Speaking notes [check against delivery]

Speaking notes [check against delivery] Presented by the Honourable Sarah Hoffman, Minister of Health To the Accelerating Primary Care Conference. Theme: People, Patients, Partners. Hosted by the Primary Care Networks Program Management Office (PCN PMO). Monday, November 28, 2016, Double Tree by Hilton West Edmonton Introduction Good morning, and thank you Dr. Bahler for that kind introduction. As you know, our government has been in office now for about 18 months. During this time, I ve had the privilege of visiting dozens of health facilities and meeting faceto-face with hundreds of health professionals across the province. I ve witnessed first-hand many of the incredible aspects of the health care system in our province. My visits with health professionals and communities have deepened the respect I have for the hard work they do each and every day. Alberta s health care professionals are thoughtful, diligent and committed to providing the best care for their patients. Many PCNs have done great work over the years to do things like improve access, improve chronic disease management and use team-based care. So thank you for those efforts and for your dedication to improving Albertans health and well-being. And thank you for this opportunity today to share our vision about how we re going to improve health care services for Albertans. The Vision Our goal is for a health and health care system that emphasizes staying healthy and well, while also supporting people who need care. Our goal is for a health system that provides the right care, in the right place, at the right time, by the right health professionals, with the right information. But what does this mean in practice? And how do we make it happen? To me, this means shifting from a focus on hospitals and facilities to more community-based care closer to home. It s a vision where health care is planned and structured around people and their community. It s a vision where people are active partners in their own health and where we support them through things like wellness advice and prevention so they stay healthy and don t need facilitybased care in the first place. 2016 Government of Alberta 1

It s a vision where we have the right structures and processes in place to support excellence in primary health care with strong health care teams, and a focus on the whole person. It builds on the brilliance and collaboration of our clinicians, scientists and entrepreneurs coming together in health, social services and medical care. It is a vision that goes beyond just health care to an integrated system that links Albertans with social agencies to address other challenges they re facing that also impact their health and wellbeing. Ultimately, it s a vision grounded in the principle that health care should begin and end at home. And this is why I believe your conference theme of People, Patients, Partners fits perfectly with the government s current direction. Benefits for Albertans When we have a health system that is based on home and community care rather than on institutions and facilities, Albertans lives will improve. They will receive care from community-based teams made up of a range of skilled professionals such as doctors, nurse practitioners, dieticians and physiotherapists who are all working closely together. These teams will know Albertans needs and will be equipped to meet those needs. Albertans will also have greater access to the care and supports they need. They ll experience seamless transitions from one part of the health system to another, and will be supported to stay healthy in their homes. They ll see health facilities in their communities used in the best way possible. They will have access to the health information they need and their own medical records when they want them. Ultimately, Albertans will experience a health system that s built around their needs rather than on the needs of the system itself. Hospital care will always be important, and a crucial part of the health care system. But for too long, we have coordinated services around facilities and acute care rather than on how Albertans health needs can be met in their community. We know, for example, that Albertans want to stay in their homes and communities. Yet 71 per cent of people in Alberta s continuing care facilities are admitted directly from hospitals. They are never given the chance to try and live at home. So we need change. Other provinces and jurisdictions around the world including British Columbia, Ontario, Quebec, the United Kingdom, New Zealand and Australia have made the shift to community-based care. These jurisdictions built support structures in the community and were able to reduce their reliance on hospitals. Alberta must act too. 2016 Government of Alberta 2

