Sarah Jennings, BSc, BScPhm, RPh, PharmD Knowledge Mobilization Officer Thursday May 28, 2015 Canadian Pharmacists Conference

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1 Culturing Change in Lab Testing Sarah Jennings, BSc, BScPhm, RPh, PharmD Knowledge Mobilization Officer Thursday May 28, 2015 Canadian Pharmacists Conference

2 CADTH is a health technology assessment (HTA) agency We inform technology-related decision-making in health care

CADTH Products and Services Drug Reimbursement Recommendations CADTH Common Drug Review (CDR) CADTH pan-canadian Oncology Drug Review (pcodr) Health

3 CADTH Products and Services Drug Reimbursement Recommendations CADTH Common Drug Review (CDR) CADTH pan-canadian Oncology Drug Review (pcodr) Health Technology Management Products Rapid Response Service Health Technology Assessment Optimal Use Other Environmental Scanning Horizon Scanning CADTH Scientific Advice

4 Why is this an issue? Clinical lab testing is integral to the delivery of health care A significant number of clinical decisions are based on lab test results Suggested that 20-50% of lab testing may be inappropriate Overutilization may lead to the provision of health care services and interventions of questionable benefit Underutilization may lead to adverse health outcomes and increased use of future healthcare resources 3

5 Why is this an issue for pharmacists? Increasing involvement in interpreting, recommending, and ordering lab tests 4

6 5 Updated April 2015.

7 Why is this an issue for pharmacists? Optimal use of lab testing involves more than just the lab 6

8 Unique CADTH approach An understanding that each jurisdiction has context specific needs, and may find it difficult to apply solutions or information that is not tailored to specific requirements Unique issues are present at multiple levels of healthcare and for multiple types of healthcare providers To address this environment, a series of custom events were co-hosted with local bodies across the country, bookended by two national webinars 7

9 Winnipeg Physician Engagement Model to Enable Health System Transformation in Manitoba Centre for Healthcare Innovation (CHI) Diagnostic Services Manitoba (DSM) Goal To support implementation strategies around optimization of diagnostic testing, the working group in Manitoba chose to focus on the foundational element of physician engagement. 8

10 Calgary Strategies to Engage Primary Care Physicians in Lab Utilization Management Alberta Medical Association Alberta Provincial Laboratory Utilization Office Goal Discuss barriers to implementing optimization strategies from Alberta primary care physicians perspective, the evidence around implementation strategies and local utilization information. 9

11 Moncton Right Test. Right Patient. Right Time. Horizon Health Network Goal To collaboratively develop draft action and priority recommendations for Horizon Health Network to optimize lab test utilization management. 10

12 Burnaby Protein Electrophoresis Testing in Patients with Multiple Myeloma Fraser Health Authority Providence Health Care Provincial Health Services Authority Vancouver Coastal Health Goal Develop a consensus of practice around the ordering frequency of these lab tests. 11

13 Halifax Building Process on Vitamin D Experience Nova Scotia Diagnostic Imaging and Pathology & Laboratory Medicine Initiative Goal Using testing for Vitamin D as a template, apply learnings to future strategies regarding lab utilization. 12

14 Regina A Burning Question in Long-Term Care Facilities Regina Qu Appelle Health Region Laboratory Services & Infection Prevention and Control Chair of Provincial Infection Prevention Control Committee Goal To set direction in the Regina Qu Appelle Health Region on ordering of urine culture and sensitivity tests in asymptomatic residents in long-term care facilities. 13

15 Charlottetown Urine Matters Health PEI Goal To engage in meaningful dialogue with those most involved around the management of UTIs, ordering urine cultures and sensitivities and the rollout of an updated UTI care pathway for seniors in long term care. 14

16 Themes from what we learned Collaboration is required Those involved in ordering and performing the tests Patients Communication and data This is not a one-time initiative. 15

17 What s next? CADTH is further committed to assisting in maintaining the momentum achieved by this series of lab events and look forward to working with local decision makers and clinicians to support their needs. 16

Caring We treat everyone with compassion, respect, fairness, and dignity

HEALTH PEI VALUES Caring We treat everyone with compassion, respect, fairness, and dignity Integrity We collaborate in an environment of trust, communicate with openness and honesty, and are accountable