Patients First: Closing the Health Care Gap in Canada [NOOK Book]


When it comes to health care, patients come first.

Patients First: Closing the Health Care Gap in Canada is distilled from one physician’s personal journey from the traditional and individual patient orientation of medicine to a broader vision of achieving the best health care for the most people at the best cost.

At the centre of Dr. Terrence Montague's vision is the patient, and he provides a blueprint that ...

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Patients First: Closing the Health Care Gap in Canada

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When it comes to health care, patients come first.

Patients First: Closing the Health Care Gap in Canada is distilled from one physician’s personal journey from the traditional and individual patient orientation of medicine to a broader vision of achieving the best health care for the most people at the best cost.

At the centre of Dr. Terrence Montague's vision is the patient, and he provides a blueprint that will deliver optimal health care results without placing an even greater burden on available resources.

The author urges that our health care system adopt the principles of Patient Health Management, in particular developing community-based partnerships, measuring results, and focusing on the four key causes of the care gap: less than optimal access, diagnosis, prescription, and compliance.

Patients First starts with a premise that no one can take issue with: Things can be better in our health care system, in every way. Dr. Montague's prescription for improved health care--how patients, practitioners and policy-makers can make incremental improvements that will make things better--is supported by case studies, population-based evidence and first-person testimonials.

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Product Details

  • ISBN-13: 9780470675229
  • Publisher: Wiley
  • Publication date: 3/18/2010
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 1
  • Pages: 192
  • File size: 2 MB

Meet the Author

Born in Saint John, New Brunswick, Dr. Terrence Montague graduated from Dalhousie University with a doctorate in Medicine. He is one of Canada’s pre-eminent experts in disease management and health outcome research.

Dr. Montague is currently vice president of Patient Health at Merck Frosst Canada, one of the country’s leading research-based pharmaceutical companies. Prior to joining Merck, Dr. Montague was Professor of Medicine and Director of Cardiology at the University of Alberta. He has occupied a number of academic positions at the University of Alberta, the University of British Columbia and Dalhousie University, and served on the editorial boards of the Canadian Journal of Cardiology, the American Journal of Noninvasive Cardiology, Chest, and HealthCare Papers. He has published more than 300 academic papers and presentations.

Dr. Montague served with the Canadian Forces Medical Services in various roles in the Regular and Primary Reserve army in Canada and overseas, retiring with the rank of Lieutenant Colonel.

Currently, Dr. Montague is a fellow of the American College of Chest Physicians, the American College of Cardiology, the American Heart Association, the Royal College of Physicians and Surgeons of Canada, and, a member for life of the Royal Canadian Regiment Association.

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Table of Contents


by Mark Poznansky, President, Robarts Research Institute.

by Ross Tsuyuki, BSc (Pharm), MSC, PharmD, Director, The Epidemiology Coordinating and Research Centre (EPICORE), University of Alberta.



Part 1: The Theory.

Chapter 1: How We Got to Where We Are.

Chapter 2: Defining Quality of Care.

Chapter 3: The Care Gap and Its Causes.

Chapter 4: The Prescribing Gap.

Chapter 5: The Compliance, Concordance and Adherence Gaps: Challenges and Opportunities.

Chapter 6: Access, Health and the Economy: Can We Afford Access Gaps?

Chapter 7: The Care Gap Gorilla: Bigger Gaps for Older Patients.

Part 2: The Practice—Patient Health Management (PHM).

Chapter 8: Background and Rationale of Patient Health Management.

Chapter 9: Learning Experiences: The Epidemiology Coordinating and Research Centre (EPICORE), the Heart Function Clinic and the Clinical Quality Improvement Network (CQIN).

Chapter 10: A Pivotal Experience: Improving Cardiovascular Outcomes in Nova Scotia (ICONS).

Chapter 11: Other Experiences in Patient Health Management.

Part 3: What Have We Learned So Far?

Chapter 12: What Works: The Action Plan.

Chapter 13: What Doesn't Work?

Part 4: Vision for the future.

Chapter 14: The Strategic Alternatives.

Chapter 15: Skate to Where the Puck Will Be: Wayne Gretzky's Strategic Plan.


Appendix A: Guiding Principles for Public/Private Partnerships: Disease Management and Outcomes Research

Appendix B: Patient Management Template, Heart Function Clinic, circa 1994.

Appendix C: CQIN Mission, Goals and Objectives.

Appendix D: Representative CQIN Partnership/Governance Structure for the Project Entitled: Mortality risk and patterns of practice in 4,606 acute care patients with congestive heart failure. The relative importance of age, sex and medical therapy.

Appendix E: Physician Order Sheet for Management of Patients with Heart Attack from a Representative CQIN Hospital, Circa 1992-1996.

Appendix F: ICONS Members and Affiliations.

Appendix G: ICONS CARE Map: Management of Anticoagulation in Atrial Fibrillation.

Appendix H: ICONS Care Map: Management of Heart Failure.

Appendix I: ICONS Standardized Discharge Order Sheet.

Appendix J: ICONS Provider Newsletter.

Appendix K: ROCQ Project Outline.

Appendix L: CURATE Treatment Algorithm for Osteoarthritis Patients.

Appendix M: Examples of Diabetes Hamilton Newsletters.



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