The Future of Primary Health Care

You may not immediately recognize primary health care, but it is essentially the first level of contact that you have with the health care system. That could mean seeing your family doctor, health unit, pharmacy, or clinic. Or it could mean phoning an advice line staffed by health professionals, or even attending a self-care workshop to learn how to take a more active role in your own health. Primary health care involves treating short-term health problems, managing long-term health conditions such as diabetes, and even helping you learn how to prevent injury and illness. Prevention is a key objective of primary health care.

Governments across Canada are working to strengthen primary health care to improve health care services for Canadians. When properly organized and coordinated, primary health care has enormous potential to introduce improvements in the health system. For you, your family, and other Canadians, it can mean better care, shorter waiting lists, improved access to health care services, and a more sustainable health care system.

Primary health care is about:

1. A team approach
A team approach means that different health care professionals work together – often in a single location – sharing information about treatment goals and what has worked and what hasn't, in order to provide you and your neighbours with the best and most appropriate care. You are encouraged to become an active member of that team and take part in the decision-making process for your care.

2. Information
Health care professionals, such as your family doctor and your nurse or specialist, can communicate with one another more easily and efficiently, thanks to advances in technology

Information sharing between members of your health care team is vital to ensure that each professional applies their own expertise to your care without duplicating effort or creating conditions that would adversely affect another aspect of your care. The result is more efficient and appropriate care. Technology such as electronic health records are important tools that will help to ensure the best health outcomes for you and your family.

You can be assured your medical records are private. Laws are in place across Canada to protect the privacy of these electronic health records.

3. Access
Initiatives are underway to improve access to health care information and services when you need them, where you need them. Many people across the country already have such access to tools such as toll-free health information lines and video conferencing links. Primary health care initiatives are working to ensure that you and every Canadian, no matter where you live, have similar access to these types of health services. Not only will this reduce trips to the more costly emergency department when a conversation with a health provider can help, it helps to ensure improved access to emergency services for you when you truly need them. It also translates into lower overall costs to the health system.

4. Healthy living
Promoting healthy living helps prevent illness and injuries. Primary health care providers support healthy lifestyle choices and contribute to safe communities. Providers can also help you to manage chronic health conditions to prevent complications and stay healthy. Healthier people means reduced treatment costs – and reduced treatment costs help lead to a more sustainable health care system.

We will look at what primary health care can offer with the help of a hypothetical family: Alex (age 22) and her parents Mitchell (age 65) and Diane (age 56).*
 

* Note: The stories of Mitchell, Diane, and Alex are hypothetical stories based on the goals and vision of primary health care.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/The-Future-of-Primary-Health-Care

Mitchell* is a 65-year-old former hockey player who recently had hip replacement surgery. After Mitchell returned home from the hospital, he worked with a whole team of health professionals as he recovered and adjusted to life after surgery.

The doctor:
After surgery, Mitchell's doctor checked his progress regularly to make sure his recovery was going smoothly and to watch for signs of complications such as infection. The doctor also advised Mitchell when it was safe to return to his regular activities, such as climbing stairs, engaging in sexual activity, and driving. When Mitchell developed an infection, his doctor recommended antibiotic treatment and coordinated directly with Mitchell's home care nurse to make sure the wound was treated.

The pharmacist:
Mitchell left the hospital with prescriptions to prevent complications from his surgery. When he visited his local pharmacy, the pharmacist taught him about his new medications. She showed Mitchell what the medications were for, how to use them, when to expect them to start working, and possible side effects. She also checked them against another prescription Mitchell used occasionally that showed up in the pharmacy's electronic database, to ensure there were no conflicts between the drugs.

The home care nurse, personal care worker, and toll-free nursing line:
After Mitchell returned home, he and his wife Diane had a few problems coping with his care. Since Diane is much smaller and lighter than Mitchell, she was worried about what would happen if he fell while she was helping him with his daily activities. Meanwhile, Mitchell was having trouble getting around the house and keeping his incision clean.

Shortly after he returned home, Mitchell noticed that his incision was red, swollen, and itchy. He and his wife Diane were concerned and called a toll-free health information line staffed by nurses. The nurse told them that Mitchell's incision might be infected, and advised them to see his doctor. She also helped them find a home care nurse who could come to Mitchell's house to help him care for the infected wound once Mitchell had seen his doctor.

The home care nurse helped Mitchell treat his wound and keep it clean. She also worked with the couple to arrange for a personal care worker to come into their home a few times each week to help Mitchell shower and dress, and take him for a walk. Diane appreciated the extra help and felt less worried about Mitchell. Mitchell's recovery went more smoothly and he found it easier to care for himself and to focus on regaining his mobility.

The physiotherapist and occupational therapist:
Mitchell's physiotherapist and occupational therapist worked together to help him get back on his feet and to provide him with strategies for coping with his limited mobility during recovery. Mitchell's physiotherapist taught him exercises to help strengthen his hip and improve his mobility. She also showed him the proper way to use his walker and cane, and demonstrated the safest ways to sit, sleep, and get around the house. Regular appointments with his physiotherapist helped keep Mitchell on track with his exercises.

The occupational therapist suggested equipment and home modifications to help Mitchell with his daily activities. For example, she showed him how to use a long-handled reacher to pick up objects from the floor so that he wouldn't have to twist or bend at the hip. She also helped him find a transfer chair to help him get into the shower, and a raised toilet seat to make it easier for him to go to the bathroom. And she taught Mitchell's wife Diane how to make the house safer for Mitchell by removing throw rugs and other obstacles, setting up a "recovery centre" (a comfortable chair where Mitchell could reach a telephone, a glass of water, his medications, the TV remote control, and books to read), putting frequently used items at arm level, and moving sharp objects and furniture out of the way.

