Strategic Clinical Network Presentation to ACC Rockies March 20, - PowerPoint PPT Presentation

Influencing Evidence-based practice and clinical innovation through a Provincial Strategic Clinical Network Presentation to ACC Rockies March 20, 2013 Blair J. O’Neill MD FRCPC Senior Medical Director, CVH + Stroke SCN, Alberta Health Services Immediate Past President, Canadian Cardiovascular Society 1 1

Cardiovascular Health and Stroke Strategic Clinical Network • Potential Conflicts – Global End Point Adjudication Committees • Pfizer – Clinical Trial Support • Pfizer • Eli Lilly • Merck 2 2

The Landscape in 2013

Evidence = Non-sustainable cost increases in Canada 34.2 M people 23.4M people 1975 to 2010 • Expenditure increases = 3.5 fold • Population increases = 1.5 fold

Why are we here? How do you compare?

Are we getting the results? Life Expectancy by Province

As more is learned - the complexity of care increases ( driving waste + inefficiency) Service 179 Physician A Service 1 Physician W Service 311 Primary Care Group Agency F Agency Y For Profit Rehab. Public Rehab. Service 467 Service 222

Additional Challenges in Canada Weather! 8

Additional Challenges in Canada Where people choose to live! 9

Additional Challenges in Canada Geography • Area: 661,848 km ( vs 130,448 km for MC) • Pop: 3,645,257 (2011) • Growth: 1.6 % • Density: 5.1 persons/km • 81% Urban • 60% of pop in 5 cities • 30% of the population will be seniors by 2030 10

Changes are needed: Alberta as an example

Health Regions in Alberta 1992-2008 Age-Standardized Mortality Rate per 100,000 Pop. Northern Lights 262.7 Alberta: 154.5 Peace Country 184.6 Aspen 194.1 Capital 147.8 LEGEND East Central 182.5 270 David Thompson 177.3 205 Calgary 145.9 Palliser 184.3 140 Chinook 163.5 Source: Alberta Health and Wellness. 2003-2005. 12 12

Health Regions in Alberta 1992-2008 Age-Standardized Mortality Rate per 100,000 Pop. Northern Lights 262.7 Alberta: 154.5 Peace Country 184.6 Aspen 194.1 Capital 147.8 LEGEND East Central 182.5 270 David Thompson 177.3 205 Calgary 145.9 Palliser 184.3 140 Chinook 163.5 Source: Alberta Health and Wellness. 2003-2005. 13 13

Alberta Health Services  Formed 2008  One Health System  One Board  5 Zones formed in 2010  SCN’s formed in 2012

Strategic Clinical Networks Support to lead Provincial Improvement and Sustainability • Phase One (established June, 2012) – Obesity, Diabetes and Nutrition – Seniors ’ Health – Bone & Joint – Cardiovascular Health and Stroke – Cancer – Addiction & Mental Health • Phase Two (TBA, 2013) – Population Health and Health Promotion* – Primary Care and Chronic Disease Management* – Maternal Health – Newborn, Child and Youth Health – Neurological Disease, ENT and Vision – Complex Medicine (current Respiratory Clinical Network + others TBD)

Why Networks? • Facilitates collaboration, joint decision-making and shared learning • Promotes the use/uptake of clinical experience, knowledge and research to reduce variation and improve care • Involve partners along a broad continuum in planning, improving and innovating healthcare services 16 16

Provincial Mandate of AHS/SCN’s • Improve population health • Ensure continuous quality improvement • Incorporate research that impacts patients • Focus on patient outcomes • Design more accessible care • Develop appropriate clinical practices • Make patient safety a priority • Ensure value for money 17 17

A Successful and Sustainable Formula for Quality Health Care $$$$ Initial SCN Goal:R&D, Innovate, Eliminate ‘ Waste ’ and Reinvest Resources 18 To improve Quality and Create a Sustainable System

SCN’s as an integral component of Alberta Innovation and Research & Development Health is a global business :  Improving Prevention, Health, and Health Care Quality and Sustainability Alberta has major competitive advantages  Our Provincial Approach is unique  Our Health system is unique  Our Universities are aligned  Our R and D structure is unique  Health/Energy/Environment/Food Health generates major economic value  MANY industries related to health  Major Supply chains (drugs/lab /repairs)  Health Human Resources  Rapid and low cost access to high quality health data = a key 19

Health and Health Care Health is a Big Business: Comparison to oil patch OIL + GAS + MINING HEALTH + HEALTH CARE • >150,000 employed • >190,000 employed – ~ 7% of workforce – ~ 9% of workforce – $79B/yr to Alberta’s GDP – $21B/yr to Alberta’s GDP • ~ 27.6% of Alberta’s GDP • ~ 7.6% of GDP (health care alone) • Oil sands • Health Care – ~21,000 jobs – 100 hospitals ~100,000 public jobs – >$3.7B/yr in royalties – Every dollar spent on public health care generates 21.7 cents in taxes – $100B in provincial and municipal and import duties (Conf. Board – 2013) taxes over 25 years • ~ $2.5B/year in Alberta in taxes/duties • R and D • Plus private health care businesses – ~$1B/year on R and D (2010) • R and D – ~$ 478M/year (in 2008) • Included ~$75M/year in biotech 20

Health and Health Care Health is a Big Business: Comparison to oil patch OIL + GAS + MINING HEALTH + HEALTH CARE • >150,000 employed • >190,000 employed – ~ 7% of workforce – ~ 9% of workforce – $79B/yr to Alberta’s GDP – $21B/yr to Alberta’s GDP • ~ 27.6% of Alberta’s GDP • ~ 7.6% of GDP (health care alone) • Oil sands • Health Care – ~21,000 jobs – 100 hospitals ~100,000 public jobs – >$3.7B/yr in royalties – Every dollar spent on public health care generates 21.7 cents in taxes – $100B in provincial and municipal and import duties (Conf. Board – 2013) taxes over 25 years • ~ $2.5B/year in Alberta in taxes/duties • R and D • Plus private health care businesses – ~$1B/year on R and D (2010) • R and D – ~$ 478M/year (in 2008) • Included ~$75M/year in biotech 21

SCNs need to align ‘top to bottom’ SCN’s need to engage academics with Health Care System Administrators Providers Patients Policy Makers/Payers Researchers

For Researchers Integrate the four pillars of health research research networks to c onnect, analyze, innovate and export Clinical research Basic research Prevention, Population and Health systems research Public Health research

For the System Overall – Will be Able to Address Translational Gaps in Research Uptake Gap 1 Gap 2 Biomedical Gap 3 Research Clinical Clinical Science & Community Practice & Knowledge Based Health Decision Practice Making Knowledge to Practice Continuum

The ‘Knowledge Translation Networks’ of all-time with engaged end-users (clinical, policy, public, etc) New Knowledge Users of Knowledge The Researcher On the same team

Highly Qualified People = Key collecting and analyzing linked data

Highly Qualified People = Key collecting and analyzing linked data

Biggest Opportunity #1 comparative effectiveness data will define value for $$

Biggest Opportunity #2 data to inform personalized medicine http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/ documents/digitalasset/dh_132382.pdf

SCN’s Can bring many key partners together as the interface to the Health System 30 ....................and MANY OTHERS

Strategic Clinical Networks: Bringing Science and Best Practices Together to Define Next Practices integrate to innovate 31

Stars are aligned - now