At Imagine Citizens Network, we believe citizen-centred care should be a priority in reforming Alberta’s primary health system.
Citizen-centred care considers the individual in the context of their life, their environment and social context and the opportunities life has afforded or limited, and the health and community options available in them. This needs to be the starting point for primary health: the understanding of the context in which the citizen lives.
We prefer the term citizen or person over patient because citizens (persons living in Alberta) have varied interests in health and health care which are sometimes not directly linked to personal experience as a patient. Citizens/persons are sometimes patients but are always individuals with lived experience related to their health and wellness which makes them the experts in their own symptoms and various interactions with health-related entities. For positive healthcare outcomes to be achieved for an individual, their lived experience must be heard and acknowledged by health and community providers.
From our early citizen engagement work, we arrived at these principles of a citizen-centred health system:
- Healthcare is a deeply human endeavour. It should be about people caring for and about people, treating all people with compassion and dignity in ways that honour cultural differences and support equity and inclusion.
- The exact nature of the citizen-provider partnership will look different for different people and will evolve over time. It must be about meeting people who are sometimes patients where they are and jointly deciding how to work together.
- Relationships between citizens and healthcare providers should be characterized by mutual trust, respect and understanding. This will be achieved through cultural humility, acknowledging and welcoming the strengths people bring to the partnership, sharing the power in the relationship, and avoiding healthcare jargon.
- Health and community organization structures and processes need to be purposefully developed to actively support these essential partnerships, including engaging citizens to become actively involved in their own care in ways that work for them.
- People know what matters most in the context of their lives and need to be supported to establish their own strategies for health and wellbeing. Healthcare is only one component of this although it’s a large component if one is living with an ongoing health condition.
In a citizen-centred care system, services are easy to access including electronically, and easy to navigate. An individual can access a consistent team of health and community professionals who work with them to develop plans for health and community services that ‘wrap around’ and support them, from prevention to achieving the best quality of life possible. Communication and information flows freely among health and community teams which includes the individual and others they designate for inclusion. These designated individuals would be recognized by health and community professionals as a part of the system of care that wraps around a person.
We offered these recommendations to Alberta Health’s Modernizing Alberta’s Primary Health Care System (MAPS) initiative.
- Care Opinion platform. Implement the Care Opinion platform to enhance communication between citizens and the system and contribute to system improvement. Care Opinion is a proven and well-established online platform that enables interactive engagement between persons/families and health-related service providers. ICN is currently meeting with interested partners to discuss implementation of this innovative technology that is already helping to improve health outcomes in the United Kingdom where it was developed, and in Australia.
- Team Care. Expand the concept of team in ‘team care’ to include a broader range of health and community professionals and services in addition to the patient and their family caregivers.
- Digital Health Records for Individuals. Move assertively to create one complete digital health record for each individual. One person, one record that meets the principles spelled out in our Statement of Principles: Personal Health Information.
- Care Partners. Establish an imperative that every patient who is managing complex health challenges has a specifically designated ‘care partner’ with whom to work closely.
- Independent Citizens’ Forum. Create an independent Citizens’ Forum comprised of diverse stakeholders whose mandate is to identify, generate and share knowledge with Albertans about our collective achievements in supporting healthy communities and healthy Albertans.
Internationally, there is a growing and widely accepted belief that in an increasingly complex ‘expert’ and siloed system that individuals (who are often understood as patients in the health system) must be central in the system. Our recommendations would support concerted steps toward welcoming and embracing people living in Alberta as essential partners as we collectively work toward a healthier Alberta.