Draft

December 2, 2010

Québec Medical Association

Technology and Managing Chronic Diseases

Fact-finding and Observation Mission

Context

For several years now, the Québec Medical Association (QMA) has been interested in the emergence of chronic diseases and the challenge this poses for the Québec health care system in general and for the medical profession in particular.

At present, about half the people in North America suffer from at least one chronic disease, one quarter have two or more chronic diseases – and the number rises to two out of three people in the over-65 age group.

There is a growing consensus that the health care system is poorly designed to meet the needs of chronic diseases. Although it is very efficient at handling acute or occasional problems, it is inadequatly prepared for a continuous response adapted to health needs.

Yet very efficient chronic disease management programs do exist elsewhere. The QMA is proposing to collaborate with partners in the information and communications technologies industry to sponsor a mission aimed at making the medical profession in Québec aware of these models.

Mission

The fact-finding and observation mission enables two groups of health care professionals, managers and researchers to go out into the field to meet with the professionals and managers of chronic disease management programs that have proven their worth. These two clinical environments – one Canadian and one American – are very different from each other in both size and environment.

The first is a health care institution in British Columbia, a province that many observers feel is certainly the most advanced when it comes to chronic disease management.

The second is the Cleveland Clinic Health System, a network of 2,000 salaried physicians, with 4.2 million walk-in visits and 165,000 hospitalizations.

As different as these clinical environments may be, they do have one thing in common: optimal use of information and communications technologies in the service of health care professionals and their patients.

Objectives

The general objectives of the fact-finding and observation mission are to:

  • Learn about clinical organization models that enable optimal management of chronic diseases.
  • Analyse the strategies designed to increase and support the involvement of patients in developing their treatment plan and monitoring their health status.
  • Understand the role that information and communications technologies play in supporting the clinical model.
  • Make the medical profession in Québec aware of these models.

Focus Areas

During the mission, the participants will be able to analyse the following (the list is not exhaustive):

 The approach to take to reflect the level of complexity of patients with chronic diseases;

 Chronic disease “classification” methods;

 The respective roles of different categories of professionals;

 Performance indicators;

 The use of information and communications technologies by professionals and their patients;

 The extent and efficiency of home monitoring technologies;

 Incentives for professionals;

 Strategies aimed at modifying patient lifestyles and their buy-in to the treatment plan;

 The role of patients in monitoring their state of health (portal, EMR, Internet, etc.).

Composition of Mission Teams

For each mission (Canadian and American), the team consists of five people recruited from the following categories of professionals:

  • physicians
  • pharmacists
  • nurses
  • co-managers of patient-centred programs
  • other professionals involved in chronic disease management: physiotherapists, occupational therapists, psychologists, dieticians, etc.
  • researchers

The exact composition of each group is at the discretion of the QMA. However, three criteria must be taken into consideration when forming these groups:

Candidates must have:

  1. A marked interest and recognized experience in chronic disease management;
  1. Demonstrated experience in interdisciplinary work;
  1. The interest, availability and skill to participate in knowledge transfer activities (writing, presentations to groups, etc.).

Recruitment

Participants will be recruited by a call for interest, mainly (but not exclusively) from among people attending the symposium on January 21, 2011.

Funding

Mission funding is provided by the QMA and its partners. The expenditures covered are for travel and reasonable accommodations and meal costs. No fees will be paid to participants in the mission, which should take two or three days, with everything to be discussed with the host institutions.

Knowledge Transfer

Mission participants must commit to taking part in an activity to transfer the knowledge acquired during the mission. In particular, in April 2011 they must attend the QMA convention, according to the terms and conditions to be defined.

Participants can also be called upon occasionally during the mission to contribute to a blog on the QMA’s Website.