Systemic changes to the health care system are the only long-term means of ensuring that Canadians aren't forever queuing up for medical procedures once the current $5.5-billion fund to fix wait-time problems runs dry, Federal Advisor on Wait Times Dr. Brian Postl says.
One-time money spent ramping up volumes to resolve wait lists for select procedures is but a short-term solution to the problem of queues, the chief executive officer of the Winnipeg Regional Health Authority said in an interview. “Eventually, the money runs out and you haven't bought change.”
In his final report to the government, released June 30, Postl argues “a transformation that puts patients at the centre of the system” is in order if wait times are to be ultimately reduced.
Among requisite elements of the recommended transformation:
• more use of common, regional wait lists, rather than lists kept by individual doctors;
• prioritization of patients by acuity and concomitant slotting into first available slots of intervention;
• a $2.4-billion/5-year outlay for health-related information technologies;
• system-wide electronic health records to give health professionals “current and accurate information on which to base a diagnosis or treatment decision”;
• digitalization of diagnostic images;
• electronic patient registries;
• provincial Colleges of Physicians and Surgeons monitoring of “professional practice with respect to physician management of wait times”;
• appointment of a provincial wait time “champion” to coordinate the response of regional health authorities and institutions, as well as develop and disseminate best practices within a national network;
• identification of additional priority areas in which benchmarking is necessary.
The latter recommendation stems from concerns that so-called “Cinderella diseases” that weren't targeted by the nation's health ministers in the 2004 First Ministers' 10-Year Action Plan to Strengthen Health Care to reduce wait times in 5 priority areas (cancer, cardiac, diagnostic imaging, joint replacement and sight restoration) are now being starved out by the focus on those conditions.
There's “anecdotal evidence” that wait lists are now longer for some procedures than they once were because of the focus on the 5, as human resources are poured into those conditions, Postl says. “So if you're in a region or province that may have a shortage of anethesia, for example, and you're cranking up your cardiac and hips and knees, do you divert your anesthesia resource into those areas and does that mean it comes from some other area, which creates a longer waiting list? It's something we have to keep tabs on, because I'm not sure the Canadian public sees the exchange of waiting lists as a positive thing.”