The team:
All of the professionals on Mitchell's primary health care team shared information using his electronic health record. Mitchell, as an important member of the team, was also involved in the decision-making process. Thanks to his team, Mitchell is now on the road to recovery after his hip replacement.
 
* Note: The stories of Mitchell, Diane, and Alex are hypothetical stories based on the goals and vision of primary health care.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/The-Future-of-Primary-Health-Care

What can primary health care teams offer to people with long-term health conditions? Let's look at a hypothetical story set in a place where primary health care is well developed and operating efficiently.

Diane* is 56 years old and has had type 2 diabetes since she was 47. Type 2 diabetes can lead to complications such as heart attacks, strokes, kidney damage, nerve damage, blindness, and foot infections (which can become severe enough to require amputation). Fortunately, Diane has a much better chance of avoiding these complications, thanks to the care she receives in her community.

Many people in Diane's community, including Diane herself, are of Indigenous heritage. Because Indigenous people are at a higher risk of diabetes, Diane's community has developed excellent diabetes care services. Diane uses the services of the team of health professionals at a local diabetes clinic to help her manage her disease. Diane is an important member of her health care team, helping to make decisions about her own care and treatment. Being involved in the decision-making gives Diane more control over her health and her treatment, which in turn helps motivate her to keep track of her blood sugar, take her medications, and stick to her diet and exercise plan.

This is how several members of the community primary health care team helped Diane to better manage her diabetes.

The doctor and nurse practitioner:
Since doctors are scarce in Diane's community, a nurse practitioner works with the doctor at the clinic to regularly monitor her blood sugar results, blood pressure, weight, kidney function, cholesterol, and nerve function to make sure the diabetes is under control and there are no signs of any complications associated with the disease. Diane's doctor, her nurse practitioner, and a physiotherapist who consults with the team helped her develop an exercise routine she could stick to.

The pharmacist:
When she was first diagnosed, Diane's pharmacist showed her how to use the blood glucose monitor and taught her about her new medications. After she started medications, Diane's pharmacist helped her monitor her blood sugar levels, and called Diane's doctor to suggest changes to her medications to help keep Diane's blood sugar within a healthy range. Since then, Diane has been able to control her blood sugar quite well, but she still visits her pharmacist regularly for medication refills and checks her blood pressure in the pharmacy's blood pressure machine.

The dietitian:
The dietitian at the clinic helps Diane with meal planning and gives free talks at the local high school to help other people with diabetes in the community. She has worked with Diane and others in the community to develop an online database of healthy recipes and alternatives.

The optometrist and podiatrist:
Diane has a yearly eye exam to check for eye damage. She also regularly sees the podiatrist (foot doctor) at the clinic, who checks her feet and gives her advice on how to care for her feet and check them daily for damage. This helps reduce her risk of foot infections.

The team:
All of these health professionals are in regular contact with one another as part of the primary health care team in Diane's community. Most of them work together in the diabetes clinic and regularly get together to share information and consult with each other. They communicate with each other through regular discussions and refer to Diane's electronic health record to make sure that all members are aware of any changes in Diane's condition. If Diane has any questions, she can access a nurse whenever she needs to through the telephone health advice line.

Diane's primary health care team, with her as the central member, helps her manage her diabetes and live life to the fullest. It all adds up to better health and fewer diabetes complications for Diane.

 
* Note: The stories of Mitchell, Diane, and Alex are hypothetical stories based on the goals and vision of primary health care.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/The-Future-of-Primary-Health-Care

How do healthy people benefit from an effective primary health care system? Let's look at the following hypothetical story.

Diane and Mitchell's daughter, Alex,* is 22 years old. She's healthy, and with the help of her health care team, she's planning to stay that way. Alex's health care team includes her doctor, nurse, pharmacist, dentist, dietitian, and, of course, Alex herself. They use technology to share information and work together to provide Alex with the best possible health advice and care when she needs it.

A few years ago, Alex was diagnosed with depression by her family doctor. Normally, she would have been referred to a specialist, but there are no psychiatrists in the rural community where Alex lives. Fortunately, her doctor was able to access a team of mental health professionals from a larger centre, who gave her advice on medications and psychotherapy that she used to help Alex recover from her depression. Alex was happy to be treated by her family doctor, whom she has known for years. It made it much more comfortable for her rather than travelling to see a specialist.

With her depression behind her, Alex started focusing on making sure she remained healthy. She knows that heart disease and diabetes run in her family. With the help of her doctor and the dietitian at her local clinic, she developed a healthy eating and exercise plan to help her keep in top condition and avoid health problems down the road.

Alex visited the clinic to find out more about birth control and what options were best for long-term use. The nurse at the clinic helped her learn more about birth control and safe sex. And when Alex started a new pill, she talked with her pharmacist about when it would become effective, what to do if she missed pills, and what side effects she could expect.

With her family history, Alex makes sure she sees her doctor annually for her physical exam. In the physical exam, Alex's doctor checks for early signs of breast or cervical cancer (which have the best chance of a successful recovery when treated early), as well as other health conditions that could cause problems down the road, such as high blood pressure, high cholesterol, and diabetes. She also pays attention to Alex's mental health and makes sure she talks about relationships and unusual stresses in Alex's life.

Alex also uses a toll-free health information line staffed by nurses that is available in her community. When she has questions about her health, she can call and get advice from a nurse on how to deal with her symptoms and whether she should see a doctor. Calling the line has saved her several trips to the all-night clinic when she was uncertain about the seriousness of her symptoms.

Alex's story shows how a primary health care team working together in the community can support a person to stay healthy, make good lifestyle choices, and improve her chances of avoiding health problems in the future.

 
* Note: The stories of Mitchell, Diane, and Alex are hypothetical stories based on the goals and vision of primary health care.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/The-Future-of-Primary-Health-Care