How can we improve the coordination of care in Canada?

Patient safety is always an important concern. Rules and policies are in place to make sure everyone seeking care is helped without facing the risk of further harm.

Sometimes, however, issues arise and not all the information necessary to make an informed decision is available. Often, this is due to a lack of coordination between a patient’s care providers.

Room to improve coordination of care in Canada

The results from The Commonwealth Fund 2015 International Health Policy Survey of Primary Care Physicians show what Canadian family doctors think about and experience in our health systems. In some areas, the results indicate great improvements over the past several years; in others, Canada still trails behind the international community.

The survey contained 13 questions related to coordination of care. The responses of Canada’s family physicians placed us

  • Below the international average for 6 of the 13 indicators
  • The same as the average for 1 indicator
  • Above average for the remaining 6

For example, 71% of Canadian family doctors said they do not always receive relevant information about their patients after they have been seen by a specialist. Although this percentage is slightly better than the average of the countries surveyed, it is still not ideal when you consider what this means for patients whose medications or care plans have changed.

In addition, 22% of Canadian primary care doctors said that after a patient has been discharged from hospital, it takes more than 15 days on average to get the information they need to properly continue managing the patient’s care. This is the longest delay among the 10 countries surveyed.

Half of the Canadian doctors also said that at least 1 of their patients had experienced problems in the past month because care was not well coordinated across multiple sites or providers.

How can we improve?

The survey shows some significant improvements in 2 areas that can enable better coordination of care:

  • The uptake of electronic medical records (EMRs)
  • The implementation of publicly funded primary care models

The use of EMRs among Canadian family doctors has doubled over the last 6 years. That said, the technology used to record a patient’s medical history and to manage treatment plans still exists in a siloed way. Canadian jurisdictions are now trying to take the next step — ensuring that technologies used by different care providers talk to each other and follow the patient. By improving information flow, doctors and health providers can make better decisions for patients and reduce the risk of medical errors and inefficiencies, such as prescribing the wrong drug or ordering an unnecessary test. Making secure e-communication easier between care providers and patients is another priority.

As for new publicly funded models, several provinces have implemented reforms in primary care to improve the front lines of care for patients. These models include family doctors working in teams with nurses or other care providers and often include guarantees of some after-hours access for patients. Doctors working in these models had better results for the survey questions on access to care in the evenings and on weekends, coordination of care with other providers and use of EMRs. These models provide an interesting template to study going forward.

Check out how Canada compares in The Commonwealth Fund’s 2015 survey.