A report from the Canadian Institute of Health Information on health-care system efficiency is further evidence of the need for continual improvement and change for the better in health care.

The report supports the Ministry of Health’s new strategic priority document, to improve patient experience and outcomes at the best price for taxpayers.

“Our experience in managing the health-care system is similar to what CIHI has found in their measure of health-system efficiency. Their report emphasizes the importance of using health-care resources effectively,” said Health Minister Terry Lake. “Health care is continually evolving and our priority document shows that we’re willing to explore and make changes that improve the system for patients without burdening the rest of government and taxpayers.”

The CIHI report, Measuring the Level of Determinants of Health System Efficiency, suggests that certain factors affect health-care efficiency, such as greater investment in primary care, lifestyle choices and equitable access to physicians. It suggested improving the health-care system in those areas could substantially reduce premature deaths in Canada without increasing health-care funding.

B.C.’s strategic priority document builds on the Innovation and Change agenda, introduced in 2010. The plan puts the patient at the centre of health-care delivery and focuses on policies and programs to improve the overall health of the population, enhance the experience and outcomes of patients and achieve the best outcomes for the health-care dollar.

“We are in a health-care era of change by necessity, where efficiency is not an option but a requirement of sustaining the success our health-care system has seen,” said Lake. “B.C. has some of the best health-care outcomes in Canada, with per capita spending lower than the Canadian average. We can continue to build on our success.”

British Columbia is already taking steps toward these goals through programs such as A GP for Me, Healthy Families BC and the Smoking Cessation Program. The priority document will help ensure everyone involved in the health-care system are all working to a common purpose, with the patient as the focus of care.

Quick Facts:

• B.C. has some of the best health outcomes in Canada while spending less than most other provinces - $3,722 per person annually.
• A Canadian Institute for Health Information study found that administration costs in B.C. health authorities was the second-lowest in Canada, at 3.53%.

Learn More:

The strategic plan is available online at: www.health.gov.bc.ca/library/publications/year/2014/Setting-priorities-BC-Health-Feb14.pdf

The CIHI report, Measuring the Level of Determinants of Health System Efficiency, is available at: www.cihi.ca

Two backgrounders follow.

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

BACKGROUNDER

B.C.’s Strategic Priorities Document

In February 2014, the Ministry of Health published “Supporting the Health and Wellbeing of B.C. Citizens.”

This planning guide identifies eight priorities that the ministry will work toward to improve the British Columbian health-care system. The plan centres on a Triple Aim approach, focusing on making changes in the health-care system that improve the overall health of the population, enhance the experience and outcomes of patients and achieves the best outcomes for health-care dollars. It has the patient as the focus of care, engaging communities and support systems to provide better, smarter care.

The eight priorities include:

• Provide patient-centred care, to shift the culture of health care from being disease-centred and provider-focused to being about the patient's needs;
• Implement a targeted and effective primary prevention and health promotion delivery system (built on the structure of Healthy Families B.C.);
• Implement a provincial system of primary and community care built around inter-professional teams and functions;
• Strengthen the interface between primary and specialist care and treatment, to achieve better medical and surgical specialty consultation and direct treatment;
• Provide timely access to quality diagnostics (complete laboratory reform and improve evidence-based access to imaging services);
• Continue to drive evidence-informed access to clinically and cost-effective pharmaceuticals;
• Increase access to an appropriate continuum of residential care services (with a focus on people with dementia);
• Revisit and rethink the role and scope of hospitals in regional health care - including how many and what types of hospitals the province needs, whether outpatient services should be located in hospital, and exploring increased use of contracted acute services for private sector delivery of publicly funded outpatient services.

This guide will provide a map of the entire health system about the challenges and priorities in health care, and will help ensure everyone in the health system is working to a common purpose. 

The guide has the goal of maintaining and improving what is working well, and moving toward a patient-centred culture throughout the health-care system. 

That will start with effective chronic disease prevention through population health programs, such as Healthy Families BC. It includes reducing hospitalization and the need for residential care through managing chronic conditions, and effective prevention for mental illness and addictions and improving timely access to care, diagnostic imaging and elective surgery.

