Next #hcsmca chat
Wed. July 30, 2014 at 9pm ET (10pm AT, 8pm CT, 7pm MT, 6pm PT)
hcsmca = Health Care Social Media Canada more info >>
By The College of Physicians and Surgeons of Ontario (@cpso_ca)
The College of Physicians and Surgeons of Ontario (CPSO) recently released a new draft version of its Telemedicine policy for external consultation and is looking to the #hcsmca community to provide feedback on it. The draft policy sets out the CPSO’s expectations of physicians who practise telemedicine. Given the evolution of technology and the increased use of telemedicine in diverse practice settings, the draft policy contains a number of new or revised expectations to ensure it is clear, up-to-date and comprehensive.
The CPSO is committed to ensuring that the draft policy reflects current practice issues, embodies the values and duties of medical professionalism, and is consistent with the CPSO’s mandate to protect the public. But in order to do this, we need to gather opinions and insights from a wide variety of interested parties. That’s where #hcsmca comes in. Since telemedicine falls under the broader topic of information communications technology, we know it is of particular interest to this community – as was demonstrated by a number of telemedicine-related comments that arose during the June 18 discussion “Online vs. In-Person Patient Support Services.”
We welcome any and all comments on our draft Telemedicine policy. You can read the draft policy online and review our Telemedicine consultation page, which includes information about the consultation and how to submit your long form comments.
On Wednesday, July 16th, let’s examine the following topics during the #hcsmca chat:
- T1: Do you think the same expectations should apply to telemedicine as they would to care provided in-person?
- T2: If the doc you are seeing via telemedicine is physically located in another province/country, would you want to know?
- T3: Would you be concerned about the security of your personal health info being transmitted via telemedicine?
Read the transcript of July 16th #hcsmca chat.
By Colin Hung (@Colin_Hung)
Last month, those of us who live in Ontario went to the polls for our third provincial election in just seven years. The results were surprising – Kathleen Wynne’s Liberal party won a majority which none of the experts were predicting (http://www.theglobeandmail.com/news/politics/ontario-election-day/article19135292/). You could almost hear the collective sigh of relief that there won’t be another election for at least four years.
For me, the timing of the election was horrible. In the previous two years both the Minister for Health (The Honorable Deb Matthews @Deb_Matthews) and the Ontario Ombudsman (André Marin – who tweets under the handle @Ont_Ombudsman) had publicly been talking about finally implementing provincial oversight of Ontario’s healthcare institutions through a third party (Toronto Star article Healthcare check-up: Should the province’s ombudsman have oversight of hospitals?). Ontario is the only province in Canada where the scope of the ombudsman does not include hospitals. This means that in Ontario, should there be a complaint or an issue with a hospital, the escalation process only goes through the Ministry of Health – hardly a neutral third party.
This issue was so important our friends over at HealthyDebate even had a series dedicated to this topic – Expert advice for Ontario Ombudsman on his bid for jurisdiction over hospitals and long term care facilities.
When you read the articles it is clear that Matthews and Marin did not see eye-to-eye on who that third party should be. Marin, obviously, believed that the Ombudsman office was perfectly suited to handle hospitals, but Matthews disagreed. Instead she proposed creating a separate body. In January 2014 Matthews’ publicly proposed the following:
“What we’re talking about is a health-focused patient advocate. I get letters as minister from people who aren’t happy with the care they’ve received. I think it’s really important to turn those complaints into ways to improve quality.”
Notice that Matthews didn’t use the word Ombudsman but instead chose patient advocate. Her words got me thinking – is it time that provinces in Canada have a designated person/office that is responsible for advocating on behalf of patients?
Currently, each hospital and healthcare organization in Canada has their own patient advocate – usually an individual or small department that handles patient feedback as well as complaints. These “Patient Relations” teams are fairly effective at helping patients resolve issues involving the organization they represent. [Disclosure: I used to work closely with many Patient Relations teams in Ontario in my role of VP Marketing at RL Solutions].
