- A Canadian Healthcare Innovation Agenda: Policy, Governance, and Strategy
- Learning from failure: inadequate value propositions in an innovative approach to patient safety using a hand washing compliance auditing system
- Healthcare Systems: Future Predictions for Global Care
- Leveraging supply chain infrastructure to advance patient safety in community health-care settings
- WIN 2017-2018 Annual Report
- WIN 2016-2017 Annual Report
- Visibility: The New Value Proposition for Health Systems
- Scaling Innovation to Achieve Value in Health Systems: WIN 2015-2016 Annual Report
- “It’s All About Me”: The Personalization of Health Systems
- Innovation Takes Leadership: Opportunities & Challenges for Canada’s Health Care System
- Leveraging Information Technologies to Transform and Sustain British Columbia’s Health Care Sector
- Measuring What Matters: The Cost vs. Values of Health Care
- Strengthening Health Systems through Innovation: Lessons Learned
- Transforming Canada into a Global Centre for Medical Device Innovation and Adoption
- Transforming Canadian Health Care through Consumer Engagement: The Key to Quality and System Innovation
A Canadian Healthcare Innovation Agenda: Policy, Governance, and Strategy
This collection is the result of a 2016 national leaders conference sponsored by Queen’s University to explore the prospects for a pan-Canadian healthcare innovation strategy. The conference themes were inspired by the 2015 report of the federally commissioned Advisory Panel on Healthcare Innovation, led by David Naylor, which examined how the federal government could support innovation. A Canadian Healthcare Innovation Agenda features original commissioned chapters from academics and healthcare leaders addressing a range of issues such as the meaning of healthcare innovation, how a national healthcare agency and investment fund could be governed, the need for big data and evidence, adding value through Canadian supply-chain management, overcoming regulatory barriers to innovation, policy innovations for indigenous, military and elderly populations, the role of medical professions in promoting innovation, education, and the development of medical innovators. The Canadian healthcare system is so fragmented that any thought of a system-wide strategy for healthcare innovation is considered a far-distant ideal at best. This book presents a contrary view, outlining an agenda for Canadian healthcare innovation. It shows that Canada does indeed have the building blocks for innovation, and concludes that the time to act is now.
Chapter 8 of this book, titled The Management of Innovation: Strengthening Patient Safety and Creating Value Through Supply Chain Transformation, was co-authored by:
- Dr. Anne W. Snowdon, Academic Chair, WIN
- Dr. Charles Alessi, Visiting Scholar, WIN
Learning from failure: inadequate value propositions in an innovative approach to patient safety using a hand washing compliance auditing system
This study examined how a hand washing compliance auditing system affects physician hand washing compliance and rates of hospital acquired infections. Ultimately, data collection was significantly impaired by low recruitment and compliance rates. To learn from this project's failure, medical residents were invited to participate in an interview to discuss the project, its merits and shortcomings. Beyond existing resistance to such surveillance, study procedures, confounding contextual variables and insufficient value propositions seem to account for the project's failure. Use of a hand washing compliance auditing system is likely to fail if it is not optimally integrated into existing clinical workflows and hospital infrastructure, or if auditing seems to take the form of surveillance. Beyond the establishment of proof of concept, proof of relevance and value for all stakeholder groups must be established to embed an innovation such as this hand washing compliance auditing system.
Healthcare Systems: Future Predictions for Global Care
This book brings together professionals who have dedicated their careers to the health system. It presents a canvas to paint their prediction of the future of healthcare. This third book complements the previous two books, Healthcare Reform, Quality, and Safety: Perspectives, Participants, Partnerships, and Prospects in 30 Countries, and Health Systems Improvement Across the Globe: Success Stories from 60 Countries, by covering from around the globe, what the future might hold for healthcare systems. Rather than focusing on western nations, like other healthcare literature, this book provides a snapshot, along with 57 case studies, of future predictions of health systems globally.
