TORONTO, Oct. 23, 2017 /CNW/ - Measuring Up 2017 – Health Quality Ontario's 11^th 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 11^th 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.

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.

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.