March 6, 2008
We are all aware of the crisis Canadians are currently facing in health care – the shortage of health care professionals, the long wait times in Emergency Rooms and for surgeries and many Canadians not able to find a family doctor.
A main driver of the impending crisis of course, is our rapidly aging population:
Currently, 250,000 Canadians turn 65 every year. This number will increase dramatically in 2 years as the baby boomers start reaching 65.
Some statistics:
- In 2006 there were 4 million seniors, or more than one out of every 8 Canadians.
- By 2021, it is estimated that 19% of the total population, or almost 7 million Canadians will be seniors.
In addition, the population aged 85 and over, the segment that is characterized by many of the conditions associated with old age such as chronic disease and dementia, is the fastest growing segment of the overall senior population.
And the rapid increase of Chronic Diseases is also a critical driver of our growing health care expenditures. This is leading to an unsustainable health care system. Over 80% of seniors (nearly 3.5 million) have a chronic disease, 70% of these people suffer from 2 or more diseases. It is estimated that 16 million Canadians suffer from a chronic disease.
To put this into perspective, 60%, that is $90 billion, of our total health care costs are attributed to chronic diseases in Canada.
And the most prevalent chronic disease: Diabetes.
In the last 10 years there has been a 70% increase in the number of Canadians with Diabetes. Currently 3 million people have been diagnosed with the disease and many more are as yet undetected. Some of the consequences of Diabetes:
- It is a contributing factor in the deaths of approximately 42,000 Canadians each year.
- It is a leading cause of heart disease, stroke, kidney disease, blindness and amputation. Adults with Diabetes are twice as likely to die prematurely.
- People with Diabetes incur medical costs that are 2 – 3 times higher than those without diabetes. Diabetes and its complications cost the Health Care System $13.8 billion annually.
Compounding the challenges just outlined is the chronic shortage of nursing staff and the growing need for personal care aids, or PSWs.
I could go on; you will no doubt hear more about our challenges from other speakers today.
The point is; Ontarians and Canadians have to start to rethink how we are delivering healthcare. We must develop new, innovative and less labour intensive methods of providing care. We must take more ownership of our own health. I met with our Minister of Health and Long Term Care last week, and I know that this is on his agenda.
This brings us to We Care's Aging @ Home Strategy.
We Care has undertaken a number of initiatives to allow seniors to remain safe and healthy in their own homes for as long as possible.
In December of 2007, we announced a new partnership with the Canadian Diabetes Association. When announcing this new initiative, we stated we are partnering with the CDA to create a healthier Canada; to help the Association fund its mission to promote the health of Canadians through diabetes research, education, service and advocacy. We also launched a new diabetes program to provide education for We Care employees. Diabetes-focused training will help ensure We Care nurses and Personal Support Workers have the most up-to-date knowledge available to help people deal with issues arising from diabetes.
We have also partnered with the Sault Ste. Marie Safe Communities to publish an Independent Living Guide. There are many factors that contribute to healthy aging. While we may have little control over factors such as our genetic make-up, there are many things we can do to maintain vital, active lives. Certain risks can be eliminated and others considerably reduced by simple preventive measures. The Independent Living Guide helps seniors recognise safety risks and provides suggestions for simple changes to reduce the chances of injury in and around their homes.
We Care is distributing 20,000 copies of this guide free across Canada.
But our most innovative collaboration to date is with IgeaCare, a software developer. We Care has helped customise IgeaCare's state of the art wireless technology. This technology allows us to remotely monitor patient's health in an easy, non-invasive way from anywhere the client is – at home, the cottage, or visiting family in another city. Using IgeaCare's technology and We Care's trained staff, we can provide a comprehensive menu of services for seniors and their caregivers that is proactive, cost effective and less labour intensive than our traditional methods of health care monitoring.
Our new program named Re-Act, directly supports Ontario's Chronic Disease Prevention and Management Framework. The Framework integrates the role of individuals, families and health organizations in the community, promoting productive interactions and relationships, resulting in improved clinical, functional and population health outcomes.
Re-Act works as follows – wireless technology links a We Care nurse to a caseload of seniors living in their homes. The system monitors an array of health indicators – blood pressure, pulse, blood glucose, oxygen, spirometry and weight as well as provides insight into medication compliance. Our nurse reviews the results daily and categorises them as normal, moderate or high-risk alert, and takes appropriate action.
The nurse may telephone the client to gather additional information, decide a home visit is necessary, or communicate with the Family Physician, specialist or other health care provider regarding the latest findings. The frequency of the monitoring can be increased until the client has stabilised and vital signs have returned to normal.
Each client's personal profile is customised to reflect their preferences for food and exercise, allowing the nurse to provide suggestions that are pertinent to that client. Clients looking for more information on a disease, new exercise options or healthier diet suggestions can access training materials on a variety of topics.
Our new national partnership with the Canadian Diabetes Association provides education material sponsored by the CDA, including video learning modules, which will be streamed directly to clients when appropriate.
Maureen Markel Reid of McMaster University states that, "proactive nursing health promotion is more effective and no more expensive than reactive, on-demand care".
We see the benefits of the Re-Act program as follows:
- Reduced visits to Emergency Rooms
- Reduced hospital and institutional admissions
- Reduced length of stay in hospitals
- As family caregivers provide much of the care for seniors leading the caregivers themselves to develop health problems, we expect the program to relieve some of the burden on them.
We are currently in discussions with several LHIN's and CCAC's to implement this system in their areas. Once implemented, we are confident that client's, their families and health care workers will accept this technology and come to rely on its benefits.
Our confidence comes from a similar pilot program we undertook in 2002. At that time, in a partnership with March Networks, Aliant Telecom and the University of Calgary, we implemented a converged voice, video and data solution for 45 clients in Nova Scotia.
The goal of this pilot, as designed by the University of Calgary, was to gauge client and nurse satisfaction, access to care, equivalence in quality of care and potential cost savings in supplementing conventional home care with remote home telehealth visits.
In his Independent Evaluation, Dr. Richard Scott of the University of Calgary, summarised, "Home telehealth has been shown to be effective, able to substitute for some "in-person" home care visits, able to provide very high satisfaction to patients and nurses, and able to maintain the quality of care of patients. In addition, home telehealth has been shown to offer cost savings and increased access to care through reduced travel and greater efficiency and productivity of nurses.
The study found that over 95% of patients indicated that they were satisfied with remote monitoring and consultation and were comfortable asking questions and receiving health care information from the nurse they dealt with. Nurses felt they were able to obtain adequate and accurate clinical information with which to assess the clients.
While the quantitative results were positive, the qualitative results were even more promising. Home visits conducted by a nurse travelling to a patient's home took an average of 33.5 minutes, accounting for one way travel. The total home teleheath consultations took on average just 10.5 minutes. This represents a saving of 75 days per year, or a 31% efficiency improvement.
Technology offers home care providers the potential to accommodate the needs of the growing population that requires some form of home care. It assures all Canadians, including those in remote communities, accessibility to qualified nursing professionals. We believe that in the near future, an appropriate mixture of home telehealth and conventional home care will become the new standards of care.
We applaud the Ontario Ministry of Health and Long Term Care's initiative to fund an Aging at Home Strategy. As mentioned before We Care has responded to several RFPs issued by LHINs to pilot our Re-Act program and we look forward to implementing our system soon.
We also look forward to working with many of you to tackle the crisis we as Canadians face in health care. Aging at Home is one strong strategy to help alleviate the crisis.
For more information, please contact:
Barbara Toccacelli
Director of Human Resources and Communications
416-922-5387 x 103