- © 2007 Canadian Medical Association or its licensors
One-quarter of family physicians in Saskatchewan have volunteered to participate in a groundbreaking initiative to implement best practices in the treatment of diabetes and coronary artery disease.
After one year, the Chronic Disease Management Collaborative reports an increase in the number of patients receiving the recommended drugs, tests and services, and a decrease in the time they wait to see their family physicians. For example, the number of patients with diabetes receiving annual kidney screening jumped from 48% to 68%, and the number of patients receiving antiplatelet therapy for coronary artery disease rose from 73% to 82%.
In one family practice in Saskatoon, the wait time for an appointment dropped from 17 to 3 days and a backlog of 100 annual check-ups was cleared in 5 months.
“It is clear that these efforts are helping to turn the tide on chronic disease in Saskatchewan,” said Dr. Ben Chan, CEO of the Health Quality Council, an independent agency of the provincial department of health. The council is using a collaborative approach to set benchmarks and share effective strategies among 73 family practices across Saskatchewan, involving 216 family physicians, 400 other health care professionals and more than 12 000 patients.
“There isn't a collaborative initiative across the country of the scale that we are doing in Saskatchewan, and we were purposeful about that scale because we wanted to reach the tipping point. We wanted to go big,” said Bonnie Brossart, deputy CEO of the Health Quality Council.
Representatives of each family practice attend 4 workshops during the year where they “share nuggets of what works and what doesn't work, and through that sharing, we're seeing a rapid improvement in results,” said Brossart.
Patient data is entered into an electronic toolkit that lists the recommended best practices for each disease and tracks implementation. This Web-based toolkit allows physicians to create flowcharts, measure progress, create reports and share information electronically with other health professionals, patients and the council.
The workshops were held in 2 stages during 2005–06 and 2006–07; data presented here are based on the first wave.
“In Saskatchewan, we have a shortage of physicians so you're always overworked and acute patients take up much of your time,” says Vino Padayachee, a family physician from Estevan and chair of the Chronic Disease Management Collaborative. “We're making a concerted effort to bring chronic disease into the forefront. We will save money and time in the long run.”
Padayachee says the Saskatchewan Medical Association is working with the provincial government to increase physician fees for chronic disease management.
To qualify, physicians will be required to follow best practice guidelines and document the results.