Health Care in Canada on Hold — Dr Jean-François Joncas, Eva Villalba, Annie-Danielle Grenier

Alya Niang

Please bear in mind that the opinions and comments of our guests do not necessarily reflect those of the Canadian Institute for Health Information.

Hello and welcome to the Canadian Health Information Podcast. I’m Alya Niang and I’m excited to be hosting a brand new season of this podcast from the Canadian Institute for Health Information, better known as CIHI.

We analyze Canada’s health care systems and policies in depth, and discuss efforts to keep Canadians healthy by looking beyond the data and talking to experts, health care workers and patients. In today’s program, we take a closer look at how the COVID-19 pandemic has derailed the Canadian health care system, forcing many forms of care to be delayed, cancelled or otherwise affected, a complete shift in priorities in order to care for patients with the infection.

We have with us Annie-Danielle Grenier, rare disease communicator and patient partner; Eva Villalba, executive director of the Coalition Priorité Cancer au Québec; and Dr. Jean-François Joncas, orthopedic surgeon and president of the Association d’orthopédie du Québec.

Annie-Danielle raises awareness, educates and advocates for the rights of people living with rare and invisible diseases — she herself suffers from more than one. She is involved in many projects, helping to change policies, co-creating surveys and educating future health professionals.

Eva Villalba is passionate about good governance, public policy, community impact, health care reform and social innovation. She has also been involved in charitable organizations, advocacy groups and non-profits in the health care field.

Dr. Jean-François Joncas specializes in hip and knee arthroplasty and reconstruction and in traumatology. For a number of years he has also been involved in the orthopedic residency program at the Université de Sherbrooke.

Hello everyone and welcome to the podcast. It’s a pleasure and an honour to discuss the current state of the health care system in Canada with you. We’re here to talk about what putting some health care on hold means for patients and practitioners and the implications for the long-term health of Canadians. We’ll also discuss what we can learn from what has happened for the next wave, for the next pandemic, who knows?

I’d like to start with Annie-Danielle. Annie-Danielle, you have had some delays in your care. Can you tell us about your experience?

Annie-Danielle Grenier

I have a complex condition with several rare diseases, among other things, so I definitely have a lot of follow-up. So, I have had a lot of delays: not just one episode that didn’t happen as scheduled. Back in 2020, I was supposed to have a follow-up of ankle surgery and physical therapy. Both those things happened a year later. In fact, when the time came, it was cancelled. The doctor said: well finally, if everything is going well, we’ll just let it drop. I can’t say that this was a major problem. Things were going well, but that’s because it was a little too late too. I needed the follow-up earlier, I had some problems, but apart from a new operation, nothing can be done. So it wasn’t worth it.

In the summer of 2020, I was diagnosed with a pre-cancerous condition in my uterus, and needed a hysterectomy as a result. That part wasn’t too bad, but when the time came for the surgery, the gynecologist told me, we’ll do your operation at the beginning of September, it won’t be long. In the end, she had to call me and say she couldn’t do it; it had to be moved to the end of September. At the end of September, it was postponed again because she had to go to Gaspésie to replace people who were too sick there. At that point it was causing anxiety, because not only was it pre-cancerous, I was afraid it would become cancerous, or that it already was, but we didn’t know, and so on. But also, I was very much at risk of death with COVID and immunocompromised. So, the closer we got to winter, the more worrisome it became for me. I could see the cases going up and then I was really scared.

My doctor was also scared. She had consulted with people in the COVID wing to get their assessment of things, to see if they had to cancel and reschedule in the spring and so on.

So those are 2 of the major episodes. On top of that, well I have problems with my eyes. It’s a progressive condition. I had the surgeries that stopped the progression, but it’s like there’s no guarantee, you don’t know if it’s going to last. So the ophthalmologist wanted to see me every 3 months, which we did until the pandemic. Then, well on the one hand, if things were going well and I didn’t have any concern, he preferred not to make me come in, because it’s a matter of hours waiting in a kind of aquarium. So he knows my conditions very well, and he took them seriously, so he didn’t want to put me at risk, but even so I was due to see him. I think I saw him once a year. Once in 2020, once in 2021, then I was supposed to see him or at least talk to him last October but I don’t even have an appointment date yet.

Things have always taken longer, and then delays, that’s nothing new in the system, everybody knows that, but it definitely got worse.

Alya Niang

Annie, how have these delays affected you mentally and emotionally? Were you afraid?

