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

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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. ONeill MD FRCPC Senior Medical Director, CVH + Stroke SCN, Alberta Health


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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

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  • Potential Conflicts

– Global End Point Adjudication Committees

  • Pfizer

– Clinical Trial Support

  • Pfizer
  • Eli Lilly
  • Merck

Cardiovascular Health and Stroke Strategic Clinical Network

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The Landscape in 2013

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Evidence = Non-sustainable cost increases in Canada

1975 to 2010

  • Expenditure increases = 3.5 fold
  • Population increases = 1.5 fold

23.4M people 34.2 M people

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Why are we here? How do you compare?

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Are we getting the results? Life Expectancy by Province

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As more is learned - the complexity of care increases (driving waste + inefficiency)

Physician A Agency F Physician W Primary Care Group Service 467 Service 311 For Profit Rehab. Agency Y Public Rehab. Service 222 Service 1 Service 179

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Additional Challenges in Canada Weather!

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Additional Challenges in Canada Where people choose to live!

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  • 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

Additional Challenges in Canada Geography

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Changes are needed: Alberta as an example

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Northern Lights

Alberta: 154.5

Source: Alberta Health and Wellness. 2003-2005.

LEGEND

270 205 140

Peace Country

Health Regions in Alberta 1992-2008

Age-Standardized Mortality Rate per 100,000 Pop.

262.7 184.6 Aspen 194.1 Capital 147.8 East Central 182.5 David Thompson 177.3 Calgary 145.9 Palliser 184.3 Chinook 163.5

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Northern Lights

Alberta: 154.5

Source: Alberta Health and Wellness. 2003-2005.

LEGEND

270 205 140

Peace Country

Health Regions in Alberta 1992-2008

Age-Standardized Mortality Rate per 100,000 Pop.

262.7 184.6 Aspen 194.1 Capital 147.8 East Central 182.5 David Thompson 177.3 Calgary 145.9 Palliser 184.3 Chinook 163.5

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Alberta Health Services

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

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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)

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  • 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

Why Networks?

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  • 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

Provincial Mandate of AHS/SCN’s

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Initial SCN Goal:R&D, Innovate, Eliminate ‘Waste’ and Reinvest Resources

To improve Quality and Create a Sustainable System

$$$$

A Successful and Sustainable Formula for Quality Health Care

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SCN’s as an integral component of Alberta Innovation and Research & Development

19 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

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Health and Health Care

Health is a Big Business: Comparison to oil patch

OIL + GAS + MINING

  • >150,000 employed

– ~ 7% of workforce – $79B/yr to Alberta’s GDP

  • ~ 27.6% of Alberta’s GDP
  • Oil sands

– ~21,000 jobs – >$3.7B/yr in royalties – $100B in provincial and municipal taxes over 25 years

  • R and D

– ~$1B/year on R and D (2010)

HEALTH + HEALTH CARE

  • >190,000 employed

– ~ 9% of workforce – $21B/yr to Alberta’s GDP

  • ~ 7.6% of GDP (health care alone)
  • Health Care

– 100 hospitals ~100,000 public jobs – Every dollar spent on public health care generates 21.7 cents in taxes and import duties (Conf. Board – 2013)

  • ~ $2.5B/year in Alberta in taxes/duties
  • Plus private health care businesses
  • R and D

– ~$ 478M/year (in 2008)

  • Included ~$75M/year in biotech

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Health and Health Care

Health is a Big Business: Comparison to oil patch

OIL + GAS + MINING

  • >150,000 employed

– ~ 7% of workforce – $79B/yr to Alberta’s GDP

  • ~ 27.6% of Alberta’s GDP
  • Oil sands

– ~21,000 jobs – >$3.7B/yr in royalties – $100B in provincial and municipal taxes over 25 years

  • R and D

– ~$1B/year on R and D (2010)

HEALTH + HEALTH CARE

  • >190,000 employed

– ~ 9% of workforce – $21B/yr to Alberta’s GDP

  • ~ 7.6% of GDP (health care alone)
  • Health Care

– 100 hospitals ~100,000 public jobs – Every dollar spent on public health care generates 21.7 cents in taxes and import duties (Conf. Board – 2013)

  • ~ $2.5B/year in Alberta in taxes/duties
  • Plus private health care businesses
  • R and D

– ~$ 478M/year (in 2008)

  • Included ~$75M/year in biotech

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SCNs need to align ‘top to bottom’ SCN’s need to engage academics with Health Care System

Patients Policy Makers/Payers Providers Administrators Researchers

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For Researchers

Integrate the four pillars of health research

research networks to connect, analyze, innovate and export

Basic research Clinical research Health systems research Prevention, Population and Public Health research

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For the System Overall – Will be Able to Address Translational Gaps in Research Uptake

Knowledge to Practice Continuum

Biomedical Research Clinical Science & Knowledge Clinical Practice & Health Decision Making Community Based Practice Gap 1 Gap 2 Gap 3

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The Researcher New Knowledge Users of Knowledge On the same team

The ‘Knowledge Translation Networks’ of all-time

with engaged end-users (clinical, policy, public, etc)

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Highly Qualified People = Key

collecting and analyzing linked data

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Highly Qualified People = Key

collecting and analyzing linked data

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

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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

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....................and MANY OTHERS

SCN’s Can bring many key partners together as the interface to the Health System

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

integrate to innovate

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Stars are aligned - now