Progress toward Health System Readiness for Genome-Based Testing in Canada.

(1) Background: Genomic medicine harbors the real potential to improve the health and healthcare journey of patients, care provider experiences, and improve the health system efficiency-even reducing healthcare costs. There is expected to be an exponential growth in medically necessary new genome-based tests and test approaches in the coming years. Testing can also create scientific research and commercial opportunities beyond healthcare decision making. The purpose of this research is to generate a better understanding of Canada's state of readiness for genomic medicine, and to provide some insights for other healthcare systems. (2) Methods: A mixed-methods approach of a review of the literature and key informant interviews with a purposive sample of experts was used. The health system readiness was assessed using a previously published set of conditions. (3) Results: Canada has created some of the established conditions, but further action needs to be taken to improve the state of readiness for genome-based medicine. The important gaps to be filled are the need for linked information systems and data integration; evaluative processes that are timely and transparent; navigational tools for care providers; dedicated funding to facilitate rapid onboarding and support test development and proficiency testing; and broader engagement with innovation stakeholders beyond care providers and patients. These findings highlight the role of the organizational context, social influence, and other factors that are known to affect the diffusion of innovation within health systems.

Laboratory medicine: The exemplar for value-based healthcare.

Value-Based Healthcare (VBHC) aims to improve the overall quality, safety, and sustainability of healthcare while reducing delivery costs of more effective care. Despite advantages associated with VBHC transformation, the road to its adoption has been lengthy. Laboratory Medicine (LM) is in a prime position to lead the transition to VBHC because of its key role in diagnosis and treatment of patients. Laboratory medicine results inform/influence 50% to 70% of all clinical decisions. This article summarizes some issues associated with adoption of VBHC and related healthcare innovations and suggests potential approaches using LM-specific examples to help accelerate adoption. Laboratory medicine is both a useful model for VBHC implementation and facilitator for related innovation adoption by helping to target patient populations that would benefit most from specific interventions. The critical value of rapidly adopted diagnostic technologies used during the COVID-19 pandemic and economic recovery provide important insights about the need to embrace and accelerate VBHC implementation.

Effect of a change management program in a medical device reprocessing department: a mixed methods study.

Faced with a variety of challenges in relation to performance, quality, staff engagement and morale in the Medical Device Reprocessing Department, managers at St. Michael's Hospital developed and implemented several innovative approaches including combining staff training and performance metrics. The results of these initiatives included a substantial reduction in the departmental budget along with higher productivity, output and quality; better staff morale; an improved relationship between management and the union; and a stronger partnership between the department and its institutional customers.

A mental health initiative to enhance schizophrenia treatment efficacy.

Improving patient outcomes while containing costs can be a challenging goal to achieve. This article describes the initiatives undertaken by one mental health department to improve medication adherence among patients with schizophrenia by increasing psychoeducation, psychosocial services, and use of long-acting injectable antipsychotic agents. Achievement of this objective depended on a sustained departmental education program. The successful clinical outcome also significantly reduced the hospitalization and costs.

Procurement change in Canada: an opportunity for improving system performance.

The Canadian healthcare system is undergoing restructuring of how goods and services are purchased. A conference "Navigating Hospital and Health System Procurement" was organized by MEDEC and the Canadian College of Health Leaders to examine the issues. This paper describes the implications and opportunities these changes present for healthcare policy, regulation, practice, and the supplier marketplace.

Hospital resource use by patients with schizophrenia: reduction after conversion from oral treatment to risperidone long-acting injection.

The chronic relapsing nature of schizophrenia is associated with significant resource use. The William Osler Health System, Brampton Civic Hospital site, in Brampton, Ontario, provides comprehensive in-patient and outpatient mental health services to the community it serves, including patients with schizophrenia. The clinical benefits observed in patients with schizophrenia treated through the injection clinic led the hospital to evaluate the costs, resource use and potential savings associated with injectable compared with oral therapy. The substantial savings accruing to the hospital and the healthcare system provide a strong economic rationale for injectable therapy as an alternative level of care for patients with schizophrenia.

Assessing innovations: what is the optimal approach for healthcare organizations?

Innovations in healthcare may improve patient outcomes and create economic benefits for healthcare organizations. The information available when an innovation is introduced to the market, however, may be insufficient to provide a compelling rationale for an institution to invest in the innovation. Generating the data required for an effective decision-making process involves assessing current performance indicators for an individual institution and the projected impact of adopting the innovation. The benefits of the innovation are verified after implementation. This article explores some of the issues and processes in evaluating healthcare innovations.