However, the care we receive as citizens of Canada is very rarely handled by a single organization. We have primary care physicians and specialists that we use alongside hospitals. There are also long-term care facilities, CCACs, home-care providers and now telehealth organizations that are also part of the “care team” for many Canadians. In this overlapping, heterogeneous environment it would be very difficult for a patient to know which organization to raise an issue with. Shouldn’t there be someone that patients could escalate issues to who had the ability to see across the entire healthcare continuum?
Furthermore wouldn’t it be nice to have a person (or office) that patients could turn to for help to navigate our increasingly complex healthcare system? To provide the patient perspective whenever and wherever healthcare policies are debated? To fight for patient rights and healthcare privacy? In short, isn’t it time we had a Patient Advocate at the provincial level?
I hope that Ontario’s new incoming Minister for Health – The Honorable Dr. Eric Hoskins (@DrEricHoskins) – carries on the work that Deb Matthews started. Whether or not the Provincial Patient Advocate falls under the Ombudsman or not, it is my personal opinion that this role is needed.
Join us on Wednesday July 9th at 1pm Eastern for the weekly #hcsmca tweetchat where we will be discussing the topic of a Provincial Patient Advocate.
- T1: Is there a need for a Provincial Patient Advocate? Or is the existing system sufficient?
- T2: Does patient advocacy and hospital oversight belong in the same place/office?
- T3: What would a Provincial Patient Advocate be responsible for? What specific duties would they have?
- T4: What would be the characteristics of a good Provincial Patient Advocate? What background? Knowledge?
- T5: Do you think we will see a Provincial Patient Advocate in the next 5 years? What’s needed to make this happen?
Dr. Wai-Sun “Sunny” Chan is a family physician who recently moved to Canada and set up practice outside of Ottawa. On Wednesday, June 25 at 9 pm ET, Sunny will moderate #hcsmca for the first time to discuss Canada’s shortage of physicians in primary care. What does this have to do with social media? Let’s explore.
By Dr Wai-Sun Chan (@DrWaiSun)
General practice or family medicine, as it is referred to in North America, is the practice of clinical medicine in the community. Traditionally family physicians are the physicians of first contact for patients, providing primary and continuing care to individuals and families. Family physicians often make the initial decision on medical issues. Sometimes they may take on role of patient advocate and are often key champions in promoting public health and health within the community through their involvement of chronic disease management, cancer screening and vaccination programs. Thus it’s not hard to see why many health systems around the world rely on an effective, organized primary care system with the family physician playing a central role.
It has been estimated that in excess of 4 million people in Canada do not have a family physician. When you consider there are approximately 35 million people living in Canada, then roughly 1 in 10 people are without a family physician. For a highly developed western country this statistic is rather shocking.
People without a family physician are
- less likely to receive continuity of care
- less actively to be involved in health promotion activities
- more likely to receive inadequate care and monitoring of chronic conditions
- more likely to experience delays in diagnosis
I qualified as a family physician in the United Kingdom over 11 years ago and have worked in both the British National Health Service and Irish health systems. I immigrated to Canada nearly 18 months ago to work as a family physician outside of Ottawa. I had heard much of the problem with the shortages of family physicians prior to my move however seeing the extent of this first hand was quite disturbing. In the first few months of opening my practice I saw elderly patients who had been without a family doctor for many years, families willing to travel over an hour to join my practice and patients residing in another province.
In my experience, family physicians are incredibly busy and patients often have to wait weeks before an appointment becomes available. Wait times to see hospital specialists are amongst the longest in the developed world and emergency departments work under incredible stress and pressure as many people use them as their first port of call for a medical assessment. The situation is far from ideal for everybody.
On Wednesday, June 25 at 9pm ET, I’d like to invite everyone to chat and explore how patients cope without a family physician and what role, if any, social media can play. If so, then how?
- T1a How do people manage without a family doctor?
- T2 Is the doctor–patient relationship (a fundamental strength of family medicine) over-rated?
- T3 Can social media play a role in helping doctors & patients cope with family physician shortage?