Making it happen To make this vision a reality for Albertans, we need a shift in thinking, a shift in planning, and a shift in resources. We need to rethink the way health care is planned and delivered to patients. Now, I know many of you in this room (possibly ALL of you in this room) have heard this before. You ve heard it from government, time and time again. And many of you are already implementing innovative models of community-based care closer to where people live. There are wonderful initiatives in our province that have helped bring health care out of facilities into the community. Initiatives such as: the community-based case management model in northeast Calgary where AHS, the Peter Lougheed Centre, the Mosaic PCN and the East Calgary Family Care Clinic are working together to improve care for patients with complex needs; or the Boyle McCauley Health Centre in Edmonton and the Alex and CUPS in Calgary that have excellent innovative approaches to delivering primary health care and supports to inner-city populations; or the Red Deer Police and Crisis Team, a collaborative partnership between AHS, the Red Deer PCN and the Red Deer RCMP where a Registered Psychiatric Nurse and an RCMP officer provide a joint response to mental health-related 911 calls. We recognize there are incredible innovations happening throughout our health care system. We want to support them. And we want to build on them. So, my message today is: we are with you. Moving to community-based care truly needs to be a collaborative process. A process that all health organizations and indeed, all Albertans, need to be part of. The only way it will succeed is if any action we attempt leads to change. Change that makes a real difference in the real world for patients, for families and for health professionals. Action with physicians And, I want to tell you, meaningful change achieved by working with our partners, is here. Last week, I had the immense honour of standing on a stage with Alberta Medical Association President, Dr. Padraic Carr to announce an unprecedented agreement with Alberta s physicians that will pave the way to more team-based care and new compensation models. The agreement recognizes government s shared responsibility with physicians in providing better quality care to patients while keeping the system sustainable. Through the agreement, and by working with physicians, Albertans will see improved health services as a result of things like: Doctors practising in communities where they are most needed; compensation for time and quality of care given to patients, not just the number of services provided; and new information technology and data-sharing that will enhance care coordination. Action on primary health care We re working right now to strengthen and improve primary health care in Alberta. This starts with what we all think about our roles and why we are here. Every single one of us needs to take responsibility to build a system that is more person-centered. 2016 Government of Alberta 3

This is culture change. It requires introspection. And it s something we can attempt to enshrine in policy and within the system, but it begins with introspection. It doesn t matter if you are the health minister, a surgeon, a health care aid or one of our IT managers we all have to start every day thinking about why we are here and that is for Albertans. The policies and system transformation will follow with things like enhanced integration and coordination of primary health care through the use of health care teams who have a variety of skills and work closely together to better meet Albertans health needs and integrating health and social supports so care is coordinated and Albertans receive seamless services no matter what their need. To this end, I m excited to see that 98 per cent of PCN business plans show provisions for mental health services, and more than half integrate mental health and chronic disease management services. Another key focus for us moving forward is to establish long-term and consistent relationships between individuals and their families with a team or a provider, and also among providers. This strong relationship will mean Albertans have a health home where there s a shared understanding of their individual needs including culture, values, religion, language and preferences. These innovations are occurring through Primary Care Networks like the one at Calgary Foothills that has 54 team members providing coordinated and comprehensive care and the Edmonton West PCN that offers after-hours clinics and dedicated programming for their local populations. Another key part of improving primary health care is to design health services on population needs. This is about meaningful community involvement in health system design to develop local solutions that will improve their residents health. And it s about improved understanding of the social determinants of health. And, of course, a strong, high performing and integrated primary health care system also involves things like effective governance and evaluation, and increasing value and return on public investment. So that is a priority for us as well. We re working with primary health care leaders to implement the PCN review s findings to improve the efficiency and effectiveness of primary health care throughout Alberta. And we re developing compensation models that focus on quality and accountability, improving audit and compliance capabilities across the health system, and optimizing best practices in primary health care delivery. All of this work will involve close collaboration with our primary health care partners. We will build on the great work you are doing, like the integrated model in Slave Lake where people often have same-day access to all health providers, and more than half of patients have been screened for common health risks. The number of visits to the local emergency department there has dropped by 14.5 per cent within two years. Over the same period, the number of semi-urgent and non-urgent cases presenting at the emergency department dropped by more than a quarter. 2016 Government of Alberta 4

