Pain Management Video

Insulin and the Future of Chronic Pain Management with Dr. Gary Lewis

This talk will begin with a brief overview of the events leading to the momentous discovery of insulin in Toronto 100 years ago, in 1921-22. Next, we will briefly summarize some of the major advances in the treatment of diabetes over the past 100 years and will then pivot to discuss the next 100 years of diabetes prevention and management and the major challenges that remain.

Public healthcare systems are overburdened with person power shortage, long waiting times, infrequent structured evaluation, and insufficient patient engagement. Annual growth of healthcare expenditure exceeds that of GDP growth, calling for more efficient and value-added care.

Even in high-income countries/areas with medical coverage, large patient volumes, complex care protocols, frequent changes in healthcare providers, lack of regular evaluation and insufficient patient engagement can lead to delayed intervention, suboptimal self-management and patient distress with poor clinical outcomes. Due to the high patient: health care provider ratio, use of information and communications technology and non-physician personnel can improve the efficacy and continuation of care delivery.

Multicomponent, data-driven integrated care assisted by non-physician personnel, information and communications technology has been demonstrated to cost-effectively improve clinical outcomes by 30 to 60%. Data stratify risk, triage care, empower patients and individualize treatment. Big data track secular trends, identify unmet needs and verify interventions in a naturalistic environment.

We need to:

1. Identify persons at higher risk of adverse outcomes using data

2. Develop tools and processes for a Remote Patient Monitoring Program

3. Reach out to those identified and offer them access to the virtual care service Integrate virtual service with primary care

4. Develop new tools and processes for information sharing including EMRs

5. Focus on chronic conditions screening and prevention

6. Evaluate effectiveness, acceptability and cost effectiveness from the patient, provider and health system perspectives

IHI Insight 2021 presented by the University of Toronto and University of British Columbia’s IHI Open School Chapters


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