Digital Health & Care Scotland Conference – Breakout 1: Joining up Care: Whole system e-referral and patient flow with Strata Health Solutions

Howard Waldner, Dean of the School of Health and Public Safety, Southern Alberta Institute of Technology, Calgary, Canada and Former Chief Executive of Vancouver Island Health Region, Canada and former Chief Executive of Dundee Teaching Hospitals

BLURB: As Scottish health and care organisations look to integrate services and provide joined-up care to patients, the delivery and management of these “pathways” will inevitably require a digital solution.

This workshop will look at how regions in the UK and Canada have implemented the Strata Pathways solutions to improve the flow and transition of patients within and across Health and Care organisations. It will examine how clinically matching patients to all out-of-hospital services can bring operational efficiencies for stakeholder organisations and how a live, cloud-based solution can deliver better outcomes for patients by ensuring they are allocated to the right care setting as quickly as possible.

Howard started by showing the variation in healthcare cost per capita for different regions in Canada – and how increased cost does not necessarily translate into better care – as we well know from literature throughout the world, particularly USA.

Alberta has taken day surgery out of high cost hospitals into lower cost places like physician offices. This frees up day surgery facilities and ORs.

They have also taken dialysis out of hospital into shopping malls!

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Key Areas of Focus

  • Improved access to interdisciplinary primary health care
    • allowing nurse practitioners to provide wider range of services
    • have found a massive decrease in Emergency Department (ED) attendances
  • Reducing / containing whole system care costs – benchmarking  / operational practice improvement
    • benchmarking means publishing a book every year with comparisons between health boards / trusts
  • Avoiding acute hospital admission
    • reducing delayed discharge and optimising patient flow
  • Strategic priority setting / disinvestment

Programme Budgeting and Marginal Analysis

This is an economics/ethics practice that Alberta uses. Limited resources mean that decision-makers must set priorities among competing opportunities. Programme budgeting and marginal analysis (PBMA) is an economic approach that focuses on optimizing benefits with available resources. Accountability for reasonableness (A4R) is an ethics approach that focuses on ensuring fair priority-setting processes. PBMA and A4R have been used separately to provide decision-makers with advice about how to set priorities within limited resources.

My Personal Thoughts

I don’t think this talk reached the full potential I thought it could have. I was left wondering what point the speaker wanted me to come away with – I think my issue was that there was poor signposting and summarisation of problem and solution. Perhaps someone familiar with this area would have understood this talk, but the whole point of events like this is to open the audience’s minds to topics they don’t normally interact with.

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