The Challenges Facing the Health System
Already manifesting itself on various fronts, there is an emerging crisis in North America’s healthcare system. Precipitated by the convergence of escalating costs, growing demand and aging infrastructure, the healthcare system is scrambling to develop strategies to meet the challenges posed by this rapidly rising tide.
Just some of the challenges we face:
- Access to care particularly in rural and northern regions
- Prevention and management of chronic illnesses
- Supporting an aging population
- Aging healthcare human resources and physical infrastructure
Access to Care
According to the 2010 Commonwealth Fund International Health Policy Survey1 65% of Canadians surveyed found it difficult to access healthcare after hours. This led to the finding that Canadians make more visits to emergency departments (44% having visited one in the past two years) than any other country surveyed* In fact almost half the Canadians surveyed (47%) stated that the care they received could have been delivered in their usual primary care setting if that had been available. This is instructive given that only 45% stated that they could get in to see their family physician on the same or next day when they are sick.
*(Australia, Canada, France, Germany, The Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States).
This situation is exacerbated in rural and northern Canada due to the geographic distances involved and the difficulty that the various jurisdictions have in recruiting and retaining healthcare providers in these regions.
In Canada alone, over $200 Billion2 is spent on healthcare annually representing 37.8% of total provincial and territorial spending.3 The most prevalent chronic diseases (Cardiovascular Disease, Diabetes, Chronic Obstructive Pulmonary Disease and certain types of Cancer) are responsible for 42% of this amount or approximately $84 Billion4. Costs associated with loss of productivity and other factors could increase the total financial impact of chronic illness to more than $150 Billion annually. The financial impact alone does not tell the most important part of this story. It is estimated that over 16 million Canadians live with some form of chronic illness and as we age many of us have more than one problem. Another confounding issue is that up to 50% of people with chronic conditions are not diagnosed and up to half of those that do get a diagnosis do not receive or adhere to evidence-based treatment. In fact in the 2008 Canadian Survey of Experiences with Primary Health Care, 40% of respondents with one or more of the seven selected chronic conditions stated that they did not make a treatment plan with their health care provider during the past 12 months5.
The good news or at least something that might provide us with some hope is the fact that many chronic illnesses can be mitigated and perhaps even prevented by changes in lifestyle. However, as you can see below in many cases Canadians have a long way to go.
|Risk Factors||Average Incidence in Canada|
|Obesity and Over Weight|
|Meet recommended physical activity||15%10|
Sykes Assistance Services - Telehealth Solutions
Sykes Assistance Services has been providing clinical telehealth solutions since 1997. Our services include symptom assessment and referral, hospital patient flow, health information, primary care support, chronic illness support, and wellness and prevention programs (e.g. tobacco cessation) providing evidence-informed, accessible healthcare designed to improve lives and save money.
Scalable, flexible, streamlined and multi-channel, our services integrate the latest communications and medical device technologies with best practices in evidence-based clinical practice and customer relationship management (CRM) to deliver improved outcomes for our stakeholders.
The Right Technology
We provide a comprehensive suite of telehealth services and tools such as contact centres, helpdesks, live chat support, Interactive Voice Response/Recognition (IVR), text, email, web sites, remote monitoring, and social media.
Demographically-appropriate platforms such as text messaging for teens and young adults, and social networking tools with which patients of all ages are becoming increasingly comfortable are being used to “close the gap” in terms of both service and distance.
A Careful Balance of Accessibility and Privacy
As technology evolves, so too will the ability to monitor patients more closely. There will be more sophisticated, simpler and less costly tele-monitoring devices. Patients will be able to upload their health data into their physicians’ electronic medical records (EMR), and patients may have their own electronic personal health records. Concurrently, Sykes Assistance Services is ensuring that secure networks meet the increasing need to protect the personal health information of our users. Each new service is supported by a security and privacy impact assessment to ensure that each program meets or exceeds the requirements of Federal and Provincial privacy legislation. Our staff is trained initially on their role in protecting and advocating for the individual’s right to privacy with additional annual refreshers to ensure that privacy is embedded into the culture of Sykes Assistance Services.