Annie-Danielle Grenier

For sure. Part of me was happy at first because I was a little bit on vacation, I had an average of 2 to 3 appointments per week. But it didn’t take long for things to change, especially when there are problems like that. The regular follow-up, when everything is going well, is not worrying, but not being able to get confirmation that the progression of my eye disease had not started again... If I couldn’t see very well, then that was worrying, I wanted to be sure it wasn’t starting again and then I couldn’t get to the next step.

Then obviously, with a pre-cancerous condition, like I said, the longer the delay, as with anything... in fact all my delays, the worry was that a problem would progress, become more difficult to treat, and so on, which has happened to me before. Certainly, for some conditions it was more worrisome than for others.

Alya Niang

Lots of anxiety, lots of worry, lots of stress. Let me bring you in, Eva. You’re very involved in the field and I’ll remind listeners that you are executive director of the Coalition Priorité Cancer au Québec. Your mission is to be a strong voice for those affected by cancer. You just heard Annie-Danielle’s experience of having her pre-cancerous surgery postponed several times and the emotional and mental impact it had on her. Can you tell us how the cancer care community has addressed this issue?

Eva Villalba

Yes, but first of all, thank you, Annie-Danielle, for sharing your experience with us. At the beginning of the pandemic, our coalition did a survey of people affected by cancer because it was being said that there was no impact on care, there was no impact on citizens, everything was fine, they were managing it. And when we did our survey, about 600 people across Quebec participated each time, 4 weeks and 9 weeks after the pandemic. Then we realized that people had 2 concerns that Annie-Danielle mentioned. The first concern was that they were more at risk because of their weakened immune system. And the second was that the pandemic was going to affect their access to care and treatment. And we have seen that it did persist, and about 72% of respondents had these fears.

This made people avoid going [for care and treatment], even when it was available, because at one point, especially in Quebec, but across Canada, we saw what in Quebec we call “load shedding,” but in the rest of Canada it’s “health system rationing.” It was really like, well, we’re going to cut back in case we don’t have the capacity to provide you with care. And that resulted in people getting deprioritized, as Annie-Danielle mentioned.

It’s very difficult for someone to understand that they are not prioritized. Everyone is important, but our system has a capacity in terms of units, so how do we manage that? The oncology community, of course, was concerned about the people who were not getting screened, who were not getting diagnosed, who missed follow-ups, and because of this, their situation became worse.

Annie-Danielle mentioned pre-cancerous cancers or people with suspected cancer, that’s what we’re very concerned about. Last year we participated in a campaign, and we continue to do so, called Nouvelle Normalité, Même Cancer [New Normal, Same Cancer]. The goal was to make people aware that you can’t wait for the pandemic to end: go see your doctor if you have symptoms, go talk to your pharmacist or your nurse. And really to encourage people to get tested. What we see, what we hear is really the anguish that Annie-Danielle talked about, this fear that care will not be there when it is needed. That’s a real concern.

Alya Niang

Indeed it is. As you mentioned earlier, we’ve heard a lot about surgery cancellations and delayed treatments from people who were afraid to go to the hospital. But for people with cancer who are waiting for a diagnosis, what kind of impact can this really have?

Eva Villalba

In fact, Quebec was the only province that actually issued reports where they measured the impact on cancer cases. Just in the first wave, from April to June 2020, we missed an estimated 4,119 cases. So, fewer cases compared to the same period the year before. This is not because there is less cancer: it’s because we’re going to see them at a more advanced stage and that’s what clinicians are telling us. We are very worried about the advanced-stage cancers we are going to see because they were not detected early.

There are also issues related to access to screening programs for breast cancer, colorectal cancer and for what is often forgotten, cervical cancer. Normally that is care provided by family physicians. And at the beginning, there was no in-person access, for almost a year: people didn’t see their family doctor in person. This means that doctors were not doing the Pap test (we prefer HPV tests now), not doing the follow-ups that are necessary, and those cancers — breast, colorectal and cervical — if they are caught early, they are very manageable, it’s better for the person and it costs the system less. But because of the “load shedding,” these cases will increase. And right now, there are things in place to try to catch up on these delays.

But we have seen, and the Ministry of Health has measured the impact of the load shedding, and we are currently in the process of catching up on these delays, but we are still very worried about advanced cancers that will be found a little too late.

Alya Niang

Dr. Joncas, still on delays, we all know that the last 2 years have been quite difficult for physicians and patients and I would say for everyone. According to the recent CIHI report that examined wait times in the first 18 months of the pandemic, between October 2020 and September 2021 approximately 62% of joint replacements across Canada were treated within the recommended 182-day time frame. The figure was 71% prior to the pandemic. This being your world, can you tell us more about those numbers and how you and your patients have experienced all these problems?

