Patients First (eBook)

Born in Saint John, New Brunswick, Dr. Terrence Montague graduated from Dalhousie University with a doctorate in Medicine. He is one of Canada's pre-eminent experts in disease management and health outcome research. Dr. Montague is currently vice president of Patient Health at Merck Frosst Canada, one of the country's leading research-based pharmaceutical companies. Prior to joining Merck, Dr. Montague was Professor of Medicine and Director of Cardiology at the University of Alberta. He has occupied a number of academic positions at the University of Alberta, the University of British Columbia and Dalhousie University, and served on the editorial boards of the Canadian Journal of Cardiology, the American Journal of Noninvasive Cardiology, Chest, and HealthCare Papers. He has published more than 300 academic papers and presentations. Dr. Montague served with the Canadian Forces Medical Services in various roles in the Regular and Primary Reserve army in Canada and overseas, retiring with the rank of Lieutenant Colonel. Currently, Dr. Montague is a fellow of the American College of Chest Physicians, the American College of Cardiology, the American Heart Association, the Royal College of Physicians and Surgeons of Canada, and, a member for life of the Royal Canadian Regiment Association.

Foreword

by Mark Poznansky, President, Robarts Research Institute.

by Ross Tsuyuki, BSc (Pharm), MSC, PharmD, Director, The
Epidemiology Coordinating and Research Centre (EPICORE), University
of Alberta.

Acknowledgements.

Introduction.

Part 1: The Theory.

Chapter 1: How We Got to Where We Are.

Chapter 2: Defining Quality of Care.

Chapter 3: The Care Gap and Its Causes.

Chapter 4: The Prescribing Gap.

Chapter 5: The Compliance, Concordance and Adherence Gaps:
Challenges and Opportunities.

Chapter 6: Access, Health and the Economy: Can We Afford Access
Gaps?

Chapter 7: The Care Gap Gorilla: Bigger Gaps for Older
Patients.

Part 2: The Practice--Patient Health Management
(PHM).

Chapter 8: Background and Rationale of Patient Health
Management.

Chapter 9: Learning Experiences: The Epidemiology Coordinating
and Research Centre (EPICORE), the Heart Function Clinic and the
Clinical Quality Improvement Network (CQIN).

Chapter 10: A Pivotal Experience: Improving Cardiovascular
Outcomes in Nova Scotia (ICONS).

Chapter 11: Other Experiences in Patient Health Management.

Part 3: What Have We Learned So Far?

Chapter 12: What Works: The Action Plan.

Chapter 13: What Doesn't Work?

Part 4: Vision for the future.

Chapter 14: The Strategic Alternatives.

Chapter 15: Skate to Where the Puck Will Be: Wayne Gretzky's
Strategic Plan.

Appendices

Appendix A: Guiding Principles for Public/Private Partnerships:
Disease Management and Outcomes Research

Appendix B: Patient Management Template, Heart Function Clinic,
circa 1994.

Appendix C: CQIN Mission, Goals and Objectives.

Appendix D: Representative CQIN Partnership/Governance Structure
for the Project Entitled: Mortality risk and patterns of practice
in 4,606 acute care patients with congestive heart failure. The
relative importance of age, sex and medical therapy.

Appendix E: Physician Order Sheet for Management of Patients
with Heart Attack from a Representative CQIN Hospital, Circa
1992-1996.

Appendix F: ICONS Members and Affiliations.

Appendix G: ICONS CARE Map: Management of Anticoagulation in
Atrial Fibrillation.

Appendix H: ICONS Care Map: Management of Heart Failure.

Appendix I: ICONS Standardized Discharge Order Sheet.

Appendix J: ICONS Provider Newsletter.

Appendix K: ROCQ Project Outline.

Appendix L: CURATE Treatment Algorithm for Osteoarthritis
Patients.

Appendix M: Examples of Diabetes Hamilton Newsletters.

Bibliography.

Index.

"This book is a must read for those who are interested in our
health care system and who want to make it better. Dr. Montague
provides an interesting overview of his journey through hospital
wards, clinical trials, patient registries, patient health
management and chronic disease management programs. Drawing on his
diverse and unique background, he gives an important history of the
past, analysis of the present and a glimpse of our future."

David Johnstone, MD

President, Canadian Cardiovascular Society

"Based on significant practice and research experience in
both the public and private, and academic worlds, over many regions
of Canada, Dr. Montague reveals to the reader, consumer, decision
maker and patient an evolving and, until now, largely overlooked
dimension in optimizing care and outcome. This optimization is
important not only within the context of an individual's
care, but within the scope of an entire practice, community or even
nation."

Ross Tsuyuki, PharmD

Director, The Epidemiology Coordinating and Research Centre

University of Alberta

"Listen to Dr. Montague. He well understands both the problem
and the solution, which is to pull out all the stops and to put
patients first. He advocates patient health management to close the
many care gaps. This will result in improved health for millions of
Canadians and then, if we do it right, by emphasizing research and
evidence-based health care and not merely budgets, our health care
system will become more cost effective and out population healthier
and more productive."

Mark Poznansky, PhD

President, Robarts Research Institute