reform and, through its subsidiary, Joule, reform and expand its existing efforts to increase physician leadership.
  • The Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, provincial colleges, and medical schools across the country should expand their efforts to embed leadership development in formal medical education and professional development.

"This paper is the first step toward improved physician engagement and leadership in the Canadian health care system," said Dr. Becky Temple, president-elect of the CSPL. "We are asking all stakeholders to initiate a dialogue and take action to support physician engagement and leadership in the context of their own organization or setting."

"The thoughtful and encompassing white paper from the Canadian Society of Physician Leaders is a valuable document, showing the way to the overdue health care reform urgently required in Canada.  The paper acknowledges the essential leadership of physicians in health system design and management at all levels, while also focusing on the required collaborative approach to system improvement.  Only by working in partnership with all stakeholders in the health care system may we expect to develop sustainable and high quality care," said Canadian Medical Association president Dr. Granger Avery.

"The document acknowledges the important step taken by the Royal College of Physicians and Surgeons of Canada in changing its basic framework for medical education (CanMEDS 2015) to acknowledge the role of physician as 'leader'," said Dr. Andrew Padmos, president and CEO of the Royal College. "We agree with the CSPL that every physician is a leader and leaders can and should be found at all levels."

"Family physicians can be leaders, both in their local communities and at the national level," said Dr. Francine Lemire, executive director and CEO of the College of Family Physicians of Canada. "This white paper provides the rationale for all family physicians to consider taking leadership roles."

About the Canadian Society of Physician Leaders (CSPL)

The Canadian Society of Physicians Leaders is the "go to" organization for physician leaders. Since 1998, it has been providing support and development opportunities for Canadian physicians to help them succeed in their leadership and management roles in health care. The CSPL, with Joule (a CMA company), hosts the only annual meeting in Canada dedicated specifically to physician leadership.


SOURCE Canadian Society of Physician Leaders

For further information:

or to arrange an interview: Carol Rochefort, Executive Director, Canadian Society of Physician Leaders, 875 Carling Avenue, Suite 323, Ottawa ON, K1S 5P1, 613 369-8322, carol@physicianleaders.ca

Long wait times make destination healthcare attractive to Canadians

Seeking quality treatment outside of Canada is a viable option with no wait times

Wait times for medical procedures are at a 20-year high in Canada. Accessing private medical treatment for non-emergency procedures IS a viable option for Canadians.  Safe, high-quality, private care is available to Canadians immediately at an affordable price.

"Canadians are becoming frustrated with unreasonably long wait times and lack of access to the care they need," states Nicola Banks, founder of Health City Canada, the Canadian office for Health City Cayman Islands. Health City Cayman Islands sees an average of 20 Canadian inquiries every week and have performed many joint replacement surgeries on Canadian patients, all of whom are back home and recovering well. "Patients should be aware that there are private options available outside of Canada and that suffering is not acceptable," adds Banks.

The practice of Destination Healthcare – also referred to as Medical Tourism – is becoming a fast-growing global industry. In the past year alone, the number of Canadians who left the country to receive medical treatment is in the tens of thousands. The accreditation standards and practices continue to evolve, empowering potential patients to seek affordable, high-quality care.

"The fact that we are only 6 days into corresponding with each other, and have made a determination and scheduled a surgery date, is way beyond our expectations,"  says the daughter of a current patient.

Health City Cayman Islands, a state-of-the-art accredited hospital, set up a dedicated Canadian office in 2016 to better serve the Canadian marketplace. "Our priority is to inform Canadians of their options when they feel there are none," says Banks. "Many inquiring patients are frustrated to the point of feeling desperate." As cited in a recent report by the Fraser Institute, long wait times can have a significant negative impact, beyond merely frustration for patients, such as increased pain, suffering, and mental anguish.

"In a perfect world, we would be able to meet the demands of Canadians needing surgery here in Canada in a timely manner," said Canada-based anaesthesiologist Dr. Cynthia Horner. "Given our current climate, this is becoming more difficult and Canadians are choosing to look for other options."  