Dr. Jean-François Joncas

As Eva said, the system is not yet 100% operational. We are concerned because COVID has helped to expose weaknesses or weak points in the system, such as waiting lists for elective surgeries like hip and knee replacements. The lists were already substantial before the arrival of COVID, but now they have definitely exploded. And it’s a much older clientele, in general, more sick, because with age, people often have minor health problems. As a result, the situation for patients waiting for day surgery in Quebec is quite good. The real losers are patients who need to stay in the hospital for one or 2 or 3 nights.

And because of the pandemic, we have even started to do day surgery for this clientele, but you still have to be relatively healthy to have an operation and then leave the hospital the same evening with a hip or knee replacement. And this is not currently accessible in all areas in Quebec.

In short, the clientele that already had to wait a certain amount of time for their surgery is now seeing the delays grow longer and longer. Obviously, for us in the treating teams, this is very difficult because we don’t know what to say to patients. As Annie-Danielle mentioned, they were promised surgery in the fall and then winter arrives and it’s still not possible, now it’s for spring. It’s not easy, we don’t always know what to tell them. We see the great distress of these people who are waiting to recover a function: most of them have difficulty walking, or doing leisure activities, or even working. It’s not a question, as in the case of the clientele Eva mentioned to us, of danger to life. It’s definitely much more a question of function, of daily activities, what we call functional impairments — the ability to walk, to get dressed, to go to work, to take a walk, to walk the dog, to go up or down stairs, etc.

So yes, our clientele is still affected, and I guess it’s going to take maybe another 2, 3, or 5 years before we catch up to the pre-COVID level, I think, unfortunately.

Alya Niang

And these affected patients, have they been able to continue working, seeing their families, or to face each day without significant suffering?

Dr. Jean-François Joncas

Well it sounds funny to say, but probably when there was a lockdown for a few extended weeks, well people couldn’t get out. After a certain time in the evening, we couldn’t go out, so in terms of activities, less sustained activities, certainly people perhaps felt the difficulties a little less. Definitely there were people who had to be put on medical leave because they were unable to do the work physically, especially work that requires physical effort, many such people had to have medical leave certificates.

Then, for older clients, it’s important when you have an ailment to get some rest, but too much is no better. There was a lot of loss of condition among the elderly due to the confinement, even for people who, at the beginning, did not have too many problems with balance or getting around. So, it’s obvious that patients who were already waiting for hip replacements also unfortunately experienced situations that may have worsened their situation and limited their ability to move around, to see their family, or simply to go out for a change of air, yes it’s possible that this happened. And it still is happening at the moment.

Alya Niang

Dr. Joncas, do you think things could have been done differently to prevent these issues, these problems?

Dr. Jean-François Joncas

It’s difficult to say because, as I mentioned, the Quebec health care system, in terms of orthopedic surgery, was already a bit behind some Canadian provinces. This is mainly due to the lack of access to technical facilities. The other thing that we realized was the shortage of beds overall. Of course, I was talking about a clientele that needed to spend a few days in the hospital after hip, back or knee surgery. So, if we had had a higher hospitalization capacity, we would probably have been able to maintain a certain level. I’m not talking about maintaining a pre-COVID level, but it would probably have allowed some patients to be operated on anyway.

Now, after the pandemic, we hope that we are back on track with regular activities. The current risks are that operating rooms are not even 100% used at the moment because there is a shortage of personnel. So, that’s a big hill to climb because you’re going to have to fill those operating rooms with staff to make them work at 100% of capacity. And, as I think Eva mentioned, there is a need to increase activities to 120 to 130%, and the same goes for us to be able to catch up. So if no operating rooms are going to be built over the next few years to provide more access, well we need to focus on the ability to train and then retain staff.

When we get to 120 to 130% we will be able to operate a little later in the evening from time to time, on weekends etc., probably, but we need personnel, in the clinics too. Unfortunately, we are far from this point at the moment.

Alya Niang

Indeed, staff is needed. To come back to you, Eva: We have heard in the media that things are going well as regards emergency procedures. Do you see things differently?

