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<b>Foreword</b> <p>by Mark Poznansky, President, Robarts Research Institute.</p> <p>by Ross Tsuyuki, BSc (Pharm), MSC, PharmD, Director, The Epidemiology Coordinating and Research Centre (EPICORE), University of Alberta.</p> <p><b>Acknowledgements.</b></p> <p><b>Introduction.</b></p> <p><b>Part 1: The Theory.</b></p> <p>Chapter 1: How We Got to Where We Are.</p> <p>Chapter 2: Defining Quality of Care.</p> <p>Chapter 3: The Care Gap and Its Causes.</p> <p>Chapter 4: The Prescribing Gap.</p> <p>Chapter 5: The Compliance, Concordance and Adherence Gaps: Challenges and Opportunities.</p> <p>Chapter 6: Access, Health and the Economy: Can We Afford Access Gaps?</p> <p>Chapter 7: The Care Gap Gorilla: Bigger Gaps for Older Patients.</p> <p><b>Part 2: The Practice—Patient Health Management (PHM).</b></p> <p>Chapter 8: Background and Rationale of Patient Health Management.</p> <p>Chapter 9: Learning Experiences: The Epidemiology Coordinating and Research Centre (EPICORE), the Heart Function Clinic and the Clinical Quality Improvement Network (CQIN).</p> <p>Chapter 10: A Pivotal Experience: Improving Cardiovascular Outcomes in Nova Scotia (ICONS).</p> <p>Chapter 11: Other Experiences in Patient Health Management.</p> <p><b>Part 3: What Have We Learned So Far?</b></p> <p>Chapter 12: What Works: The Action Plan.</p> <p>Chapter 13: What Doesn't Work?</p> <p><b>Part 4: Vision for the future.</b></p> <p>Chapter 14: The Strategic Alternatives.</p> <p>Chapter 15: Skate to Where the Puck Will Be: Wayne Gretzky's Strategic Plan.</p> <p><b>Appendices</b></p> <p>Appendix A: Guiding Principles for Public/Private Partnerships: Disease Management and Outcomes Research</p> <p>Appendix B: Patient Management Template, Heart Function Clinic, circa 1994.</p> <p>Appendix C: CQIN Mission, Goals and Objectives.</p> <p>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.</p> <p>Appendix E: Physician Order Sheet for Management of Patients with Heart Attack from a Representative CQIN Hospital, Circa 1992-1996.</p> <p>Appendix F: ICONS Members and Affiliations.</p> <p>Appendix G: ICONS CARE Map: Management of Anticoagulation in Atrial Fibrillation.</p> <p>Appendix H: ICONS Care Map: Management of Heart Failure.</p> <p>Appendix I: ICONS Standardized Discharge Order Sheet.</p> <p>Appendix J: ICONS Provider Newsletter.</p> <p>Appendix K: ROCQ Project Outline.</p> <p>Appendix L: CURATE Treatment Algorithm for Osteoarthritis Patients.</p> <p>Appendix M: Examples of Diabetes Hamilton Newsletters.</p> <p><b>Bibliography.</b></p> <p><b>Index.</b></p>

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. <p>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 <i>Canadian Journal of Cardiology</i>, the <i>American Journal of Noninvasive Cardiology</i>, <i>Chest</i>, and <i>HealthCare</i> <i>Papers</i>. He has published more than 300 academic papers and presentations.</p> <p>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.</p> <p>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.</p>

<b>PATIENTS FIRST</b> <p>CLOSING THE HEALTH CARE GAP IN CANADA</p> <p>"This book is a must read for those who are interested in our health care system and who want to make it better. Dr. Montague provides an interesting overview of his journey through hospital wards, clinical trials, patient registries, patient health management and chronic disease management programs. Drawing on his diverse and unique background, he gives an important history of the past, analysis of the present and a glimpse of our future."</p> <p>—David Johnstone, MD</p> <p>President, Canadian Cardiovascular Society</p> <p>"Based on significant practice and research experience in the public, private and academic worlds, over many regions of Canada, Dr. Montague reveals to the reader, consumer, decision maker and patient an evolving and, until now, largely overlooked dimension in optimizing care and outcome. This optimization is important not only within the context of an individual's care, but within the scope of an entire practice, community or even nation."</p> <p>—Ross Tsuyuki, PharmD</p> <p>Director, The Epidemiology Coordinating and</p> <p>Research Centre, University of Alberta</p> <p>"Listen to Dr. Montague. He well understands both the problem and the solution, which is to pull out all the stops and to put patients first. He advocates patient health management to close the many care gaps. This will result in improved health for millions of Canadians and then, if we do it right, by emphasizing research and evidence-based health care and not merely budgets, our health care system will become more cost effective and our population healthier and more productive."</p> <p>—Mark Poznansky, PhD</p> <p>President, Robarts Research Institute</p>

"This book is a must read for those who are interested in our health care system and who want to make it better. Dr. Montague provides an interesting overview of his journey through hospital wards, clinical trials, patient registries, patient health management and chronic disease management programs. Drawing on his diverse and unique background, he gives an important history of the past, analysis of the present and a glimpse of our future." <p>David Johnstone, MD</p> <p>President, Canadian Cardiovascular Society</p> <p> "Based on significant practice and research experience in both the public and private, and academic worlds, over many regions of Canada, Dr. Montague reveals to the reader, consumer, decision maker and patient an evolving and, until now, largely overlooked dimension in optimizing care and outcome. This optimization is important not only within the context of an individual’s care, but within the scope of an entire practice, community or even nation."</p> <p>Ross Tsuyuki, PharmD</p> <p>Director, The Epidemiology Coordinating and Research Centre</p> <p>University of Alberta</p> <p>"Listen to Dr. Montague. He well understands both the problem and the solution, which is to pull out all the stops and to put patients first. He advocates patient health management to close the many care gaps. This will result in improved health for millions of Canadians and then, if we do it right, by emphasizing research and evidence-based health care and not merely budgets, our health care system will become more cost effective and out population healthier and more productive."</p> <p>Mark Poznansky, PhD</p> <p>President, Robarts Research Institute</p>

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