Based on the philosophy that a patient's medical journey starts – and continues – at home, Banks and her Canadian team of physicians are dedicated to optimize continuity of care for Canadians, and inform Canadians on how to access high-quality, affordable healthcare in a timely and safe manner.

About Health City Cayman Islands
Health City Cayman Islands provides compassionate, high-quality, affordable healthcare services in a world-class, state-of-the-art, patient centred environment.  Health City Cayman Islands delivers excellence in adult and paediatric cardiology, cardiac surgery, cardiac electrophysiology, medical oncology, orthopaedics, sports medicine, paediatric endocrinology, gastrointestinal and bariatric surgery, cosmetic surgery, neurosurgery, minimally invasive spine surgery and pulmonology services.

SOURCE Health City Canada

Endangered But Not Extinct: A Doctor That TRULY Listens

Alicia Bell - Fitness Expert

What if we were to compare a typical visit to the doctor with a visit to your favorite local business:  your hairstylist, banker, or real estate agent? If you regularly see these local professionals who have become a fixture in your schedule, then you have trust in their professional wisdom.  I bet they spend some “quality” time with you -- making eye contact, perhaps a bit of small-talk, and even sharing some family updates. Usually, you would not feel rushed, and you may even enjoy the encounter.

In the world of healthcare, which requires intimate professionalism, you would, at least, expect that the same basic premise of the business/client relationship would apply. For example, you would not expect your accountant to see you (as his 65th client of the day) and still be able to address all of your needs in 15 minutes. Likewise, you would also not understand if your mechanic scheduled you to drop your car off at 2:00, but still required you to wait 2 hours before spending only 7 minutes with the car -- meaning yours most likely would not be adequately repaired.  As well, you might move on to a new hairstylist if you had to wait more than 5 weeks just to have a basic haircut. And, when you did finally make it to the chair, I would expect that you would walk out if there were a computer that the stylist insisted typing on, with full attention to it, instead of you. The sad reality of our insane healthcare system is that we have come to expect and accept all of these behaviors in our appointment experiences with our healthcare providers.

“Wall Street”-style medicine ran by health insurance companies and executive CEOs without medical training has gradually taken over the reins of clinic management in all specialties. The quality of a patient encounter is currently based on factors that have little to do with the relationship between a doctor and a patient. Instead, measurable “metrics” are stressed which press the efficiency of the provider to get from room to room. Incentives are provided with increased pay to those providers who are able to force-fit more patients into their schedule. The administrative work generated from each visit from inefficient computer-based electronic health records keep the provider’s head down and attention distracted, so a personal conversation with real connection is virtually non-existent. The doctors who agree to work in this environment are not able to bring their compassionate selves to the visit with their patients due to the pressures of being a human calculator at warp speed to fulfill the demands from management.

So, how do you find a good doctor in the fast-food-style industry that healthcare has become? There are indeed some standing supporters of authentic, empathic doctors that doggedly retain the art of medicine in their practice. They are no further than your local towns, but you do have to look for them. Just as health food stores are not as populated as fast food restaurants, it might be a bit of a worthwhile hike to find a doctor who strives to make an empathic bond with each patient. In order to practice the type of medicine that is not dictated by insurance companies, some may have creative fee structures. But, those who truly care about the health of all most likely will have charges that agree to your budget, and often have ways you can be reimbursed by your insurance company if they are not under your coverage umbrella.

Why should we seek a doctor that “listens” to us? The truthful answer is that a problem is uncovered and often solved in a setting of a trusting relationship. The bond of empathy forms a connection that “plugs” the physician and the patient into a higher level of communal problem solving, together. Science has proven that compassion helps to restore a sense of peace and a resting state, as well. This  “dose of ease” is often what we all seek in solving problems or curing any disease state -- from ulcers to high blood pressure, and much more.  When there is a release of strain, body systems are able to shut off the frantic “fight or flight” modes that exhaust our body’s systems. In the sacred relationship between a patient and physician, the gears of natural healing and hope can begin to engage. Fear can be put to rest for peace of mind, and the collaborative, open space for discussion can mean that understanding and clarification can take place. This is not too much to ask for in your next visit with your healthcare provider.

