By Laurie Lafleur, AuntMinnie.com contributing writer

May 28, 2018 -- As we know all too well, there is a shortage of physicians in Canada. While Canada's physicians rank among the best in the world, the country's healthcare system comes up painfully short when it comes to care accessibility, wait times, and communication.

In fact, Canada was ranked as one of the worst on these dimensions in a survey shared by the Canadian Institute for Health Information and conducted by the Commonwealth Fund International Health Policy Center, which evaluated 11 developed countries, including the U.S., the U.K., and several across Europe.

What many don't know, however, is that this problem is likely to get worse in the very near future. No matter how you slice it, there are more patients than there are care providers in Canada these days. The increase in aging baby boomers is contributing to an increased demand for care and also resulting in a larger number of Canadian physicians retiring from the workforce -- at a higher rate than the country's medical schools are producing new graduates.

Laurie Lafleur
Laurie Lafleur from Paragon Consulting Partners.

Canada's universal healthcare system is lauded for how it delivers free and equal care to all citizens regardless of their economic or medical situation. However, currently, a staggering number of Canadians -- ordering in the millions -- find themselves without access to a family physician, resulting in Canadian patients being among the heaviest users of urgent care clinics and emergency departments, overburdening facilities and providers that are meant for truly emergent care. The result is painfully long wait times in waiting rooms filled with other patients who are sick (often with contagious conditions), uncomfortable, and frustrated.

For those Canadians who are lucky enough to secure a family physician, most are met with busy signals or answering machines when the time comes to seek care. They often must wait up to a week or more to secure an appointment, as most family physicians have packed rosters of more patients than they can reasonably care for.

When specialized services are required, the process starts all over again, and additional wait times are incurred. This is especially true when diagnostic imaging procedures such as CT or MRI scans are required: Patients with nonemergent conditions can expect to wait anywhere from a month for CT to as long as six months or more for MRI.

Once the specialist consultation finally occurs or the imaging is acquired, results are poorly communicated between care providers and patients, as many doctor's offices continue to rely on fax machines as a method for communicating results -- an archaic technology that has become all but obsolete in most other industries.

In addition, images remain largely inaccessible to the referring community, unless physical copies are mailed or transported by the patients themselves. As a result, the images are often not available to support follow-up discussions about diagnosis and treatment planning.

Because they are so overburdened, many doctors' offices take a "no news is good news" approach, expecting patients to wait indefinitely (and anxiously) to hear about their results -- only to hear the sound of crickets. While this helps to reduce the workload for providers and front-office staff, it does nothing to curb the frustration of patients, who want to participate in the care process by seeing their images and understanding their results -- positive or negative -- as soon as they're available, rather than wait and wonder.

Throughout all of this, the burden for communication and coordination between care providers often falls upon ill-equipped patients. As they're bounced between physicians, specialists, and imaging departments, they are expected to convey their care pathway, relevant findings, and sometimes even physical media containing imaging or other test results between care providers. Unfortunately, patients, not being trained physicians themselves, often don't understand or remember all of the details of their many encounters, which can result in unnecessary duplicate appointments or tests (further overburdening the system) and, even worse, delayed care or missed diagnoses.

While it is a gross understatement to say that these experiences are suboptimal for patients, they can be equally negative experiences for care providers as well. Canadian physicians work an average of 50 hours or more per week, leaving them overworked and burned out, with more than half having reported symptoms such as stress, fatigue, and depression.

These conditions have been proven to contribute to increased medical errors and decreased engagement and patient advocacy. It's no surprise that when you mix overtired and overworked physicians, as well-intentioned as they may be, with equally tired and frustrated patients, the result is often an overwhelmingly negative experience on both sides, with poor clinical outcomes to boot.

So, what can be done to address these concerning trends? Aside from training more physicians to improve physician-to-patient ratios, an initiative currently being undertaken by the Canadian government, it is clear that what the Canadian healthcare system really needs is to become more efficient. The following three sections outline some ways that improvements can be realized for both patients and providers.

Help patients help themselves

Self-service portals are used more often than not in consumer-driven industries. People can easily book their own air travel, movie tickets, or restaurant reservations with a few simple screen taps. Similar portals that allow patients to schedule their own appointments online are an easy way to address the first bottleneck in our healthcare system.

For example, with this capability, patients could easily compare their own schedules with those of their care providers and self-book an appointment time that works for both parties. This would deburden front-office staff who could then spend more time following up on patient results and fielding questions, rather than juggling calendars.

Additionally, self-scheduling could help reduce wait times and improve the utilization of diagnostic imaging modalities for imaging facilities by enabling patients to more easily opt for appointment times that fall outside of conventional daytime hours. This would allow patients to receive their imaging exams sooner and imaging facilities to maximize modality uptime.

A good relationship starts with good communication

Can you imagine not having immediate access to your important emails or social media accounts when and where you want them? These days everything you could possibly want to share about yourself (perhaps more than some would care to know) can be made available for all to see, instantly.

Similarly, to truly drive efficiency across the care continuum and improve patient and provider satisfaction, facilities, healthcare providers, and even patients need to be connected with a shared platform that does away with fax machines and physical media.

This empowers patients to assume ownership and control of their own medical records, exponentially improves communication between providers and patients, and has the potential to accelerate the care process by providing physicians with ready access to relevant information at the point of care, without relying on their patient's own recollection and interpretation of events. And a few trees may even be saved in the process.

The doctor will (virtually) see you now

Don't let your doctor's office fool you -- technology has come a long way. For instance, with the introduction of online banking and mobile apps, we no longer have to wait in line to see a bank teller anymore.

So why, then, do we pack ourselves like sardines into waiting rooms for simple conditions or to discuss our imaging results? Video conferencing and live chat agents have successfully been servicing consumers in retail and other industries -- in fact, in today's instant gratification society these types of tools are not just appreciated, they're expected -- and these technologies are equally applicable to some healthcare use cases.

Connecting providers and patients in real-time through virtual technologies has a number of benefits. First, it gets patients out of waiting rooms, expands accessibility to rural areas where physician shortages are more acutely felt, and facilitates more efficient communication between patients and providers while reducing overhead. This enables physicians to provide better follow-up services for discussing both positive and negative specialist and imaging results.

Second, it has the potential to create an ecosystem where physicians can flexibly and collectively share and distribute workload to better meet the growing demand for care and improve after-hours and weekend coverage.

Finally (and most importantly), efficiently and effectively connecting patients, providers, and information fosters a collaborative environment where patients are empowered and physicians are engaged, resulting in better clinical outcomes and improved satisfaction for all parties involved.

Change is hard, it's true. But it's also necessary for ensuring Canadian patients will continue to receive high-quality and timely care, and for protecting front-line care healthcare providers from undue burnout and stress. By embracing the paradigm shift that has occurred in other service industries and adopting technologies that create a more efficient, accessible, and collaborative healthcare ecosystem, this vision could become our new reality.

Laurie Lafleur was born and raised in Ontario and is a senior imaging consultant at Paragon Consulting Partners, providing consultative and advisory services for healthcare and technology organizations. Having worked with care providers and vendors across Canada, the U.S., and Europe, she brings more than 17 years of relevant experience in software engineering, product marketing, and business strategy within the healthcare IT and imaging informatics industries.

The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.


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