Eva Villalba

I wouldn’t say I see things differently: we note that everything that was urgent has been dealt with as a priority, which is a relief. But, we prefer to intervene upstream, we prefer not to have to go to the ER. Something that was worrying, for example, recently it came out in the media that they were changing targets. Before, the target was that 90% of oncology surgeries should be done within 28 days. Now, the target for many is within 2 months, 56 days, and we’ve changed the way we do things somewhat, which doesn’t necessarily bother us because they say that some slow-moving cancers, for example some prostate cancers, can wait 2 months. Why prioritize all cancers, we should adapt to the reality of each one.

On the other hand, as always, and as we claim as a patient advocacy group, if we don’t tell patients why we are doing their surgery, if we had said to Annie-Danielle that we will operate on you in October. Okay, we have a clinical reason why we’re going to operate on you in October instead of September. But if we tell her September and every 2 weeks we change, well that will definitely create anxiety.

So, the problem, I think all the urgent cases in surgery have been done. It is certain that people start to think that they are the ones who are deprioritized, they are less important, their disease or their cancer or their condition is less important. This really needs to be addressed and explained that there is a good reason. But at the same time, we can prioritize, but we must not forget to explain and take the time to communicate to the patient why there has to be a wait, why he or she is going to be scheduled for such-and-such a date and what we’re going to do in the meantime, what information or support we’re going to provide to patients while they’re waiting for surgery. Because if we tell them: we’ll call you, wait by the phone and don’t go out, that person is not going to sleep, they’re not going to eat well, they’re going to be eaten up by anxiety and anguish. With simple, effective communication, this could be avoided. That wouldn’t cost the system anything, but it requires a slightly different approach.

So, as regards delays, I would say that urgent oncological surgeries have been done, but what worries us is that something that isn’t considered urgent today can become urgent. We cannot continue rescheduling indefinitely, we cannot go on postponing and postponing. We should really have a clear plan of attack and objectives, an action plan to address these capacity issues we are talking about.

Alya Niang

Indeed, as you say, Eva, we can’t keep postponing. Annie-Danielle, are your appointments now back to normal? Do you have a message you would like to share with Eva?

Annie-Danielle Grenier

No, I can’t say things are back to normal. First of all, the pandemic is not over, even if it sometimes feels that way. So it’s still dangerous for me to go to the hospital, especially since there are places where the situation is taken less seriously than others, unfortunately. Then when they say “we follow all the rules,” that doesn’t reassure me very much because while I was in intensive care, after my surgery, my hysterectomy, there were nurses who came in without masks even though I was in isolation protocol.

It’s hard for me to be reassured by “Ah yes, yes, we do everything right here.” Then “everything right” is constantly decreasing. So, that’s it, just from that point of view, there are appointments in person, for me, if that is essential. Or, it’s been 2 years since I’ve had such-and-such a follow-up, they’ll try to do it in the summer and hope that it’s not at the same time as a wave. So that alone means that things are not back to normal. Then, even for other people, even virtual or regular follow-up appointments, there were already delays before the pandemic. I was talking about my eyes earlier: the ophthalmologist who wants to see me every 3 months, he wrote 2 months and then we sometimes managed to have an appointment at 4 months. He called me once, but it wasn’t an appointment, it was a five-minute meeting to answer a question and that was it.

Alya Niang

Annie-Danielle, I sympathize with you regarding all these inconveniences. We can imagine the anxiety and pain on the general health of people who have experienced these delays in one way or another. Let me ask you, as a communicator and patient partner, what have you learned from other patients?

Annie-Danielle Grenier

I would say that I have learned a lot. I’m definitely a member of the rare disease community. A lot of what we learned was about our resilience (we already knew about that), but above all we talked about how the first weeks of the pandemic had some good aspects for some people, as Dr. Joncas mentioned. Many people in my situation with rare diseases, we had difficulty even realizing what was going on because it was already similar to our daily lives. Then we realized that the psychological impact for us was less than it was for people who are not used to having to cancel things or not being able to go out and so on.

But definitely, as the pandemic stretches out, our resilience takes a hit. Even though we understand... as I say, I knew why I wasn’t prioritized and I understood that the someone with COVID who was choking took priority over me. It’s logical to prioritize like that, but at some point, when you have complex conditions, what happens is that you don’t fit into the little boxes when there are prioritizations like for vaccines — for example, people with complex diseases, rare diseases. Sometimes you can be more at risk than someone who is 80 years old but in great shape. That was not taken into consideration at all. So that’s it, it’s something that was very hard on the rare or complex disease community in general.

Alya Niang

Dr. Joncas, we have been through a number of waves, many situations, many problems. Today, my question is, what solutions are being considered to address the surgical backlog or what solutions could be implemented in the future? What are the consequences?

