August 16, 2012—Learning about gains in Canadians’ health status—especially from patients themselves—would provide a more comprehensive picture of population health and health care services, according to a report by the Canadian Institute for Health Information (CIHI) and Statistics Canada.
There is currently little clear connection between processes of care and outcomes—important information in determining the value obtained from health care investments. Although there are no standard, comprehensive, repeated measures of health status at the population level in Canada that could be used to assess outcomes of care, the country has seen progress:
- In home and continuing care, the Resident Assessment Instrument (RAI) system allows care providers to gauge individuals’ progress.
- In rehabilitation, the FIM® instrument helps care providers assess patients’ physical and cognitive status.
Both of these tools feed into CIHI databases, allowing our reports to inform decisions at multiple levels in the health care system.
By providing the patient’s perspective and adding information on quality of life, patient-reported outcome measures (PROMs) would provide further insight to help assess how the health care system is
- Meeting individual needs (including quality of life);
- Meeting the needs of the population; and
- Being accountable to Canadians.
Orthopedic surgeons in Manitoba already use PROMs to assess outcomes of joint replacement patients. In the United States, PROMs are used in selected programs and practices, such as the Dartmouth Primary Care Cooperative (CO-OP) Information Project, to monitor health status changes in patients; as well, the Centers for Medicare and Medicaid Services in that country has been using the Health Outcomes Survey to monitor the performance of programs since 1996. Also, the United Kingdom has developed PROMs and plans to collect them routinely for the majority of its National Health Service activities within the next decade.
CIHI’s development of the Canadian Multiple Sclerosis Monitoring System (CMSMS) is another example of work under way to support information needs at the patient level. The CMSMS is a nationwide system that will capture patient-reported outcomes in the form of the Health Utilities Index (HUI) as well as other patient-level data. This will lead to better understanding of not only disease patterns and the treatment process but also the impact of this treatment on patient outcomes and quality of life.
The report makes clear that users of patient-reported outcomes include those from all levels, from clinicians and administrators to policy-and decision-makers.
Moving forward requires the collection of data that reflects well-defined, standardized measures of health outcomes to impact care. Through collaborative efforts and by building on existing information and practices, the information needs of the health care system in Canada can be assessed and addressed.
When: August 16, 2012
About the Health Utilities Index
The Health Utilities Index (HUI) is a family of generic health profiles and preference-based systems for the purposes of measuring health status, reporting health-related quality of life (HRQL) and producing utility scores. HUI evolved in response to the need for a standardized system to measure health status and HRQL to describe 1) the experience of patients undergoing therapy; 2) long-term outcomes associated with disease or therapy; 3) the efficacy, effectiveness and efficiency of health care interventions; and 4) the health status of general populations.
Established in 1994, CIHI is an independent, not-for-profit corporation that provides essential information on Canada’s health system and the health of Canadians. Funded by federal, provincial and territorial governments, CIHI is guided by a Board of Directors made up of health leaders across the country. Our vision is to improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.