Improving cardiovascular outcomes in Nova Scotia (ICONS): a successful public-private partnership in primary healthcare.
Broadly defined, disease, or health management, is a focused application of resources to improve patient outcomes; its premise: things can be better. In particular, the gap between what best care could be, and what usual care is, can be reduced and, consequently, care and outcomes can be improved. This paper reviews the evolution of the partnership/measurement paradigm of disease management and considers its value in sustaining Canadian healthcare. Lessons from ICONS (Improving Cardiovascular Outcomes in Nova Scotia), a major public-private health partnership of physicians, nurses, pharmacists, patients and their advocacy groups, government and industry, are highlighted. Launched in 1997, ICONS' proof-of-concept phase ended in 2002. Due to its positive impact on the cardiovascular health of the population and its integrated and accountable administrative processes, ICONS became an operational program of the Nova Scotia Department of Health. This successful community-based partnership represents a major achievement in organizational behaviour in the arena of primary healthcare. It supports optimal care as evidence-based and seamless, recognizing the patient as the nucleus. It should be considered for other disease states and constituencies where the goals are closing care gaps and delivering the best health to the most people at the best cost.
Montague
Terrence
T
Department of Patient Health, Merck Frosst Canada Ltd., Kirkland, QC.
Cox
Jafna
J
Kramer
Sarah
S
Nemis-White
Joanna
J
Cochrane
Bonnie
B
Wheatley
Marlene
M
Joshi
Yogi
Y
Carrier
Robert
R
Gregoire
Jean-Pierre
JP
Johnstone
David
D
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D003191:Comprehensive Health Care / Q000458:organization & administration; D019468:Disease Management; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007373:Interinstitutional Relations; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D017149:Private Sector; D011635:Public Health Administration; D017150:Public Sector; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D016896:Treatment Outcome