Dr. Jean-François Joncas

It’s like I was telling you earlier, orthopedic surgery and all elective surgeries, Eva mentioned it, all the emergency cases, they have all been done. Obviously, fractures and cases that required quick interventions, we dared to discriminate positively. Currently, technical facilities in Quebec are limited. There are no new hospitals under construction that I know of. There may be operating rooms that are being renovated. We hope that in these settings they will add one or 2 operating rooms to be able to meet catch-up needs in the future.

Also, in the immediate future, it is important to recover and train as many staff as possible to run the operating room. I think we also need to question the relevance of requiring staff to have a bachelor’s degree to work in the operating room, when at one time attendants were trained to provide instruments to surgeons, and it worked very well.

The various trades, in quotation marks, the various unions will have to realize that there is work for everyone and no one encroaches on the competence of anyone else. As Mr. Dubé, our minister, rightly said, we must optimize the skills of all, and also decompartmentalize skills. So, if we allow people from different backgrounds to help out, starting with graduate nurses, nurses with degrees, nurse practitioners, nursing assistants and attendants, we already have a good cohort of personnel. In orthopedics, we can add podiatrists. Physiotherapists and occupational therapists can be added to help support family physicians in the initial assessment and pre-consultation.

For the future, as soon as we have enough staff to run operating rooms optimally, we will have to anticipate perhaps extending operating days by an hour or 2 at the end of the day to allow one or 2 more surgeries. And then maybe on the weekend from time to time — this has already started in some Canadian provinces.

In the long term, we will also have to plan for the fact that we may have made too many cuts, including operating rooms in Quebec and hospital beds. I think we may have to swing the pendulum the other way and then anticipate the aging of the population, perhaps other pandemics with — unfortunately — the same constraints. So, all that has to be planned for.

Then, of course, innovation is welcome right now. We were talking just now about doing one-day hip replacement surgeries. Five years ago we would have been told we were crazy to say that, but now it’s starting to be a reality. So people are starting to look at things like that.

Here again, it will take the support of natural caregivers because families, friends and relatives will have to be aware that if we want someone close to us to have an operation quickly, we may have to take care of them a little so that they can return home sooner rather than always relying on the sacrosanct hospital for care.

So, we as a society have to think about what we can do to help the system.

Alya Niang

Thank you. Eva, what are the medium and long-term impacts of delays on cancer?

Eva Villalba

We’ve already talked about the short- and medium-term impacts, and as I mentioned earlier, we know that in the next 10 years we will have 8,000 more cases of cancer due to the pandemic. This is an estimate because the data we have is not as up-to-date as we would like, but we are starting to get data. And we don’t have data regarding stages yet, but we know that the ministry is looking at the subject at least during the pandemic period and we should receive that data. How many more people will be diagnosed in the advanced stages? We know from what clinicians tell us that figures are rising and that easily manageable cancers are fewer than before the pandemic. So that’s a real concern.

To home in on Dr. Joncas’ point earlier, one of the things we have realized is that, during the pandemic, our approach was too hospital-centric. We tried to protect hospitals instead of trying to protect vulnerable people. And vulnerable people are found everywhere including in the community and they need to receive care even outside of hospitals as such. So, I think that the best thing we could do, and what we can do to minimize the long-term impacts, is to have a vision of our health system as a complete system that also includes front-line care with family physicians, with specialized nurse practitioners who can help us have a little more capacity in our system, with pharmacists who can now do many more things and who are close to the people in their community, who also have a good level of trust from their patients. I think we can also look at how to do things in clinics that provide public services, but with resources who are already in the private sector, who do not work 100% in the private sector, but could be partly devoted to day surgeries to relieve the pressure on that area, for example.

So, I think there are ways of improving matters, but at the same time, we must address the shortcomings that, as Dr. Joncas said, have been highlighted in this pandemic. For example, all those people who still do not have access to a family physician. If everything is based on a referral from a family physician, what are we doing for these people? And what do we do — Annie-Danielle touched on this — with people who have comorbidities, several illnesses simultaneously? Do we continue... I think that one of the things we have seen is the impact of the fragmentation of our health system, and one of the solutions to help this and we hope that, with the major overhaul plan and the bill on health data that Mr. Dubé has tabled, we hope that this data will enable us to keep track of patients, that the data will follow patients, so that they will be better taken care of and that we will not just work on one piece of their health, but that we will see their health as a whole.

Alya Niang

One final word and I will continue with you, Eva. What would you like Canadians to know?

