In Canada we are in the midst of coronavirus\npandemic and all efforts deployed so far aim at mobilizing general public to\nlimit interactions and at mobilizing healthcare resources for anticipated\nincrease in admissions of very sick and critically ill COVID-19 patients. All\nthese preparations and disease management actions have forced a number of\ntransformative changes that we should be sustaining once life returns to new\n\u201cnormal\u201d. <\/p>\n\n\n\n
Although provinces and healthcare institutions\n(hospitals, long term care facilities, etc.) have had emergency and pandemic preparedness\nplans much of which has been built from the previous SARs outbreak in 2003 –\nnone of which has been tested to the extent forced by current coronavirus\npandemic. The unprecedented inflow of COVID-19 patients that require\nhospitalization and the impact of mitigation strategies to contain spread of\nthe virus has significantly stressed organizational functions and social\ncohesion. For many Canadians this may be the worst experience of a lifetime,\nbut ironically it might be the best experience in terms of leadership,\nresilience, collaborations and work commitment. <\/p>\n\n\n\n
Applying a management lens, we posit a number\nof positive transformational changes that might emerge from the efforts of containing\ncoronavirus pandemic.<\/p>\n\n\n\n
Canadian Medical Association in its 2019\ndiscussion paper on virtual care in Canada identified three main barriers to\nthis type of care delivery: compensation mechanism, licensure restrictions, and\nlack of interoperability between different systems. While coronavirus outbreak\ndid not alleviate last two, it removed a compensation mechanism barrier. With\nmost of the clinics closed and physicians advising patients by phone or using video\nconferencing platforms, OHIP introduced \u201cBilling Amendments to Enable\nDirect-to-Patient Video Visits and Modernize Virtual Care Compensation\u201d to establish\npayment structure for virtual patient visits. As many patients and physicians\nhave learned, it is not necessary for a patient to travel hundred miles for\nphysician\u2019s consult, when in many instances such a consult can be conducted\nwith patient staying at home. While this new \u201cnormal\u201d will most likely impact\npost-pandemic care delivery, let\u2019s hope that two remaining barriers will be addressed\nin a near future.<\/p>\n\n\n\n
Institute of Medicine in its discussion paper\npublished in 2012 advocated care delivery by interprofessional and\ninterdisciplinary teams as a pillar for modern and effective care. In response interdisciplinary\ncare teams were created for different disease sites, but true uptake of\nteamwork in the healthcare was uneven. Coronavirus pandemic changed all of\nthat. Effective containment and triage strategies required coordinated teamwork\nof family physicians, community nurses, population health specialists, and a\nnumber of clinical specialties. While such teamwork proved to be successful in\nthese extraordinary times, it is important that it is carried over after the pandemic\nsubsides. Thus, work around implementing Ontario Health Teams and creation of\nregional integration platforms for services should build on the best practices\nthat we have learned from the coronavirus response. <\/p>\n\n\n\n
One of the main factors hampering our efforts\nto effectively respond to the challenges of coronavirus pandemic is sparsity of\ndata and data gaps. We know how many people are tested positive but we do not\nknow how many people are infected; we know how many people have died but we do\nnot have complete picture regarding how many people have recovered. Different\nprovinces have different testing and reporting practices making any comparisons\neven more difficult. Current situation taught us that we need to be much more\naggressive in collecting data so our actions are evidence-driven. Having such\ndata, analytics and AI could be deployed to look for progression patterns,\npredictions for recovery, etc. An interesting example of innovative data use\ncomes from Kinsa (https:\/\/www.kinsahealth.co\/) – Health Weather Map (https:\/\/healthweather.us\/)\nthat shows peoples\u2019 temperature that was collected through Kinsa Bluetooth\nthermometers \u2013 and could be used to identify new hotspots of the virus earlier\nthan using data coming from regular testing. Experience of last couple weeks\nshowed that we need to speed up work at a population level so we have better quality\ndata for informed decision making. This also asks for leveraging patient data\ncoming from the hospitals\u2019 electronic health record and integrating it with the\npopulation health data. Foundations for such integration already exist and it\nis crucial that we move forward. <\/p>\n\n\n\n
The notions of resilience, agility, creativity\n\u2013 cornerstones of successful organizations \u2013 were always part of the vision for\nhealth system transformation. As the current situation evolves we rely heavily\non these attributes at a personal and organizational level when responding to\nthe COVID-91 crisis. We need to ensure\nthat they are embolden in the future of healthcare delivery. \n\nOur\nlives will be changed post COVID-19 outbreak and this change should build on\nthe positive lessons we have learned and some of them we outlined here. We will\ncome stronger as a society and as a health system for we are all in this\ntogether. \n\n\n\n<\/p>\n","protected":false},"excerpt":{"rendered":"
Health transformation in times of a pandemic<\/p>\n","protected":false},"author":41,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-771","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/posts\/771","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/users\/41"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/comments?post=771"}],"version-history":[{"count":0,"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/posts\/771\/revisions"}],"wp:attachment":[{"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/media?parent=771"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/categories?post=771"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.telfer.uottawa.ca\/thtex\/wp-json\/wp\/v2\/tags?post=771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}