The Canadian Medical Association (CMA), the College of Family Physicians of Canada (CFPC), and the National Specialty Society of Community Medicine (NSSCM) today released Lessons from the Frontlines, a collaborative report on H1N1 describing the physician experience on the frontlines of the pandemic.
"The H1N1 influenza pandemic strained public health resources and primary care providers alike," noted NSSCM President, Dr. Matthew Hodge. "Preparing for the future means we must strengthen the relationship of these critical frontline workers."
The national organizations, representing over 80,000 physicians engaged in all aspects of Canada's health care and public health systems, have proposed concrete steps to improve Canada's pandemic response capability:
- a pan-Canadian communications strategy to better link primary health care and public health professionals; - the rapid adoption of electronic medical records to enhance disease surveillance; - a singular pan-Canadian response to clinical practice guidelines including vaccination programs during times of health crises; and, - infrastructure funding to reduce the variation of preparedness across the country and integrate primary-care expertise into public health at all levels.
Communications were a consistent source of concern during the H1N1 pandemic. In situations where scientific evidence is rapidly changing, the processes used to distribute information to both front-line public health and clinical professionals must eliminate confusion. Coordinated, unified communication strategies are needed at the national, provincial/territorial and local levels.
Lessons from the Frontlines also states that communications can be enhanced through the sharing of data between the public health and primary care systems. Expansion of the use of electronic medical records in primary care, with bi-directional links to public health electronic health records, could have facilitated disease surveillance and rapid communication of clinical information.
During times of public health crisis, it is crucial for public health and primary care to work together. "The H1N1 experience confirmed the vital role that family physicians must have in any pandemic situation," says CFPC President, Dr. Cathy MacLean. "Because they are essential to the provision of front line care for Canadians it is very important that family doctors be part of the advance planning as well as the delivery of services related to a pandemic."
Lessons from the Frontlines also highlights the fact that, while the outcome was positive, there were challenges with mass vaccination programs. Among the issues that arose: many public health units were stretched as expectations exceeded resources; and the variation and lack of coordination in providing important clinical information and vaccination during this crisis eroded the public's confidence in the federal, provincial and territorial response. The report states that a harmonized, singular national clinical response during times of public health crisis will ensure future consistency.
"At the end of the day, our shared objective is protecting the health of Canadians and to do that we cannot work in isolation," said CMA president Dr. Anne Doig. "Public health, primary care and governments must trust in each other's professionalism and expertise and work together between and during health emergencies to protect Canadians from future health threats.
We have had two "wake-up calls" - SARS and H1N1. Let's not wait for a third to find that we are not yet prepared."
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