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How many people in Caesar's time felt that their health care and average life expectancy were good enough? They must have been a minority or at least they did not represent the only opinion. If they had, then the greatly increased life expectancy that we enjoy today, much of which has occurred over the last half century, would have to be ascribed to some very favourable play of chance. Life expectancy just improved of its own accord.

Chance can certainly go in our favour half of the time, but we can continually facilitate and accelerate our health status by trying to innovate and improve. There are still large care gaps in many of society's most burdensome illnesses. Things can always be better. It works as a very good starting point.

Successful patient health management initiatives

There have been many successful patient health management initiatives in Canada in the last decade or so, including CANOAR, CQIN, CURATA, FORCE, EPICORE, TEAM, ROCQ, MAAUI, MOMM, ASTHMA and ICONS (Improving Cardiovascular Outcomes in Nova Scotia). ICONS was conceived as a province-wide, partnership-measurement model of disease management to focus on patients with both acute and chronic heart problems.

Because of its very beneficial impact on the cardiovascular health of the population and its successful integration of community-based administrative culture and processes, ICONS became an operational program of the Department of Health of Nova Scotia in 2002. In the view of health policy makers and others primarily concerned with administration of health care, this successful disease management initiative was a major innovation and achievement in organizational behaviour in primary health care.

Patient health management initiatives like ICONS share many common characteristics, including the following:
  • Patient-centred approach to prevention, diagnosis and therapy of illness
  • Drug and non-drug therapy
  • Collaboration and coordination of services and interventions
  • Shift away from isolated inputs and controls, such as bed counts or hospital closures
  • Monitoring, measurement and feedback of practices and outcomes
  • System view of health; integration of components
  • Improvement of the health of whole populations
  • Knowledge creation and dissemination
The Canadian pharmaceutical company Merck Frosst has been an early and active supporter of many patient health management programs in Canada. Today, it provides a facilitating structure for creating partnerships in the health care system and can assist health care partners launch new patient health management initiatives.

To find out more about partnership opportunities, contact Dr. Terry Montague at  .