HSCI 305 Lecture Notes - Lecture 9: Electronic Health Record, Canada Health Act, Canada Health Infoway

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HSCI 305
DAY 9
November 9, 2017
Health Reform
- 40-50% background content research
- 40-50% options content evidence and according to crediable sources and my thoughts
- 5-10% recommendation content
- How to incorporate 3I’s and control knobs
o Background section
o What institutions are in place?
o Interests who’s involved, who cares?
“This one interest group will not be for this idea”
This institutional structure has to change in order to make this change
possible”
o Control Knobs
Use to access different policies
Evidence
Financing and why
- Double spaced
- Times New Roman
- Vancouver style references
- Include word count
- 2.5cm for all sides (standard margins)
In the news…
- Drug costs rising fast in Canadian health-care spending
o Rises $6,600 per person in Canada
- How bad teeth are at the root of income inequality in Canada
o Access to dentistry
o Want to include dental care to Canadian health-care
- Halifax doctor ties health-care woes to poor use of medical professionals
o Doctor shortages in Nova Scotia
- Kitchener’s Dr. Michael Lee-Poy recognized for transgender care work
o Co-developed TransEd program to help students provide quality care for
transgender patients
Picking up where we left off in the history lecture
Which of the following did not take place in the early 1990s (as described by Detsky and
Naylor):
A. The Federal government downloaded its operating deficit to the provinces and
municipalities
B. Population growth and aging contributed to a growing need for health services
C. The number of staffed short-term hospital beds decreased by almost a third
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D. There was widespread public perception of a physician shortage
E. Spending on homecare increased
Events since the Canada Health Act
- 1990s: Aggressive federal action to cut spending
o Detsky and Naylor provided an overview of this period
o This period is the source of many misconceptions that persist through to today
- 1995: Canada Health and Social Transfer single block funding mechanism through
consolidation of federal cash and tax transfer in support of:
o health care
o host-secondary education
o Socials services
o Social assistance
- 2002: Romanow and Kirby Reports
o Agree that Canada best served by a universal publicly funded health care system
o Urge federal gov’t to take a bigger share of the cost in order to promote change
Romanow Report
- AKA Royal Commission on the Future of Health Care in Canada
- Recommended sweeping changes
- Background to 2004 round of federal/provincial/territorial bargaining with an additional
$41 billion committed
Recommendations
- Set out 47 recommendations on topics including
- I’ll only list some in class.
Which of the following was not a recommendation of the Romanow Commission in 2002?
(No right answer because they are all recommendation)
A. A personal electronic health record for each Canadian
B. Expansion of the Canada Health Act to include medically necessary home care services
C. Expansion of telehealth approaches
D. Funding for Aboriginal health services provided by the federal, provincial and territorial
gov’ts and Aboriginal organizations should be pooled into single consolidated budgets
E. The federal gov’t should play a more active leadership role in international efforts to
assist developing nations in strengthening their health care systems through foreign aid
and development programs
Recommendations CHA
- Recommendation 5 The Canada Health Act should be modernized and strengthened by:
Confirming the principles of public administration, universality and accessibility,
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updating the principles of portability and comprehensiveness, and establishing a new
principle of accountability; Expanding insured health services beyond hospital and
physician services to immediately include targeted home care services followed by
prescription drugs in the longer term; Clarifying coverage in terms of diagnostic services;
Including an effective dispute resolution process; and Establishing a dedicated health
transfer directly connected to the principles and conditions of the Canada Health Act.
Recommendations Electronic Health Records
- Recommendation 8 A personal electronic health record for each Canadian that builds
upon the work currently underway in provinces and territories.
- Recommendation 9 Canada Health Infoway should continue to take the lead on this
initiative and be responsible for developing a pan-Canadian electronic health record
framework built upon provincial systems, including ensuring the interoperability of
current electronic health information systems and addressing issues such as security
standards and harmonizing privacy policies.
- Recommendation 10 Individual Canadians should have ownership over their personal
health information, ready access to their personal health records, clear protection of the
privacy of their health records, and better access to comprehensive and credible
information about health, health care and the health system.
Recommendations Rural and remote health services
- Recommendation 30 The Rural and Remote Access Fund should be used to attract and
retain health care providers.
- Recommendation 31 A portion of the Rural and Remote Access Fund should be used to
support innovative ways of expanding rural experiences for physicians, nurses and other
health care providers as part of their education and training.
- Recommendation 32 The Rural and Remote Access Fund should be used to support the
expansion of telehealth approaches.
- Recommendation 33 The Rural and Remote Access Fund should be used to support
innovative ways of delivering health care services to smaller communities and to improve
the health of people in those communities.
Recommendations Aboriginal health
- Recommendation 42 Current funding for Aboriginal health services provided by the
federal, provincial and territorial governments and Aboriginal organizations should be
pooled into single consolidated budgets in each province and territory to be used to
integrate Aboriginal health care services, improve access, and provide adequate, stable
and predictable funding.
- Recommendation 43 The consolidated budgets should be used to fund new Aboriginal
Health Partnerships that would be responsible for developing policies, providing services
and improving the health of Aboriginal peoples. These partnerships could take many
forms and should reflect the needs, characteristics and circumstances of the population
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