Chapter 3 of this book, titled Canada: The Future of Health Systems: Personalization, was co-authored by:
- Dr. Anne W. Snowdon, Academic Chair, WIN
- Dr. Charles Alessi, Visiting Scholar, WIN
- Dr. John Van Aerde, Chief Editor, Canadian Journal of Physician Leadership
- Dr. Karin Schnarr, Assistant Professor, Lazaridis School of Business and Economics, Wilfrid Laurier University
Leveraging supply chain infrastructure to advance patient safety in community health-care settings
The purpose of this paper is to examine the opportunity for supply chain processes and infrastructure to reduce the risk of medical error and create traceability of adverse events in community care settings. Patient safety has become an important area of focus over the past few decades, with medical error now accounting for the third most common cause of death in Canada and the USA. The majority of patient safety studies to date have focused specifically on safety in hospital settings; however, deaths and harm experienced by patients in the community (home care, long-term care, complex care and rehabilitation settings) are not well understood.
This paper discusses the evidence that adverse events occur at similar, if not more, frequent rates in community care settings.
The authors propose that above and beyond current efforts to increase awareness and promote a “safety culture” in health-care settings, system infrastructure should be designed in a way that enables clinicians to provide the safest care possible. There is currently no line of sight across the health-care continuum. The authors suggest that improving system infrastructure would reduce the occurrence of adverse events.
Such visibility across the continuum of care holds the potential to transform health-care in Canada from a fragmented system, where information is inadequately captured and transferred from provider to provider, to a system that provides complete, accurate and up-to-date information regarding patient care, procedures, medications and outcomes so as to provide the best and safest care possible. System visibility achieves quality and safe care, which is transparent and accountable and achieves value for patients.
WIN 2017-2018 Annual Report
A Message from Dr. Anne Snowdon:
I am delighted to share with you the World Health Innovation Network (WIN) 2017/18 Annual Report.
It has been an extraordinary year of growth and impact for WIN. This could not have been achieved without the incredible contribution and commitment from our global partners. Through WIN, we are opening gateways to international collaboration, research, and capacity building that collectively strengthen countries’ economic and health frameworks to ensure the best value for citizens. I would like to thank our partners for their continuing support that enables our success!
Dr. Anne Snowdon, RN, BScN, MSc, PhD, FAAN
Scientific Director & CEO, SCAN Health
WIN 2016-2017 Annual Report
A Message from Dr. Anne Snowdon:
I am delighted to share with you the World Health Innovation Network (WIN) 2016/17 Annual Report.
We are very proud of the results achieved over the past year at WIN. We could not have achieved this success without the incredible contribution and commitment of our many partners world wide. Thank you for your support!
Dr. Anne Snowdon, RN, BScN, MSc, PhD
Scientific Director & CEO, SCAN Health
Visibility: The New Value Proposition for Health Systems
One of the greatest challenges facing global healthcare systems is patient safety; medical errors are now the third leading cause of death in North America. This paper proposes a new direction to improve patient safety and performance. By transforming the healthcare supply chain, we can achieve visibility and attain greater value for patients, health system leaders, industries and governments.
Scaling Innovation to Achieve Value in Health Systems: WIN 2015-2016 Annual Report
A Message from Dr. Anne Snowdon:
I am delighted to share with you a copy of the Inaugural Odette World Health Innovation Network (WIN) 2015-2016 Annual Report.
We are very proud of the results achieved over the past year at WIN.
At this time, I wish to express our deepest appreciation to Dean Allan Conway and the Odette leadership team for their support during our first year.
Dr. Anne W. Snowdon, RN, BScN, MSc, PhD
Professor, Strategy and Entrepreneurship
Chair, World Health Innovation Network
“It’s All About Me”: The Personalization of Health Systems
Health systems have experienced unprecedented change in the last several decades, resulting in new ways for consumers to seek and engage health services and revolutionary technologies that have completely transformed how health challenges are managed. Consumers can connect virtually to global experts to access information about health. Discoveries in genetics are providing a mechanism for consumers to evaluate their risk for disease. Pacemakers are able to wirelessly transmit heart rhythms, enabling individuals with cardiac arrhythmia to connect to a cardiologist. Yet, these impressive advances may not have realized their potential in the populations they serve. Why?
