Thank you.
I'm Dr. Catherine Kells. I'm a practising interventional cardiologist in Halifax, Nova Scotia, and I'm president of the Canadian Cardiovascular Society.
On behalf of the more than 2,000 cardiovascular physicians, surgeons, and scientists across the country, I want to thank the committee for inviting me to present this important health innovation project that can improve patient care and more effectively use health care dollars.
As an interventional cardiologist, I'm the doctor you will meet in the middle of the night if you come in with a heart attack.
Despite the incredible advances we have made in cardiovascular care, heart disease remains one of the top two leading causes of death in Canada. Twenty per cent of all Canadians will die of heart disease.
I spend most of my days and every night on call working to save the lives of mothers, fathers, husbands, co-workers, and friends. I am extremely well trained in the Canadian system. I keep up with all the latest literature and techniques.
However, unbelievably, when patients ask me what their risk of death or complications might be when I'm about to put a stent in their arteries, I can't answer them. I cannot reassure my patients by telling them my own success rate, my complication rate, or their long-term risk of death or recurrence. I cannot compare our results in Nova Scotia to those of other provinces, and if my patients ask if they should go to Toronto to have heart surgery because it's the biggest centre, I cannot honestly tell them how we compare, because I don't know.
Unlike many other countries, in Canada we do not have a pan-Canadian, unbiased reporting system that reports the outcomes of our interventions and therapies in cardiovascular disease. In fact, in the 2013 OECD report, Canada's rank was 10 out of 11 countries for quality.
There are provinces and some institutions that do report outcome data. From those reports, we know that the quality of cardiac care does vary substantially, depending upon where you and your loved ones receive treatment.
Canada's inability to measure outcomes on a national scale is a critical health issue but also an economic issue. The price tag of cardiovascular care is currently $20 billion annually, and it's predicted to reach $28.3 billion by 2020 as our population ages, yet we don't measure the outcomes to ensure we're getting value for the dollars invested.
We, the professionals who take care of the patients in the cardiovascular community, want to improve cardiovascular care across the country, but as said by my friend and colleague, we cannot manage what we do not measure.
That's why the CCS is making one strong recommendation to the Government of Canada: to invest, in budget 2018, in a pan-Canadian initiative, using real-world data, to inform and improve the delivery of cardiac care across Canada.
Not only is the recommendation critical, it's highly achievable. While Canada may be information poor when it comes to national cardiovascular outcomes and comparative data, it's actually data rich.
Much of the real-world data already exists in databases and electronic medical records spread in silos throughout the country, but it's not enough to measure the quality of care within a single province or a hospital alone.
This Canada-wide problem needs a Canada-wide solution. Some provinces, including Nova Scotia, where I work, have only a single cardiac centre. Without the ability to compare hospital performance across the country, we cannot identify system-wide gaps and share best practices to benefit the health of all Canadians. By linking, analyzing, and providing data back to the doctors and health care providers on a continuous basis, we can achieve enhanced care for patients and a more effective use of our health care dollars.
By comparison to others, the recommendation I'm bringing to you today is a bite-sized innovation. For $2.5 million per year, cardiovascular specialists across Canada believe they can transform the quality of cardiovascular care. We're asking for a five-year commitment of funding to scale up our initiative and demonstrate its value.
Our initiative is physician- and surgeon-led, bottom up, and the community is highly engaged. We're working collaboratively with partners, including the provincial registries and CIHI , so we don't duplicate their work.
By bringing together data silos, connecting health professionals to the data they need to see, and translating that evidence into actions, we will enable Canadians to live longer and healthier lives, experience increased productivity in their workplaces and communities, and contribute to our country's economy.
No funding mechanism currently exists within Canada to make this project sustainable, and that's why I'm here today. Budget 2018 can send a clear signal that the federal government is committed to improving the quality of cardiovascular care for all Canadians.
Thank you for the opportunity. I look forward to questions later.