Auditor General urges action on management of chronic diseases

Alberta must take action “immediately” on how patients with chronic diseases like asthma, arthritis and diabetes are treated, Auditor General Merwan Saher says in a new report.

While he states that individuals delivering services were giving patients excellent care, Saher determined that the system is too fragmented.

“There is an overarching need for purposeful, province-wide action to manage the growing burden of chronic disease,” states the report released Tuesday.  

“New actions must be dramatic. Small, incremental improvements would be overwhelmed by rising chronic disease numbers.”

The costs of treating chronic diseases are the prime reason why health care costs keep going up. They drive people to doctors, hospitals and emergency rooms. And these conditions will become more prevalent as the population ages, Saher notes.

In 2012-13, the province spent at least $4.5 billion on the treament of the 735,000 people in Alberta suffering from hypertension, diabetes, chronic obstructive pulmonary disease (COPD) and coronary artery disease.

For all the money spent on these patients, there appeared to be little coordination in how their conditions are managed.  

Saher discovered that Alberta Health has not set expectations for what services these patients should received nor has a system been put in place to find out who they are.

He also found that Primary Care Networks lack health care professionals besides doctors to provide the care required by these patients.

Health care information is not being shared because staff don’t understand what they are allowed to share.

“Enhanced use of healthcare data does not have to compromise personal privacy,” the report states.

Saher recommends Alberta Health and AHS take a number of actions with one year.

AHS should identify all chronic disease patients who need a family doctor, set provincial standards for chronic disease management and assess what kind of demand is out there for these types of services.

Alberta Health should set expectations for the types of services provided by doctors, primary care networks and AHS; get physician offices to set up better electronic medical records and figure out ways for secure record-sharing between providers.

Saher is expected to comment further on the report Tuesday afternoon.