Health Quality Ontario Unveils New Data on Existing Health Interventions and Highlights Areas for Change in the Province's Health Care System
TORONTO, April 28, 2014
TORONTO, April 28, 2014 /CNW/ - As the province's advisor on health care
quality, Health Quality Ontario (HQO) has released the 4th edition of its Ontario Health Technology Maps ProjectReport. This report is unique as it looks at the adoption of evidence-based
medical and surgical procedures and laboratory tests that can be
tracked through existing databases. It provides information to health
care professionals on variations in care across the province, and
changes needed to improve the quality of health care for Ontarians.
The Maps Project Report is also designed to empower the public and
stimulate educated discussion with their health care providers.
Patient care founded on evidence is an essential component of a
high-quality health care system. Since 2003, HQO's Ontario Health
Technology Advisory Committee (OHTAC) has been analyzing existing
clinical data and making evidence-based recommendations on how to
improve health interventions for Ontarians. Based on OHTAC's advice,
the HQO Board makes final recommendations to the Ontario Ministry of
Health and Long-Term Care, health care providers and decision-makers
and the public. The Maps Project Report tracks how these interventions
are being implemented across the province. The following are two key
highlights from this year's Report where adjustments should be made to
improve patient care:
Thermal Balloon Endometrial Ablation (TBEA): TBEA is a non-invasive treatment option for dysfunctional uterine
bleeding, which is abnormal uterine bleeding with no known underlying
medical cause. It is a common and sometimes debilitating condition in
women of reproductive age, and up to 30 per cent of women in this age
group will seek medical assistance for this problem.1 Hysterectomies are also used to treat abnormal uterine bleeding, but
they are invasive procedures that can result in longer hospital stays
and complications, including incontinence and other urinary problems,
fatigue, infection, pelvic pain and sexual problems. The Maps Project
Report showed that TBEA rates remain low in Ontario compared to
hysterectomies and recommended the use of TBEA for the treatment of
dysfunctional uterine bleeding where appropriate.
Continuity of Care for Chronic Disease Management: The Maps Project Report found that 45 to 60 per cent of Ontarians with
chronic illnesses (such as diabetes and congestive heart failure) are
receiving a high continuity of care (meaning 75 per cent of their
visits with health care professionals are with the same health care
provider).2 This is important because research has shown that high continuity of
care is associated with reduced hospitalization rates and reduced
emergency room visits. 3 With the population aging - Canadians over 65 now make up the
fastest-growing age group4 and almost 80 per cent of Ontarians over 45 have at least one chronic
condition5 - more Ontarians will require regular interaction with their health
care providers to effectively manage their chronic illnesses and
symptoms. HQO recommends that continuity of care be the preferred model
for chronic disease management.
"Health technologies and services are constantly evolving and it is the
role of Health Quality Ontario to gather the data surrounding these
interventions and evaluate it so that health care professionals know
what adjustments to make to ensure quality health care for Ontarians,"
says Dr. Joshua Tepper, President and CEO of HQO. "Through
evidence-based research and data analysis we can determine how an
intervention is performing and what changes to make so that moving
forward, health care professionals are confident in the decisions they
are making to improve the health and well-being of their patients."
An Agent of Progressive Change: Moving Evidence into Practice
Throughout the Maps Project Report's history, there have been a number
of cases where actions have evolved based on HQO's recommendations.
HQO continues to monitor these areas to evaluate how any adjustments
have enhanced patient care.
Epilepsy Services: The Maps Project Report highlighted that epilepsy patients faced
significant gaps in care. In particular, patients eligible for a
surgery that could help them control the number of seizures, faced wait
times of over a year for the diagnostic testing needed to determine if
they were eligible for the surgery. At the time, only approximately
two per cent of surgical candidates received surgery. Based on a
thorough analysis of the data, in 2012, HQO recommended that access to
diagnostic testing and surgery needed to be improved for patients
living with epilepsy.
Results: The provincial government provided $867,500 in initial base funding
for improved epilepsy services in 2012/2013, which increased to
$8,675,000 in annualized based funding in 2013/2014. In addition, 21
additional epilepsy monitoring units were established to speed up
diagnostic testing to determine surgery eligibility. This year's
Report showed these investments have made an impact and that surgery
rates are up for eligible epilepsy patients.
Bariatric Surgery: In 2005, HQO recommended increased support for the use of bariatric
surgery in Ontario for the treatment of morbid obesity, because many
Ontarians were forced to undergo the surgery outside of the country.
Results: Since the Ontario Bariatric Services Strategy began, four Bariatric
Centres of Excellence, four stand-alone Regional Assessment and
Treatment Centres (RATCs) and two paediatric RATCs have been created in
Ontario. These centres received funding to increase capacity to a least
2,800 surgeries per year. In the fiscal year 2011/2012, no Ontarians
had to leave the province for the surgery - a significant decline over
even 2009/2010, which saw nearly 2,000 individuals head abroad.
"This year's Report has demonstrated that ongoing analysis of our health
care system is essential in ensuring Ontarians have access to the best
care possible," says Dr. Les Levin, Vice President of the Evidence
Development and Standards branch at HQO, which is the branch
responsible for the Maps Project Report. "Our aim is that future
reports will provide measurable targets and benchmarks to help spur
ongoing quality improvement within Ontario's health care institutions."
Maps Project Report Methodology
There were 21 interventions included in this year's Maps Project Report
and they were selected based on the availability of administrative data
from the Discharge Abstract Database, the National Ambulatory Care
Reporting System, Ontario Health Insurance Plan claims, and the
Laboratory Inspection and Licensing Database for Hospital Laboratory
Data. The report analyzed the clinical data gathered between April 1,
2011 and March 31, 2012, and compared the rates across the province's
14 regional Local Health Integration Networks.
Click here to access the latest version of the Ontario Health Technology Maps Project Report and to see HQO's research and recommendations related to all 21 health
Health Quality Ontario (HQO) is an arms-length agency of the Ontario
government, mandated to evaluate the effectiveness of new health care
technologies and services, report to the public on the quality of the
health care system, support quality improvement activities and make
evidence-based recommendations on health care funding. Visit www.hqontario.ca for more information.