When I was on a home visit just last month, I met Anna, a 90-year old Italian nonna who is fiercely committed to remaining at home, despite her declining health and mobility. She’s no longer able to garden like she used to but there she was on the front porch, basking in the sun beside a lone tomato plant in a pot with a sprig of fresh basil.
Like each of us, Anna is one-of-a-kind and her health care should be too. We need to listen, learn and tailor care to each individual. At the same time there are some universal themes. People want to live at home, they want to be well cared for and respected, and they want services that fit their needs and lives.
Ontario’s Patients First agenda provides us with an amazing opportunity to move forward. Granted, the changes are ambitious for a health system that is as large as it is complex. While much of the hard work is still ahead, some levers for change are in place.
Home care specifically is getting a lot of attention, and for good reason. It is less costly than hospital care and can consistently deliver healthy results while allowing people to be in the comfort of their own homes.
To achieve success in home care, we must move away from paying for services on a per visit or hourly basis. Patients are diverse and have different needs, even when they are dealing with the same health condition.
Under new models of funding, such as bundled care, organizations are paid not for specific services but based on the number and type of patients they care for, the quality of their care and the results they achieve. This gives health professionals more freedom to work directly with people to understand their individual needs and provide the most appropriate care and services.
With staffing shortages and an aging workforce, it is time to simplify home care. We can make the most of the talent we have by allowing health professionals to use all of their skills and knowledge in caring for people. Using the example of chronic disease, this would include meeting current needs as well as anticipating and preventing future problems. When teams are empowered to focus on patient care and are responsible for the process and results, they organize themselves.
Countries, like the Netherlands, which have adopted this approach are seeing 100-per-cent patient satisfaction rates, significant cost savings and more satisfied employees.
Given the level of health spending, taxpayers and citizens want to know how well the system is working – and so they should. This does not need to be costly and complicated. There is a lot of data such as improvements in health status and patient satisfaction that can be reported and analyzed in an automated way. The results we are measuring should be useful and made widely available in more user-friendly formats to help people understand their choices and make good decisions.
We can meet the needs of people, caregivers and communities with more emphasis on direct patient care, more interaction between clinicians, and more specialized services for the vulnerable. Finally, innovation of all kinds – particularly social innovation centred on new approaches to addressing societal challenges like homelessness, end of life care and family caregivers – is essential.
Today, the health care system is poised for change; let’s hope it happens, because the world around us isn’t waiting. In virtually every industry, we are seeing a shift towards services that are more convenient, customized and focused on personal empowerment. It’s time the health system jumped on board.
Let the revolution begin.