CADTH and Choosing Wisely Canada Announce Expert Panel to Help Guide Post-Pandemic Health Care

CADTH and Choosing Wisely Canada have convened a group of clinicians, policy experts, and patient advisors to identify actions that health systems can take to improve post-pandemic care for Canadians.

The Expert Panel on Post-Pandemic Care is composed of leaders from across the country who bring a range of experience and perspectives to this work. This includes front-line medical expertise, caregiver and lived experience, policy analysis, quality improvement, and ethics. Together, the expert panel will deliver guidance on how health care systems can optimize resources available to deliver the priority tests and procedures that are most beneficial to patients in the pandemic’s wake.

The COVID-19 pandemic is having a profound impact on Canadian health systems by way of delays and cancellations of non-urgent care, elective procedures, some diagnostic procedures and screening tests, and a significant number of surgeries. Health system leaders are equally worried about the number of patients with illnesses that remain undiagnosed. When health systems begin to reopen and scale up these clinical activities, efforts to reduce wasteful and non-beneficial tests and treatments can, in turn, help make crucial and necessary care available more quickly.

Developing the Recommendations

Importantly, this project creates the opportunity to pilot an exploratory conversation with patient representatives, clinicians, and policy makers to identify the medical services and procedures that offer low to no known clinical value, in order to support a clinical focus on delivering high value care when the pandemic recedes.

Choosing Wisely Canada will review its existing evidence-based recommendations with clinician experts and curating an initial short list of low-value treatments. The expert panel will then develop final recommendations for clinicians and decision-makers. Recommendations will be considered for inclusion in the short list if they are:

• common in clinical practice, can cause harm, relatively frequent, and resource intensive
• associated with an area of need delayed by the pandemic or where there is an existing backlog
• a potential strain on health care human resources and system capacity
• aligned with categories of overuse identified by Choosing Wisely Canada and the Canadian Institute for Health Information.

The results of this work will be presented at Choosing Wisely Canada’s National Meeting in May 2021 and will be published in CADTH’s Canadian Journal of Health Technologies.

Expert Panel Members

• Cindy Dumba, Patient Partner, Choosing Wisely Saskatchewan, and Lead Patient Partner, Choosing Wisely Canada
• Sophie Ikura, Executive Director, Health Commons Solution Lab, Ontario
• Maggie Keresteci, Executive Director, Canadian Association for Health Services and Policy Research, Ontario
• Dr. Ken Milne, Emergency Physician and Chief of Staff, South Huron Hospital Association, Ontario
• Dr. Paddy Quail, Family Physician and Medical Leader, Supportive Living, Alberta Health Services
• Dr. Susan Shaw, Critical Care Physician and Chief Medical Officer, Saskatchewan Health Authority
• Dr. Christy Simpson, Head and Associate Professor, Department of Bioethics, Dalhousie University, Nova Scotia
• Dr. Alex Singer, Family Physician and Director of Research and Quality Improvement, University of Manitoba
• Johanna Trimble, Public Member, Geriatrics and Palliative Care Committee, Doctors of BC
• Dr. Adina Weinerman, Internist and Medical Director, Quality and Patient Safety, Sunnybrook Health Sciences Centre, Ontario

Quotes

“COVID-19 has upended the delivery of health care across the country — we’re unlikely to see a return to business as usual and with that comes the potential to do things differently and better. The renewal of our health systems will be a complex undertaking and a unique opportunity to re-examine what we prioritize. CADTH is honoured to collaborate with Choosing Wisely Canada and the Task Force to develop evidence-informed guidance that can help increase our focus on the care and interventions that provide clear benefits to patients.”
 ~ Suzanne McGurn, President and CEO, CADTH

“Health care services are facing incredible pressures to address massive backlogs and foregone procedures that will strain an already stretched system. This review, in partnership with CADTH, will provide important foresight into how we ensure limited health care services are directed toward things that add the greatest value for patients and the public. We’re proud that Choosing Wisely Canada recommendations, developed by national clinician societies, are laying the groundwork for this review to inspire change at the system level.”
 ~ Dr. Wendy Levinson, Chair, Choosing Wisely Canada

Quick Facts

• A recently published article in the British Medial Journal highlighted that only 5% of patients required imaging for low back pain. The remaining 90% to 95% had no indication of a serious cause and could be managed by other means including physical therapy, exercise, or pain management. 
   
•  Amid fears of blood shortages in the COVID-19 pandemic, many hospitals accelerated their efforts to reduce inappropriate red blood cell transfusions to ensure this vital health care resource was available when needed most. 
   
• Primary care clinicians are calling for rethinking screening exams for low-risk patients and focusing on the most beneficial screening tests at optimal intervals.
   
• Sharp drops in emergency department utilization were seen during the pandemic and some organizations have set up virtual consultations for emergency needs. This can help clinicians and patients avoid unnecessary X-rays and imaging tests for common injuries such as sprained ankles and mild concussion.
   

About CADTH

CADTH is an independent, not-for-profit agency funded by Canadian federal, provincial, and territorial governments (except Quebec) to provide credible, impartial advice and evidence-based information about the effectiveness of drugs and other health technologies to Canadian health care decision-makers.

About Choosing Wisely Canada

Choosing Wisely Canada is the national voice for reducing unnecessary tests and treatments in health care. One of its important functions is to help clinicians and patients engage in conversations that lead to smart and effective care choices. Choosing Wisely Canada is led by a team of clinicians and staff based at St. Michael’s Hospital (Toronto), the University of Toronto, and in collaboration with the Canadian Medical Association.