PricewaterhouseCooper (PwC) have recently published the citizen’s guide to improving Ontario’s healthcare system, entitled “Public Priorities for Ontario’s Health System”. A few weekend workshops led to 13 recommendations which are sensible and not at all unexpected for those who are already working and engaging with “consumers” of healthcare. Nonetheless, below are the 13 recommendations reposted from the Globe and Mail article.
1. Navigation
The health system is enormously complex and when patients are sick/injured/demented they are scared and needy. Chief among the needs of patients is having a navigator oversee their care and answer their questions.
2. Access and timeliness
Health care delayed is health care denied. The citizens’ panel says this is a priority but we need not throw more bodies at the problem. Rather, make better use of existing resources like nurse practitioners (particular in ERs), centralized specialist referral, etc.
3. Patients as partners
Patient-centred and family-centred care should be more than PR slogans; they require a cultural shift. “Patients need to be empowered as active and knowledgeable partners in the health-care process.”
4. Primary care
Access to primary care is inadequate and inefficient. Basic needs should be provided by nurse-practitioners in addition to doctors, and incentives should be offered to get practitioners into rural and remote areas.
5. System integration
Information-sharing and communication are mired in the Stone Age. The panel wants electronic health records now, and expansion of health information lines such as 211.
6. Information sharing and eHealth privacy
While eHealth records are essential, there needs to be assurances the data are secure. Patient records should also be freely available to patients.
7. Accountability and incentives
Our current payment methods reward volume not quality. The panel wants to see new funding models for health-care professionals that link compensation to measurable patient outcomes and patient satisfaction.
8. Community care
There is too much inappropriate hospitalization and institutionalization, particularly of elderly citizens. The panel wants to see a massive shift to community-based services.
9. Communication
Excellent communication is a hallmark of first-class care. But patients don’t always receive the information they need or understand.
10. Language barriers
In multicultural Canada, more needs to be done to serve patients in their first language. There also needs to be more plain language and less jargon.
11. Disease prevention and health promotion
Investment in prevention is inadequate. The panel says all sin taxes (alcohol and cigarettes) should be spent promoting healthy lifestyles. In particular, they call for mandatory nutrition and phys-ed classes for students in kindergarten to grade 12.
12. Pharmaceuticals
Access to prescription drugs is uneven, making treatment unaffordable for some. The citizens’ panel recommends a pharmacare plan, but one where drug costs are kept down with bulk buying and other measures.
13. Mental health and addiction
There is a need to reallocate funds to mental health, particular prevention programs and making addiction treatment more affordable.
