How should we measure quality in home care?
Trevor Cranney gets 60 hours of home care a month. Though he’s happy with the quality of care he’s getting, he doesn’t think it’s enough. “I suffer from ALS, and I’m unable to feed myself, brush my hair or do anything,” says the 42-year-old, who was recently given six to nine months to live. He would like …
The public should have a major role in deciding funding for large clinical trials
A dispute between some researchers and the Canadian Institutes of Health Research (CIHR – Canada’s largest health research granting agency) about how many large clinical trials should be funded by the CIHR has recently gone public. The scientists believe that more large clinical trials should be funded in Canada, and they should decide which ones. …
What Canada can learn from Sweden’s health registry system
In 2007, a group of Canadian cardiologists found themselves in a unique position. New – and expensive – implantable cardiac defibrillators were being used by fewer than a dozen doctors. And the Institute for Clinical Evaluative Sciences was offering to help them create a registry that would track outcomes for five years. Soon, they had the largest registry …
Building trust between physicians and patients in an era of Dr. Google
Clinical knowledge has now become easier to obtain than ever. Open-access medical journals that waive subscription fees for readers, electronic medical record systems such as My e-Health in British Columbia that allow patients access to their own lab results, and full subscription to point-of-care tools such as UpToDate by patients have flattened the information hierarchy …
Why unnecessary medical tests are bad for patients
Discussion of health care reform is too often confined to our bubble
If you regularly peruse the pages of Healthy Debate, you’re in the bubble; one could call you an ‘insider’. If you’ve heard of the Canadian Institute of Health Information or Health Quality Ontario, or if you scan the news for columns by André Picard, Kelly Grant or Tom Blackwell, then you are an insider. Do you ever tune into White Coat Black Art, …
From the factory floor to the emergency department: Hospitals explore Lean method
Can health care learn from assembly lines? Manitoba’s St. Boniface General Hospital thinks so. It’s been using Lean, a system inspired by Toyota, on processes around the institution. Last year, one of its projects was to reduce wait times for CT scans. Staff ran a Rapid Improvement Event, where a team mapped out patient flow and …
Medical education’s silence on death a disservice to doctors and patients
Society is in denial about death, especially in the context of medical care. People visit their doctors for cures. Few expect to be told there is no fix, let alone that their illness will lead to their deaths. Medical education reflects that same social discourse. Though I frequently provide care to dying patients, my medical education was …
Can insurance companies learn the results of an HIV-AIDS test?
Paternalism to patient-centered: do people want to know incidental findings?
A recent article in Healthy Debate highlighted the possibility of uncovering incidental findings as a significant challenge in genomic sequencing. An incidental finding is a genetic condition that causes a disease unrelated to the reason genetic testing was initially ordered. For example, imagine you have been recently diagnosed with a serious disease, such as colon …
How Norway’s innovative library made high-quality health information free for everyone
If you’re looking for evidence-based health information in Canada, a lot depends on who – and where – you are. A physician in a teaching hospital? No problem. But family doctors in rural areas, nurses or physiotherapists have a much harder time accessing up to date materials. And the general public is more likely to find …
Health Canada’s nutrition label changes still need improvement
When federal Health Minister Rona Ambrose announced proposed changes to nutrition labels this summer, dietitians and the public were excited. With the current labels, shoppers looking for healthier products needed to be either a biology expert or a math whiz to succeed. But will the new ones solve the problem? Here are five of the proposed …