Guest Editorial on Health Care Systems

Dr. Robyn Tamblyn, Scientific Director, CIHR Institute of Health Services and Policy Research

Imagine a future where patients tap into the power of the Internet to manage and improve their health as members of their own health care team … where health care providers welcome and integrate affordable innovations … where we learn about other countries’ best models of care delivery. This can be a reality.

In some ways, it already is. The University of Saskatchewan’s Dr. Debra Morgan recognizes that health care is a community exercise and that solutions for improvements must include patients and families. Her project – identifying the needs of rural dementia patients and their families – represents a major step forward in re-imagining care to meet individual needs. It embraces a community approach in which family members and caregivers become integral to patient care. It means working with community providers to understand the issues, and connecting patients, families and providers through telehealth solutions.

But we are just getting started. The Internet, patient portals, digitalized personal health records and mobile technology are creating new opportunities for more efficient support for home-based self-management and timelier access to care. Strategies such as e-visits with providers and the use of home-monitoring devices can strengthen the patient-provider partnership.

We can deliver better care to more people by deploying next generation “smart e-health applications” to leverage rich longitudinal patient and population-level health information and provide care that is timely, person-centred and evidence-based.

Adopting affordable innovation across the Canadian health care sector is also key to advancement. Innovations such as Kangaroo Mother Care, championed by Laval University’s Dr. Réjean Tessier, demonstrate that remarkable, cost-effective solutions developed in lower- and middle-income countries can be adopted for high-quality, sustainable Canadian health care. There are many other learning opportunities to optimize quality, safety, effectiveness and cost. Kenya, South Africa, and India have leveraged cutting-edge point-of-care technology and social media to prevent and manage chronic disease. These low-cost innovative solutions developed abroad are transforming health care for many populations and must be brought to Canada.

Another lesson to be learned from the global classroom is the importance of a rigorous approach to international comparative research. Learning about the best and adopting or adapting what is appropriate for the Canadian context can inform renewal and change. International comparisons of our health care system at the macro, meso and micro level create an incubator for change by facilitating a reassessment of traditional practices and approaches, enabling us to adapt and integrate novel technologies and solutions from other countries.

How can we capitalize on these opportunities to improve the health care system we have and inform the health care system we want? It will take dynamic collaboration, strong leadership, a solid commitment to the value of different forms of knowledge, and the creativity of multiple professionals and disciplines.

We can already imagine it … let’s create it.