It will include a consistent quality of care for those in residential care, with a strong focus on those with dementia, as noted in our Seniors Action Plan. It also includes effective and compassionate care for those at the end-of-life.

The guide is available online at:

www.health.gov.bc.ca/library/publications/year/2014/Setting-priorities-BC-Health-Feb14.pdf

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)

BACKGROUNDER

Examples of bending the cost curve in health care

The Ministry of Health and health authorities have been working hard implementing changes to improve patient care, while reducing increases in health-care spending. In 2009, we recognized that we could not maintain such large funding increases and so we began focusing on our administrative costs, on becoming more efficient and on turning to innovations like LEAN design.

As a result of these efforts, we’ve managed to reduce growth rates down to around 4% between 2008-09 and 2010-11 and then down to about 2.3% last year. Over the next three years, health spending is projected to grow by an average of 2.6% each year.

There are several examples of how finding efficiencies have allowed us and will continue to allow us to focus more money on direct patient care:

PharmaCare

B.C.’s generic drug pricing program has allowed the Ministry of Health to find over $100 million in savings - allowing the ministry to reduce the PharmaCare budget by 8.5% for this coming year, while still maintaining services.   
 
Community Care

$50 million is being invested annually from 2012-13 to 2014-15 on integrated primary and community care programs where a health-care team works together, with the patient and their loved ones actively participating as partners in care. 
 
One example of this is BreatheWell - a program for patients with chronic obstructive pulmonary disease. BreatheWell involves home visits by a nurse and respiratory therapist who work with a doctor to develop a care plan, coaching and education to help clients keep control of their condition and action plans to deal with flare-ups. Last year, the 320 clients involved in this program saw a 71% decrease in admissions to hospital and a 66% decrease in emergency department visits.
 
Primary Care

Last February, we announced A GP for Me with the doctors of B.C. - $132.4 million to build on our success and further expand this program across the province. 
 
Studies show that better health outcomes for patients start with a strong primary care system. When a patient has an ongoing, continuous relationship with a family doctor who knows their background and medical history, they will receive better care overall, from preventative care to more accurate diagnoses, better medication management and better co-ordination with other health-care providers.

By signing up for A GP for Me, a family doctor commits to providing full-service family practice to all of his or her patients, which supports attachment for current and new patients. 
 
Laboratory Services

Since 2007-08, we have been able to save $850 million through volume discounting and fee schedule changes. Legislation was recently introduced to streamline and integrate lab services throughout B.C. This will strengthen governance, accountability and benefits to patients.

LEAN Design

Health authorities have introduced several LEAN design programs to avoid unnecessary steps and be more efficient. For example, in Fraser Health, Surrey breast cancer patients are now offered three diagnostic tests (imaging, cytology and physical examination) during a single visit to the Jim Pattison Outpatient Care and Surgery Centre, which cuts diagnosis times. 

In Northern Health, the amount of time it takes for patients to be referred through the Prince George Home and Community Care office until they receive long-term care home support services has been reduced from an average of 68 days to 14 days.

In Interior Health, more than 60 modifications have been made to processes in the pre-surgical screening/operating room booking processes at Kelowna General Hospital in order to make the journey more patient and family-centred, and more efficient.

Reducing Administration and Duplication

Island Health reduced the hours of their satellite laboratory collection locations from 7:30-4:30 p.m. down to 7:30-12 noon. Those labs are within three kilometres of hospital labs and only received an average of five to seven visits each afternoon.

Health Shared Services BC is projecting savings of $200 million from leveraging the buying power of all the Health Authorities to undertake joint purchasing agreements for supplies, co-ordinating contracted services, consolidating “supply chain” services, and avoiding capital spending by co-operating on less costly solutions.

In Budget 2014, the ministry’s corporate budget - which includes administration - is  growing at only 0.1% this year and 1.0% in the following years, less than overall growth.

All health authorities have focused on reducing unnecessary administration costs, such as travel, catering and other expenses.

Our efforts are leading the country. A Canadian Institute for Health Information study found that administration costs in B.C. health authorities were the second lowest in Canada, at 3.53% in 2010-11, down from nearly 5% in only three years.

Media Contacts:

Kristy Anderson
Media Relations Manager
Ministry of Health
250 952-1887 (media line)