Eva Villalba

First of all, unfortunately, sometimes we have to fight to get the care that is our right. It’s a shame, but I would encourage Canadians to really go and get tested, to go and see their doctor or their nurse or their pharmacist if they have symptoms, not to wait for everything to get back to normal, because it’s never going to get back to normal anyway. Also, if ever they have issues of access, problems, I would tell them that there are groups like us, like the RQMO which is concerned with orphan and rare diseases, there are many organizations, patient associations, that can support these people if they have problems of access and have resources that can help them. Because it’s extremely difficult to navigate our health care system and sometimes it helps to talk to peers or people who have been there.

So I would encourage Canadians to go to their family doctors or other professionals and also to contact patient associations, community organizations and patient advocacy groups.

Alya Niang

Thank you. Dr. Joncas, any final words you’d like Canadians to know?

Dr. Jean-François Joncas

Every province has experienced issues specific to its population, but overall, the majority of problems have been experienced in all provinces. There are discussions between provincial leaders to see what has worked well, what has not worked so well, and what can be done to prevent similar situations. Then, too, people are coming together to make plans for the restart and to ensure that Canadians are not left behind in terms of catching up, for example.

I also think that maybe Canadians need to start questioning their politicians because the federal government has overall responsibility for the health of its citizens, but the provinces administer health care. So, there are small variations, there are perhaps things that should be clarified. Is there room to introduce a little more collaboration with the private system? When I say the private system, I’m not thinking at all of what’s happening in the United States, not at all, not at all. For example, in Quebec, for the last 50 years, radiologists have owned their radiology clinics, but the government adds a little extra remuneration so that they can acquire equipment, maintain it, and staff as well. Therapists are not allowed to do that, surgeons are not allowed to do that. That depends on Canadian law.

I don’t see that happening in the short term, but perhaps in the medium to long term, as in the major Commonwealth countries, in England, New Zealand and Australia. They have a parallel system where everyone has access and at the end of the day, it’s not the credit card that pays the bill, unlike in the United States. You have to be careful, I realize that when you talk about private, people get worked up, they immediately think of the situation in the United States. It’s not like that at all, it’s more like collaboration. Eva mentioned it, specialized medical centres in Quebec, we hope that it becomes a collaboration, especially if governments are perhaps less ready to invest in concrete, in buildings, maybe there is a way to find an option. There are countries that do it and it works quite well.

Alya Niang

Annie-Danielle, a last word?

Annie-Danielle Grenier

Eva touched on an important point, I think, with prevention. I was saying earlier, the pandemic is not over, well that’s kind of the message I would send and not just to Canadian patients, but also to professionals and to governments, that if we don’t prevent all infections... the latest data on long COVID, we’re talking about 10 to 30% of people. These are people who are going to need more care, and then it’s caregivers who won’t be there as well. So, it’s not a good equation.

Then there are those who are more at risk or immunocompromised. There are people like me, there are some who are not quite so bad, so to speak, but I don’t think it’s good for the health system that there are a lot of infections. People who are vulnerable may not die, but they will need care, and that will cost even more.

Right now, there’s the number of beds that are occupied in Quebec since December, it’s crazy. That definitely slows everything down. So, when we talk about prevention, that is mandatory, but maybe to continue wearing masks is important for the whole health system and for the economy, even if that’s an argument that is often forgotten. I think that’s an important consideration.

On the innovation side, I think it’s also a lot about going into partnership with patients, respecting patients’ experiential knowledge, and all that. This is something that we have seen a little more over the last 2 years: patients are able to take their temperature or blood pressure by themselves, and we can rely on what they tell us to go further with virtual appointments, for example, that has happened much more and it’s something we didn’t see before.

That’s part of the collaboration too, not just having the other professions contribute, but the patient as well. That’s empowerment.

Alya Niang

Thank you, Annie-Danielle, thank you, Eva and thank you, Dr. Joncas. It’s been a great pleasure to talk with you on this subject that is close to our hearts. And I think you’ve contributed a lot of valuable information in this podcast. Thank you very much again.

Thank you for listening and we hope you found this episode informative and useful. Come back next time when we’ll be taking a close look at other interesting health topics. Our executive producer is Jonathan Kuehlein and a big thank you to Aila Goyette. To learn more about CIHI, please visit our website www.icis.ca. CIHI stands for Canadian Institute for Health Information. Don’t forget to subscribe to the Health Information Podcast and listen to it on the platform of your choice. This is Alya Niang. See you next time.