Sunday, January 15, 2012

Wish granted! Saskatchewan's healthcare plan leads the way

My apologies to anyone who, over the weekend, asked me how work was going.  I probably talked your ear off about this exciting healthcare news: Saskatchewan's plan for transformation and innovation.

This is exactly what I was wishing for 2 weeks ago.

There is so much hope and potential packed into this brief press release that I've been savouring it all weekend.  Many points deserve comment, but for now I'll pick out a couple of doozies.

"Better care, better health, better value".  

Has the Triple Aim ever passed through the lips of the leader of a North American geopolitical unit? (Actually, yes.  Google says (key words "governor triple aim", "premier triple aim") Oregon Governor Kitzhaber (a physician) is a proponent of Triple Aim.  But still, it was a nice piece of hyperbole while it lasted...)

"All people are connected to a care team that includes a family physician".  

I don't want to read too much into this phrase, but I know that the people who write these speeches are mighty careful about their choice of words.  So, I see "care team" and "includes" (rather than "lead by") as significant.

"A five per cent decrease in the rate of obesity in children and youth"

This acknowledges that health care should not solely focus on high-tech, institutional "rescue care".  Tackling childhood obesity will involve all the social determinants of health, such as education, income, and social resources.  Can a tobacco-free Saskatchewan be far behind?

"All people will have access to a specialist and diagnostics within one week"

One week to see a specialist? That's a stretch goal.  And I want in on it!  As the release points out, other systems have achieved this already.  Again, the careful choice of words here doesn't say that a person necessarily needs to see the specialist in person.  They could have a telephone or videoconference consult, or their primary care team could consult with the specialist and then provide specialist-directed care locally.

But, words are cheap, and press releases are priced to clear.  What makes me think that this isn't just rhetoric in advance of the premiers' meeting this week?  I've heard similar lofty goals when Saskatchewan announced its Surgical Initiative.  Giving everyone the option to have their surgery within 3 months?  And making that change within 4 years?  Audacious!

But, as I've had the privilege to work with the patients, providers and administrators involved with the Surgical Initiative, I've seen an absolute commitment to achieving this goal.  Ideas for clinical innovation come from the front-line providers and patients.  Support and resources come from administrators.  Even after one year, the changes were impressive.

So, I'm excited about this new vision because of our track record so far.

You have been warned: Best to steer clear of this topic with me this week.  Unless you've got an hour or so to spare!

1 comment:

  1. I agree with the parts of the press release you've highlighted, Kishore. I too am excited about the opportunities to shift the focus of health care to the best way to care for people rather than continuing to equate care with visits to a single health professional. The promise of primary care teams with physicians is great. Accessing specialists in a timely way - also great. The promise of no waits for Emergency care concerned me however without us first significantly improving primary care. Without a redesign of primary care, with improvements to coordinating better with specialists, the Emergency wait time targets are unrealistic and may detract us from our focus on getting primary care right.