Our expert answers 3 Questions
How to achieve spread and scale of Medical Home transformation elements and improvements in transitions of care (primary-specialty integration), in the Canadian context. It’s a primary-care-based system but composed of large numbers of small independent practices, without the organizational advantages of integrated delivery systems, and with relatively little regulation. It is essentially a problem of understanding and changing physicians’ mental models, at a large scale.
Significant improvements in quality, safety, efficiency, and value for dollar will require doing things differently. We have a relatively well developed understanding of what needs to be done – but how to accomplish it in the Canadian setting is not at all clear. The challenge is both of great practical importance and a fascinating problem in cognitive engineering in its own right.
The province intends to pursue transformational change in both primary care and transitions of care, in the interest of improving both patient outcomes and value for dollar in our universal-coverage system. The findings of our research have been, and will continue to be, influential in government and the largely self-regulating medical profession here, both in terms of health workforce and compensation policy.