Ensuring Clinical Excellence
In keeping with our exacting standards of excellence, we recruit only highly qualified clinicians and support personnel. Our clinical staff place the healthcare needs of patients at the forefront, ensuring the highest possible standard of evidence-based care at every contact.
Extensive personal and professional development, specifically designed to deliver improved care and customer satisfaction, is required of all staff working with us. Our clinicians are provided rigorous orientation to tele-practice, supported by individual mentors and ongoing coaching to assure a safe evolution from novice to mastery.
Quality assurance and continuous quality improvement are at the core of what we deliver. Our pioneering approach to operational excellence has allowed us to match the best practices of customer relationship management with evidence-based clinical practice.
Sykes Assistance Services has embedded continuous process improvement into the culture of the organization. Our five step Continuous Improvement Process—Define, Measure, Analyze, Improve, and Control—underlies all of our performance analyses and improvement recommendations. We have implemented Lean and Six Sigma continuous process improvement using tools such as value stream mapping, A3 Plan-Do-Study-Act cycles, root cause analysis and Kaizen events. The fusion of Lean and Six Sigma works particularly well in healthcare because of its emphasis on customer/patient value. By eliminating waste and improving value, one can reduce costs and improve patient satisfaction and loyalty.
High Touch Patient Care
Every interaction that we implement has elements of best practice communications, behaviour change and support – delivered in a thoughtful balance of high-tech and high-touch patient care. While the technology of telehealth enables the right provider to be available at the right time; it is the competencies and communications process used by the healthcare provider that makes the difference in patient outcomes.
We view the concept of telehealth coaching in its broadest sense:
- If we are supporting a scheduling service, our callers or users will have a different experience than if they called another program. They will feel cared for and at the centre of the process - not someone being shuffled through the system and treated like a number
- If we are performing triage, we build a relationship with the callers so that they see the process as a journey taken together. They feel empowered and are more likely to follow the advice provided because, in effect, they were part of the decision itself
- For Wellness and Disease Management clients, we carefully consider the whole person and all other aspects of their life situation. Through the use of motivational interviewing, cognitive behavioural counselling, and social learning processes, our professionals help our clients to envision, commit to and achieve lasting, positive health behaviour change
1. Health Council of Canada. (2010). How Do Canadians Rate the Health Care System? Results from the 2010 Commonwealth Fund International Health Policy Survey. Canadian Health Care Matters, Bulletin 4. Toronto: Health Council of Canada. www.healthcouncilcanada.ca
2. Davis, Karen: Mirror, Mirror on the Wall; How the performance of the US Health Care System Compares Internationally. (Commonwealth Fund, 2010), 21
3. Canadian Institute for Health Information, National Health Expenditure Trends, 1975-2011 (Canadian Institute for health Information, 2011).
4. Mirolla, Michael; The Cost of Chronic Disease in Canada (2004, The Chronic Disease management Alliance of Canada), iii). csmonitor.com/USA. “New health care bill pros and cons: Will it cut costs?” Accessed 12/23/10.
5. Helping Patients Help Themselves: Are Canadians with Chronic Conditions Getting the Support They Need to Manage Their Health?; Canadian Healthcare Matters Bulletin 2, January 2010 pg.4
6. Tjepkema M, Sheilds M. Nutrition Findings from the Canadian Community Health Survey – Overweight Canadian children and adolescents. Statistics Canada 2005 (accessed July 2012)
7. Wilkins K, Campbell NRC, Joffres MR, McAlister FA, Nichol M, Quach S, et al. Blood pressure in Canadian adults. Health Reports 20(1):1-10.
8. www.heartandstroke.com / statistics (accessed July 2012)
9. Health Canada. Canadian Tobacco Use Monitoring Survey 2006. Ottawa, 2007
10. Rachel C. Colley, Didier Garriguet, Ian Janssen, Cora L. Craig, Janine Clarke and Mark S. Tremblay: Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian Health Measures Survey