Health systems around the world are challenged by increasing demands for healthcare services in the face of diminishing economic resources. Every developed country in the world expends substantial economic resources on healthcare which has driven health system priorities to focus on cost containment and sustainability. Yet, as health system costs continue to increase over time, the value health systems are able to achieve for the population they serve remains unclear. Why is it that despite decades of advances in science, health systems struggle to deliver value to populations they serve?
Innovation Takes Leadership: Opportunities & Challenges for Canada’s Health Care System
The health of a population is directly related to its productivity and a country’s economic, growth and competitiveness. Yet, Canada’s health care future is uncertain. Our system faces a rapidly rising demand for quality health care services that are timely and accessible to an aging population experiencing increasing rates of chronic illness1 . To ensure Canada’s future economic competitiveness, we must work to ensure the sustainability of a strong health care system. How? The World Health Innovation Network believes the answer lies in health system innovation: technological, procedural and cultural.
So, if that’s the answer, how are we doing? In short, not so well. A 2008 McKinsey & Company report found that Canada earns a “D” grade in innovation, placing 13 among 17 developed nations in this economic and future prosperity indicator2. Further, according to the Conference Board of Canada, “Canada ranks near the bottom of its peer group on innovation, ranking 14th among the 17 peer countries. Canada’s low relative ranking means that, as a proportion of its overall economic activity, Canada does not rely on innovation as much as some of its peers. Overall, countries that are more innovative are passing Canada on measures such as income per capita, productivity, and the quality of social programs.”
1Conference Board of Canada. (2008). How Canada Performs: A Report Card on Canada 2 McKinsey and Company. (2008). Breaking Away From the Pack: Enhancing Canada’s Global Competitiveness, pp. 1-3..
Leveraging Information Technologies to Transform and Sustain British Columbia’s Health Care Sector
Much has been written about the promise of health IT to derive operational efficiency for our health systems, to increase patient safety, to ease the work life of health practitioners and even to transform the way health care is delivered. However, these promises have been elusive – with cost-overruns and lagging rates of adoption common across Canada. Health IT has become politically charged and citizens are skeptical and wonder why it needs to cost so much. Many health care managers are putting off the necessary investments in technology, faced with competing budget priorities of immediate health care needs in our emergency rooms, surgical suites and clinics, or dealing with investments that have real, but far-off return.
This paper provides a forward-thinking perspective on the role information technology could play in British Columbia’s (BC) health care system by 2020 and the impact it could have on BC’s economic development in relation to Outlook 2020, an initiative of The Business Council of British Columbia. Based on international and domestic evidence, this paper re-affirms the promise that health IT is important for health system transformation and better patient outcomes. It consolidates the current state of the science to create new momentum. Recommendations are put forward on how to restart a positive conversation about ways to all stakeholders can come together to achieve the ultimate goal of using health information technology (IT) to help create a sustainable health care system and an economic engine for BC and for Canada..
Measuring What Matters: The Cost vs. Values of Health Care
There is a clear misalignment between what Canadians value, and how Canadian health system performance is measured and funded. Canadian values have shifted substantially in recent years, towards a preference for greater autonomy and empowerment in managing their health care and management. Canadians’ values reflect the desire for a more “personalized” health care system, one that engages every individual patient in a collaborative partnership with health providers, to make decisions that support health, wellness, and quality of life. Yet, health systems are focused on performance management in terms of costs, operational inputs, such as services delivered, or quality measures such as medication errors, readmissions to hospital, and mortality rates.
