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Patients to get identity numbers

Jeanne Atherden, the Minister of Health and Seniors (Photograph supplied)

Universal, unique numbers for anyone who touches the health system will be introduced by the Ministry of Health.

This Unique Patient Identifier will enable providers to better coordinate care as part of the ministry’s push to improve the island’s “poorly integrated” health information system, Jeanne Atherden said.

The health minister, who was providing an update on the Bermuda Health Strategy and Action Plan, also revealed that the cost of dialysis will be reduced on June 1 and that, combined with a reduction in the cost of diagnostic imaging fees and long-stay beds at the hospital, this is estimated to result in savings of more than $20 million in one year.

“If successful, it will represent the single, largest reduction in health costs our system has ever seen,” Ms Atherden told the Association of Bermuda International Companies.

“In addition, we have been working to improve our health information system, which is currently poorly integrated. This prevents the communication necessary to reduce health costs and improve outcomes.

“We are on the cusp of introducing a Unique Patient Identifier to be used across all healthcare settings,” she said. “This will be a universal, unique number assigned to anyone who touches the health system and will enable providers to better coordinate care.

“For example, a Unique Patient Identifier can assist in prescribing and managing medications, monitoring and using diagnostic tests, which can help prevent hospitalisation.

“Importantly, this Unique Patient Identifier is a necessary foundation for an integrated electronic health system, so it is a fundamental step towards this larger health reform goal.”

The Bermuda Health Strategy was launched in January last year to present a vision for health system reform over a five-year period. This is supported by the Bermuda Health Action Plan, which details specific actions to achieve this vision. A further Action Plan has also been put in place to also address key long-term care issues.

According to Ms Atherden, strides have been made to reorganise payment systems to focus on value and outcomes, improve benefit design to reduce unnecessary hospitalisation, and to develop a healthcare workforce plan to address the needs of 21st century Bermuda.

“What is clear to Bermuda is that we could not afford the trajectory it had been on for 20 years.”

But she added that for the “first time on record” health spending went down by 1.1 per cent in 2015, adding: “We finally bent the cost-curve — and we’re the first country to do so, compared to the OECD.”

However, she said that spending $11,102 per capita on health is still too much and there is “some way to go to achieve sustainability”.

“Currently there are approximately 170 patients on dialysis at the cost of $200,000 a year, each,” she said, adding that “this $34 million expenditure has been targeted in our reforms”.

Coverage for kidney transplants, which can cost $130,000 a year, will increase, she said, making transplant more accessible so that patients can come off dialysis.

In addition to reducing the cost of dialysis treatment, Ms Atherden said the price of diagnostic imaging fees at the hospital will be brought down to the level charged in the community, and the price of long-stay beds at the hospital will be reduced for eligible patients.

Ms Atherden also revealed that more than 100 people are enrolled in the Patient-centred Medical Home and the Enhanced Care pilot programme for under and uninsured patients with chronic conditions.

Legislation is also being drafted to improve care quality in residential and nursing homes as part of the Long Term Care Strategy introduced last year, she said.

Furthermore, the mental health act is under review and more information for care givers and developers is available on the Government website.

“And we introduced a ‘Personal Home Care’ benefit that has enabled persons to be cared for at home safely and more cost-effectively. This new benefit has been especially successful and one private insurer has already incorporated it to its own policies. We are working with other insurers to follow suit as it is great for patients and much less costly.”

The Ministry has also started a project to simulate private sector investment in long term care, saying the need for additional capacity is great.

She added that this was evidenced by the “current bed crisis affection the hospital”, with about 120 long-stay patients who do not need hospitalisation, but have no other place to be cared for.

“The Government cannot build this capacity, so we are looking to the private sector and are in active discussions with developers and potential financiers to mobilise this sector.”

She added: “But long term care is not just about bricks and mortar. It’s also about support for caregivers and workforce capacity.

“As such, health workforce planning has been a key initiative and is under active consultation at present.”

Better regulation of the health sector has also been a priority to improve quality and reduce costs, she said.

Ms Atherden noted that headway has been made in the regulation of healthcare professionals. However, she added that legislation for the regulation of healthcare businesses has not yet been passed.

“This is naturally frustrating as this regulation is paramount to control the unrestrained utilisation of healthcare resources which has contributed so much to the increase in health spending.

“However, I remain committed to introducing the necessary regulatory controls, and hopeful that the Bermuda Health Council Amendment Act will ultimately be passed.”

Ms Atherden also reiterated that the standard premium rate and HIP and FutureCare premiums will go down “for the first time ever” by $4.07 per month as of June 1.

• To see Ms Atherden’s full remarks, view the PDF under “Related Media”.