In my book, “Discovering Your Own Doctor Within,” I include real patient stories that delve deep into what is possible when there is a commitment to listening with an open heart.  No metrics, no computers, no rush…  The ability to hone laser-like attention into deeper sources of symptoms arises naturally and easily. Often, when a person is truly heard, he/she begins to share clues that surprise even them. This saves money on unneeded procedures. More importantly, it also gives us hope that the human side of medicine is still maybe only endangered, but not extinct.


About the author
Dr. Amy E. Coleman is the CEO and founder of Wellsmart, a company that cultivates technologies and healthcare strategies that strengthen the patient/doctor relationship. She served as a United States Air Force flight surgeon, and was appointed the youngest and first female Commander of the U.S. Air Force Special Operations Clinic. There, she helped guide global medical missions and build creative clinic systems, including those employing complementary care methods still employed today throughout the Air Force.


Dr. Eric Hoskins, Minister of Health and Long-Term Care speaks at the NPAO Annual Conference. (CNW Group/Nurse Practitioners' Association of Ontario)
Dr. Eric Hoskins, Minister of Health and Long-Term Care speaks at the NPAO Annual Conference. (CNW Group/Nurse Practitioners' Association of Ontario)

Minister Hoskins affirms his $85 Million Funding Commitment to Primary Care Teams over the Next Three Years

TORONTO, Sept. 23, 2016 /CNW/ - Nearly 4 million Ontarians are now being served by inter-professional health care teams such as Community Health Centres, Nurse Practitioner Led-Clinics, Aboriginal Health Access Centres and Family Health Teams. However today, nearly 1 million people in Ontario are still unable to find a nurse practitioner or family physician for regular health care.

Minister Hoskins reaffirmed the government's commitment of $85 million in team-based primary care at Nurse Practitioners' Association of Ontario's 43rd Annual Conference held in Toronto today. This commitment is retroactive to April 1 of this year, and includes increases in benefits and wages. The Minister stated that the money is expected to flow within weeks.  It is among his key results highlighted in his Mandate letter received today from Premier Wynne.  Implementing this commitment will be vital to the Minister's ability to fulfill his renewed mandate to ensure that everyone in Ontario who wants a primary care provider is able to access one.

"On behalf of the people we serve, this investment is critical," says Theresa Agnew, NPAO Executive Director. "It means patients won't end up in an emergency department unnecessarily or a walk-in-clinic. Primary care is the front door of the health care system. This will stop it from becoming a revolving door by ensuring continuity of care, recruitment and retention of staff. Ontarians will receive primary care in their own communities by the right health care provider at the right time close to home. It puts patients first."

"This new funding demonstrates government's commitment to strengthen primary care as the foundation of Ontario's health system," says Angie Heydon, CEO, Association of Family Health Teams of Ontario. "This funding is an urgently-needed first step toward putting interprofessional primary care teams onto more equal footing, to attract and keep the skilled professionals needed to deliver better care, better health and better value for Ontarians."

"We are very heartened that the Government is stepping in the right direction to correct a serious imbalance in improving access to interprofessional primary health care.  This funding is crucial to enable Ontario to do a better job ensuring people who face barriers to health can access the services they need from interprofessional teams." says Adrianna Tetley, CEO of the Association of Ontario Health Centres.

NPAO is the professional voice for 3,000 Nurse Practitioners in Ontario. Our mission is to achieve full integration of Nurse Practitioners to ensure accessible, high quality health care for all.

AFHTO provides leadership to promote high-quality, comprehensive, well-integrated interprofessional primary care for the benefit of all Ontarians. It is the advocate, resource and network for 181 Family Health Teams and 5 Nurse Practitioner-Led Clinics, and welcomes all who provide interprofessional comprehensive primary care in Ontario.

AOHC is Ontario's voice for community-governed primary health care.  It represents 108 community-governed primary health care organizations, including Ontario's Community Health Centres, Aboriginal Health Access Centres, Community Family Health Teams and Nurse Practitioner-Led Clinics.