Hi Everyone, One of our questions from yesterday was around what the AMA is doing. I had a conversation with Shan, who is the Public Affairs Director at AMA. She sent me an e-mail with an update around the things AMA is focusing on. She also advised that with cabinet being up in the air, no one really knows what hot topic issues will come up. Successfully implementing the AMA Agreement is primarily about rebuilding trust between the parties. That will take some time, joint efforts and evident good results. Here are the key ways the agreement can help: System Wide Efficiencies and Savings: We will seek to improve equality, productivity and patient satisfaction through initiatives like an Alberta implementation of Choosing Wisely Canada. (Choosing Wisely seeks to encourage good conversations between physicians and patients about commonly requested treatment options and services that the evidence does not support and that may cause in fact cause harm.) Primary care: Primary Care Network Evolution lays the road to providing every Albertan with a medical home. The medical home (or health home as it is sometimes called) is the place where an individual receives all his/her primary care. It is also his/her entry point into the system for surgical or other specialist care and then the place where he/she will return when those episodes are finished. The medical home needs to exist in a complete system not just in the layer of primary care. From a medical policy perspective, it’s about integrated care with clear roles and responsibilities for patients and providers. Electronic medical records (EMRs): Alberta has been a leader in use of EMRs, but progress has stalled. Let’s make the most of our existing investment to generate the data we need to improve quality, safety and access. Physician compensation: Doctors are willing to change the ways in which we are paid to help advance system objectives. It’s not about more money but it can be about aligning how physicians are paid with the type of care they are delivering. Fee for service, alternative payment plans, blended payment models are all examples that may be appropriate in different situations. Modernizing the fee schedule to reflect new technology and other factors is also part of the picture. 3 Priorities What needs to happen next to move Alberta’s health care system forward? Physicians see three priorities: 1. Providers as stewards of the system and partners with government Estimates show that 80% of the costs in health care arise from decisions of physicians and other providers, in the form of infrastructure use and human costs for tests, services, procedures and other kinds of care. Physicians have a professional responsibility to act as faithful stewards of health system resources. We are eager to partner with government to make a better, more patient- and family-centered system. This can only occur with healthy relationships between government, physicians and all the health providers. The current level of engagement is poor and has been so for some time. Morale among physicians and other providers is very low for a number of reasons. Primarily, people don’t feel that they are being heard. All health care providers need to be properly engaged. Both sides need more than words about making a change. Physicians will stand with government as a partner and are willing to do things differently. However, we need to observe some visible action. For example, most other provinces recognize their respective medical associations as the agent of physicians by giving legislated recognition to the relationship between physicians and government. It would be a positive step to do the same in Alberta. 2. Patients as informed and engaged owners of the health care system Every health system on the planet today talks about patient-centered care. Everyone agrees that patients need to be involved and engaged in their care. Achieving this takes more than willingness. Patients need appropriate resources to be informed partners in their care. Examples include the kind of support that will be available through the medical home, quality of care initiatives like Choosing Wisely Canada, giving patients access to their own personal health information. They need to know the progress of their care and be in a position to seek further conversation for informed decision making. The data that patients receive must be delivered in a way that is relevant to them. 3. Integrated care flowing around a medical home for every Albertan Alberta has made a strong start toward a 21st century primary care system. There are 41 primary care networks (PCNs) in which physician-led, multidisciplinary teams are delivering -integrated primary care for millions of Albertans. The AMA’s PCN Evolution Framework (part of the provincial primary care strategy) lays out a plan for making a medical home available for every individual who wants one. The medical home must exist in a larger neighborhood. It’s not enough to limit the conversation to primary care. Patients flow from primary to secondary and tertiary care (i.e., surgery. diagnostics and other specialist services) and back again. We need to do a better job of linking that care to primary care. We need to coordinate with government and Alberta Health Services programs in health promotion and disease prevention, liaise with social services and more. Continuity and integration at all levels and among all the players will fill the gaps and smooth the patient’s informed travel through the system.
Posted on: Sat, 13 Sep 2014 01:38:12 +0000
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