This is exciting progress at the local level that I know all of us want to see across the system. Action on continuing care Providing continuing care close to home is key to helping Albertans remain independent and active in their communities as they age or as their needs change. Part of the NDP s platform last election was to open 2,000 new long-term care spaces. And we have been hard at work since May 2015. One of the first things we did in health was to pause the Affordable Supportive Living Initiative to review every single approved project and to work with our partners to ensure these projects were going to meet the needs of Alberta communities. This included recognizing the need for dementia beds in addition to long-term care. The result is, in every case, the ASLI projects we approved and that are now at various stages of design or construction, are opening with some beds at higher levels of care. We re not done the need is only going to grow and we are going to make sure that our aging population gets the care it deserves and needs. I look forward to talking about this more in the months ahead. Another key part of our platform is home care, and we have invested an additional $67 million an increase of 12.7 per cent for home care this year. This funding will support the expansion of home care services to ensure Albertans receive the right services in the right place. Again, this is about delivering care in communities. It leads to better patient experience and better patient outcomes. Action on Health Information Management If you haven t had to relay your medical history over and over when visiting a health professional, you likely know someone who has. So another action we re taking to shift Alberta s health system to community-based care is to improve health information management in the health care system. Our government is investing $400 million into a new Clinical Information System for AHS that will bring all AHS health facilities and its 1,300 different clinical information systems onto a single platform. The AHS Clinical Information System will help to reduce disjointed care, gaps and overlaps, errors and delays. A single source of information will support team-based, integrated care that will help health professionals in AHS facilities provide the best possible care to Albertans. Another exciting IT development we re making progress on involves adding community health care information into Alberta Netcare. When Albertans visit their doctors offices or other clinics outside an AHS facility, this information will be added to their electronic medical records. It means Albertans won t have to tell their story over and over again and will ensure their health care providers have the best information to provide the most appropriate health service. 2016 Government of Alberta 5

This will result in improved treatment and will help people from falling through the cracks due to the lack of timely, relevant information. Most importantly, Albertans themselves will soon be able to access their own medical records online. Starting in 2017, we will be introducing a new Personal Health Record that will provide Albertans with a secure place to record their health information, as well as access their prescription drug information from Alberta Netcare. By spring 2017, we expect results from approximately 50 of the most highly used lab tests to be available to patients who want to view and access their own results. Ultimately, Albertans will have access to their entire personal health record. As a result, they ll be better informed and better able to be partners in decision-making with their care teams. Action on mental health and addictions Unfortunately, the personal stories of tragedy and pain associated with mental health and addiction issues in Alberta is growing. So our government is also taking action to strengthen mental health and addiction services for Albertans. One of the first things our government did was to launch a comprehensive review of Alberta s mental health system. We are now working to implement many of the recommendations in the review s report. We are also working with stakeholders on an action plan to integrate addiction and mental health services with other health and social services across the province. The plan is focused on children and youth, people with multiple and complex needs, people with addictions and Indigenous people and communities. It will transform Alberta s addiction and mental health system so Albertans have the care they need where and when they need it. The action plan will identify ways to improve access to, and navigation of, addiction and mental health services within the health system and in the community. It will outline cross-government work to be done with schools and post-secondary institutions to improve delivery of mental health services and develop learning resources and will address youth suicide prevention and early intervention and prevention. Last month we announced a range of new tools to address overdoses and deaths related to fentanyl and other opioids including things like expanding access to opioid replacement therapy and funding several community agencies establishing supervised consumption sites. These tools complement more than $7 million already invested this year in new addiction treatment programming and recovery beds. But we know there s more to be done to address the tragic fentanyl and opioid crisis that is devastating so many lives. So we ll continue working to address the crisis through things like expanding opioid dependent treatment. 2016 Government of Alberta 6

Conclusion Ladies and gentlemen, the key to success in all of this work, and in our goal of having more community-based care closer to home, is integration. Integration is key to Albertans getting the care and services they need in a timely fashion, and it s key to ensuring Albertans don t fall through the cracks. It is a path that will take time, and it will take tremendous collaboration. It is a path that builds upon and supports the great work already happening on the front-lines of our health care system. So let s continue working closely together to put the needs of people, families and communities at the center of all we do. When we do that, we ll ensure Albertans and their families get the appropriate health care they need in the months and years ahead. Thank you very much. 2016 Government of Alberta 7