1. Quality Dimensions

2. Costs of Cardiovascular Care - US
Mozaffarian Circ 2015;131:e29-

3. Sustainable? 34.2 M people 23.4M people CIHI website 1975 to 2010
Expenditure increases = 3.5 fold
Population increases = 1.5 fold
23.4M people
34.2 M people
CIHI website

4. Sustainable? Alberta Health Clinical Area Inpatient Costs ED + UC
Physician Services
Total
Addictions and Mental Health
$194,898,187
$11,499,681
$219,134,001
$425,531,869
Bone and Joint
$149,284,168
$21,615,954
$161,930,594
$332,830,715
Cancer
$116,225,723
$9,655,216
$68,344,711
$194,225,649
Cardiac and Stroke
$202,145,065
$21,811,328
$149,068,838
$373,025,231
Diabetes Nutrition Obesity
$37,766,695
$2,559,936
$63,247,102
$103,573,733
Seniors Health
TBD
Alberta Health

6. Currently everyone in our system is working hard, and doing their individual parts. But we won’t achieve full integration until we can correctly align all of the pieces of the puzzle for the patients.
We are proposing recommendations that will accelerate the path to a fully integrated and highly functioning health care system.
This patient centered system will minimize gaps in the patient journey allowing clinical information to flow along the patient journey resulting in high patient satisfaction and greater value. Utilization of clinical pathways will allow clinicians to practice using flexible evidenced based protocols supporting the highest level of patient care.
Now I would like to invite Sandra to walk us through the methodology and learnings from our research.
“The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.”
IOM, Crossing the Quality Chasm: A new Health System for the 21st Century 2001

7. What is the Future State?
Priority must be on quality and not cost
Quadruple aim is a balance of competing factors
Appropriateness is the responsibility of all
Standardized pathways decrease practice variation and waste
Choosing Wisely must become part of the culture
Costing knowledge needs to start during training
Innovation is a reality and also needs to be embraced