Canadians perceive health care as one of the most fundamentally important features of our society. There have been numerous studies of Canada’s health care system, and in every work to date, the perspectives and views of Canadians have been an important frame of reference for health system renewal and reform.
Strengthening Health Systems through Innovation: Lessons Learned
Every developed country in the world is challenged by the increasing demands for health services and the rising costs of health care associated with rapid advances in technology and aging populations. Canada is facing similar challenges, yet has made less progress in meeting these demands when compared to other developed countries. The question is: how can Canada learn from other countries in order to more adequately prepare for the future of growing demands on health systems? The purpose of this white paper is to examine the progress made within the health systems of seven comparator countries so we may learn how they have been able to help meet population health needs more effectively and make progress in health system redesign and transformation.
The costs of Canada’s health systems are consuming nearly half of provincial tax revenues, while the demands for services continue to grow, plagued by long wait times and limited integration of services across the continuum of care. When compared with other countries, the quality and outcomes of health services in Canada are ranked among the lowest of comparator OECD (Organisation for Economic Co-operation and Development) countries. The current system costs are dominated by acute care hospital services; however, chronic illness management is not as well developed for an aging population and will require innovative new approaches that can cope with the growing population demands, now and in the future..
Transforming Canada into a Global Centre for Medical Device Innovation and Adoption
Medical devices are a diverse group of products used to enhance the quality of patient care by restoring function, and aiding in the diagnosis, prevention, treatment and management of diseases and disabilities. Medical devices range from low-risk supplies such as bandages and thermometers to innovative imaging devices and drug eluting stents. Devices play an important role in modern health care. They improve treatment outcomes and promote less invasive procedures, reduce patient recovery time, shorten the length of hospital stays, reduce costs and enhance health system sustainability.
Canada pays a large price for publicly funded healthcare. In 2010, the combined spending on health care of the public and private sector in Canada was more than 1.6 billion1. This amounted to 11.7% of Canada’s total gross domestic product (GDP). Hospitals account for the largest proportion of health expenses (.3 billion), followed by drugs (.1 billion) and physician services (.3 billion). In 2009, growth in national healthcare costs were 1.56 times greater than the growth of the nation’s GDP2. Canada continues to spend an increasing percentage of its wealth on health care while the demands for services continue to grow along with the costs of healthcare service delivery.
1Canadian Insitute for Health Information. Health care spending to reach 2 billion this year. 2010. [accessed 2011 May 20]; Available from: http://www.cihi.ca/cihi-extportal/internet/en/document/spending+and+health+workforce/spending/release_28oct10 2 Conference Board of Canada. Healthy Provinces, Healthy Canadians: A Provincial Benchmarking Report; 2006.
Transforming Canadian Health Care through Consumer Engagement: The Key to Quality and System Innovation
Canadians are living longer today than ever before. Life expectancy for Canadian women is expected to rise from 82.9 years in 2006 to 87.3 years in 2036. Men are expected to increase their life spans from 78.2 years in 2006 to 84 years in 2036; precisely when the longevity of the Baby Boomer generation will result in persons over 65 years of age accounting for 24.6% of Canada’s total population. With Canadians living longer, the burden of ever-increasing demands falls on the health care system. Demands will grow exponentially as older Canadians demand and strive to maintain their independence and quality of life.
The aging Canadian population is increasingly challenged by chronic illnesses that place greater demands on Canada’s publicly funded health care systemii. Increasing instances of the most prevalent chronic illnesses in Canada, including diabetes, heart disease and stroke, ensure pharmaceutical costs are perpetually increasing. Health system resources are spread thin to maintain the availability of hospital beds and meet the demand for health services that comes with an increasing volume of elderly patients. Given the limitations of current health service infrastructure, at some time in the coming decades, every hospital bed in Canada could be occupied by an elderly patient admitted for joint replacement surgery.
iiConference Board of Canada. 2006. Healthy Provinces, Healthy Canadians: A Provincial Benchmarking Report. February, 2006..