Surely we can do better – room for improvement in continuity of health care

Health Quality Council releases new report

Imagine being able to sit down at your computer and see your own health record – to check on test results, see whether referrals have been made, check upcoming appointments. This would be connected to a single electronic health record system in Alberta so that no matter where you are in the province or what provider you see, everyone on your care team has access to the same information. From the perspective of IMAGINE, this access to information is crucial for patients to be active partners and advocates in their own care and to support effective continuity of care. A new report from the Health Quality Council of Alberta (HQCA) agrees.

The HQCA report, Improving Continuity of Care: Key Opportunities and a Status Report on Recommendations from the 2013 Continuity of Patient Care Study focuses attention on problems in continuity of patient care. Following up on HQCA’s 2013 report that made 13 recommendations to “mitigate problems in quality and patient safety related to breakdowns in the continuity of patient care”, the new report gives a status report on progress and points out that much still needs to be done.

So what is continuity of care? Continuity of care is when there are no unnecessary breaks or delays in a person’s care. The care delivered is clear, connected and consistent. The HQCA reports note that breakdowns in care are more likely to occur when patients require specialized tests or procedures or need access to providers who are not part of their usual primary care team. Good continuity of care depends on good and reliable information for providers and patients alike and good understanding of who is responsible for what.

The new report gives a status report on all 13 original recommendations but focuses on four in particular. From those come the following “opportunities and advice for improvement in continuity of care”:

  • Continue work to implement a province-wide, integrated clinical information system.
  • Implement a single, province-wide electronic referral system, integrated with the provincial clinical information system.
  • Develop a personal health portal to provide Albertans with full access to all their health information to ensure they are true partners in their healthcare, able to advocate for care to maintain or restore their health, as well as help monitor when their care continuity may be at risk of breaking.
  • Implement a critical test results management system integrated with the provincial clinical information system to ensure timely communication of critical test results.
  • Ensure that providers have access to a continuously updated, reliable, provincial provider registry housing contact information for all providers to assure that the right provider can be contacted to initiate the next steps of a patient’s care.
  • Determine if further improvements to existing physician practice standards in Alberta need to be made regarding management continuity of patient care.

These recommendations are strongly aligned with IMAGINE’s goals. They draw attention to a need for electronic health record and health provider systems in Alberta and a way for patients to access their own health information. These are critically important from IMAGINE’s perspective in order for patients to be active partners in their own care and for their care providers to more effectively communicate with each other.

IMAGINE supports the further recommendation from the report that the Health Quality Network be given the responsibility to monitor progress on the implementation of advice and recommendations in the report and to publicly report on the results. The Network is chaired by the HQCA and made up of all the key health organizations in the province (Alberta Medical Association, College of Physicians and Surgeons of Alberta, Alberta Health, Alberta Health Services, College and Association of Registered Nurses of Alberta, Covenant Health, Office of the Alberta Health Advocates, University of Alberta Faculty of Medicine and Dentistry, University of Calgary Faculty of Medicine). The Network also includes representation from the Patient Family Safety Advisory Panel from the HQCA which is made up of Albertans from all corners of the province. This will bring the important voice of citizens to the table, without which, the system is really just talking to itself.

There has yet to be a public response from government to the HQCA report, despite the fact that it was written at the request of Alberta Health as a follow up to the 2013 report.