Doctors have responsibility to improve value of healthcare by providing precision medicine, tailored to individual patient needs, says patient outcomes expert

Canadian healthcare practitioners urged to seize the opportunity to add great value to healthcare and to their patients by delivering precision care

MONTREAL, Oct. 21, 2016 /CNW/ - Doctors have a professional responsibility to improve the value of the healthcare they provide by ensuring their treatment actions are tailored to the needs and situation of each individual patient, instead of a one-size-fits-all approach designed for a non-existent "average" patient, a leading patient outcomes expert will tell 2016 Canadian Cardiovascular Congress in Montreal tomorrow.

Instead of deciding on care based on the non-existent "average" patient, it must be tailored to promote the best possible outcome in each individual, and new tools and data make that possible, says Dr. John Spertus, who will deliver the opening 2016 Heart and Stroke Foundation Lecture.

"We have many very high-tech and useful tools at our disposal now – including for surgery and drug treatments – but they are expensive and have great potential impact on patients so we need to ensure we use the right ones in the right patients and involve them in that shared decision-making," says Dr. Spertus, director of health outcomes research at St. Luke's Mid America Heart Institute in Kansas City, Missouri, and professor of medicine at the University of Missouri.

"We have to recognize that every patient is different – in their specific illness, their other health conditions and their personal hopes and expectations for treatment, including willingness or not to withstand different levels of risk or pain," he says. "It is only by considering all these elements prior to deciding the best course of action that we can maximize the value we provide the patient and the healthcare system"

Fortunately, he notes, we also now have simple yet technologically advanced tools available to help doctors make these individual decisions far faster and more accurately than ever before, as well as tools to engage patients in collaborative decision-making. "We can now provide precision medicine for each patient," he says, "and it's our responsibility to do so."

As an example, he cites patients with coronary artery disease causing angina, a leading cardiologic problem. They could be treated with medication or with insertion of stents to open arteries or have even more invasive coronary artery bypass surgery. There are different medications and different types of stents. Many factors influence what would be best for an individual patient, including their disease status, lifestyle, other medical conditions and willingness to go through surgery and its potential complications, such as bleeding, which will depend on yet other risk factors. Simple questionnaires and models can help guide this decision-making.

Dr. Spertus doesn't believe in creating complex decision-making models to replace doctors' own judgment, but rather to help them exercise it. "There can be very good medical reasons for deviating from what a model says should be done. I celebrate that. What I can't abide are doctors who do the same thing automatically despite patient differences or rule out a certain approach or treatment because they just don't like it or had one bad experience. That's no reason to deny that option to a patient for whom it would be the most appropriate choice."

He adds: "We need to approach our work as physicians in terms of how we provide value, not just services, to both the health system and patients. It's our responsibility to use the data and tools that are available to ensure we are providing the best chance for the best outcome tailored to each patient as an individual. That is the best use of our scarce healthcare resources and creates value."

Heart & Stroke Promote Recovery program helps Canadian survivors
The Heart and Stroke Foundation embraces Dr. Spertus's ideas that each patient's needs must be evaluated individually to develop the best course of treatment and action. The Foundation supports these efforts in Canada through its Promote Recovery program, which is designed to engage and support Canadians dealing with heart disease or stroke by providing them with or guiding them to the resources that are most suitable for their condition, location and lifestyle.

"The goal of Promote Recovery is three-fold," says Gavin Arthur, PhD, senior manager, Promote Recovery, for the Heart and Stroke Foundation. "We want to improve the quality of life for those with heart disease, stroke survivors and care-partners. We want to reduce survivors' risk factors to prevent future events or disease progression, and we want to improve access to care, services and support they need."

The program does this with the same approach as that of Dr. Spertus, putting the patient at the centre of all activities to ensure they get the best support for their particular circumstance. "Survivors and care-partners today can't just be given some brochures and wished 'good luck'," says Dr. Arthur. "We want people to be involved in their recovery. We want to help prevent the anxiety and depression that can complicate recovery by making them part of a strong community of support. Our work includes providing their medical care team with tools to help in that process."

There are five program components, some of which are already active and some of which are in development: online support and recovery centres, peer-to-peer support networks, a community support resource finder, advocacy for more and better recovery services, and building a survivor community and network.

"We want to move from just providing information to being an active enabler and partner with survivors and their care partners, working together with them to help them recover, achieve the best possible quality of life and prevent future events," adds Dr. Arthur.

Heart and Stroke Foundation position
Through its Promote Recovery program, Heart & Stroke will innovate and support with new tools and information designed to help individuals self-manage their recovery. It will act as a voice for survivors and care partners to advocate for improved services and policies that support their efforts. Heart & Stroke is also committed to developing a trusted and deep relationship with survivors and care partners to encourage their further involvement in the work of the Foundation, including engaging patients more deeply within in its research strategy.

The four principles of the Heart & Stroke Promote Recovery work are:

• Respect the needs, wishes and preferences of survivors, their families and care partners and tailor information, tools and resources accordingly
• Ensure survivors remain informed and active participants in managing their own recovery
• Provide programs and initiatives that will address varying needs across time and disease stage
• Ensure that best practices and scientific evidence continue to inform all of the work

The Heart and Stroke Foundation supports the goal presented by Dr. Spertus of patient treatment and care tailored to the specific needs of the individual. As he looks ahead to tomorrow lecture addressing the Canadian cardiology community, he says: "I want to excite them to seize the opportunity to add great value to healthcare and to their patients by delivering precision care."

The Canadian Cardiovascular Congress brings together over 3,500 heart health experts to exchange ideas and present the latest breaking research. It is being held in Montreal from October 22 to 25. Follow us on Twitter @SCC_CCS, #CCCMTL

The Canadian Cardiovascular Congress, the largest gathering of cardiovascular and allied health professionals in Canada, is co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

The Canadian Cardiovascular Society is the national voice for cardiovascular physicians and scientists. Its mission is to promote cardiovascular health and care through knowledge translation, professional development, and leadership in health policy.

The Heart and Stroke Foundation,a volunteer-based health charity, leads in eliminating heart disease and stroke, reducing their impact through initiatives to prevent disease, save lives and promote recovery. Healthy lives free of heart disease and stroke. Together we will make it happen.

SOURCE Heart and Stroke Foundation

For media interviews, please contact: Diane Hargrave, [email protected], 416-467-9954, ext. 104; After October 26, 2016, contact: Jane-Diane Fraser, Heart and Stroke Foundation of Canada, [email protected], [phone], Cell from Oct 21 to 25: 613-406-3282