The Chronic Disease Challenge The Chronic ... - Capital Health

EDMONTON AND CALGARY PILOT ALBERTA INFOWAY CHRONIC DISEASE MANAGEMENT SYSTEM
www.capitalhealth.ca SUMMER 2008
The
Chronic
Disease
Challenge
Empowering
staff, patients and
primary care providers
Staff with patient at
Edmonton Southside
Primary Care Network

capitalhealth.ca
408-LINK
OR TOLL-FREE
1-866-408-LINK (5465)

SUMMER 2008
IN FOCUS
5 Preventive Medicine
Addressing problems early on, or before they happen,
saves time, money and the health of our residents.
Capital Health is working with family physicians to
do just that through the shared care approach of
local Primary Care Network (PCN) health teams.
BEST PRACTICES
9 Reducing medication errors
PARTNERSHIPS
10 Alberta Infoway CDM pilot
RESEARCH
12 Monitoring diabetes in Alberta
13 Advice line offers real-time support
14
LEADERS IN HEALTH
14 Self-management program for youth
IN THE COMMUNITY
16 Empowering patients through
education
17 Future plans for chronic care
18 Chronic disease community networks
19 Preventing falls in seniors
BEST PRACTICES
8 The Right Platform
Primary Care Networks are changing the way services get
delivered and improving the quality of care delivered by
health professionals. Nowhere is this more striking than in
chronic disease, where PCNs are proving to be the right
platform for supporting people in managing their condition.
15 Electronic Manager
An electronic patient registry that has been helping
health teams manage patients with diabetes will expand
to support patients with other chronic conditions. To date,
the chronic disease management (CDM) registry contains
information on more than 12,000 patients with diabetes.
9 12 15
NEWS AND NOTES
20 Grey Nuns Community Hospital
expands women’s health
21 New institute supports geriatrics
ON THE COVER: patient Caroline Jodrey with nurse practitioner
Sheri Fielding (left), dietitian Robin Anderson and Dr. Carmen Gingles
by Laughing Dog Photography Inc.
THIS PAGE: Lisa Gerard (from left), Jenn Fearon and Peggy Clarke
(top left), pharmacist Amy Lau by Laughing Dog Photography Inc.
(bottom left), RN Karen Kastelic by Stephen Wreakes/Capital Health
(bottom right).
Canada Post Publications Mail
Agreement Number 40639561
www.capitalhealth.ca SUMMER 2008 ~ CHQ 3

FROM THE DESK OF SHEILA WEATHERILL
Chronic disease management –
empowering patients and practitioners
Chronic disease is approaching epidemic levels around the world, yet the health system
is still not meeting the needs of people with chronic conditions. Chronic illness makes up
between 60 and 70 per cent of all health budgets, yet health systems are still focused on
acute and episodic care.
Many people live with multiple
chronic problems, from arthritis and
high blood pressure to diabetes and
lung disease. Seventy to 80 per cent
of people over 65 years have three
or more chronic conditions. Eighty
per cent of visits to physicians are
related to chronic disease. As our
population grows older and lives
longer, the burden on the health
system will only increase. To make
a significant change in delivering
health care, we need to change our
approach to people with chronic
conditions.
In reading this special issue on
chronic disease management, you
will see the comprehensive approach
Capital Health is taking to proactively
prevent, assess and manage chronic
disease. We have partnered with
Alberta Health and Wellness, other
health regions, University of Alberta
researchers and our own Primary
Care Networks (PCNs) to find better
ways to improve the continuity
of care among family physicians,
specialists, hospitals and community
care.
As a leader in e-health, Capital Health
uses electronic technology to ensure
multidisciplinary teams have the
decision support tools they need
at the point of care. We are also
piloting a provincial chronic disease
management initiative that offers
real-time health summaries for
patients with chronic conditions
to improve the communication and
coordination of care among health
providers.
Capital Health has partnered with
PCNs, Calgary Health Region and
Canada Infoway to build a chronic
disease management registry.
Initially focused on diabetes,
the electronic patient registry
(see page 15) gives physicians and
care providers updated information
to better manage their patients’
conditions, thus reducing long-term
risks and hospitalization.
Dr. Richard Lewanczuk, Medical
Director, Chronic Disease Management,
Capital Health, oversees
Edmonton’s diabetes program.
He says integrated, interdisciplinary
care for patients with diabetes makes
a huge difference; Emergency visits
by diabetics in the region are the
lowest in the province.
University of Alberta public health
researchers are also working with
Capital Health and PCNs to implement
and evaluate new care programs for
patients with diabetes. One PCN is
developing the region’s first early
intervention program for their
pre-diabetic population.
On page 14, you can read about the
support we are giving young adults
with chronic disease through the
first official adaptation for youth
of the Stanford Chronic Disease
Self-Management Program.
As our health system evolves to
improve care and reduce costs,
we envision the day when every
person has a family physician; the
family physician is supported by an
interdisciplinary team; our primary
care teams can detect early chronic
disease and intervene before complications
arise, while preventing
chronic disease in patients at risk;
and we use electronic tools to track
and update medical conditions from
birth to support our residents in
lifelong health maintenance.
Sincerely,
Sheila Weatherill, C.M.
President and CEO
www.capitalhealth.ca
Capital Health Quarterly is published by Capital Health Public Affairs.
EDITOR
Dawna Freeman
dawnafreeman@cha.ab.ca
780-482-8660
ART DIRECTOR
Julie Wons
CONTRIBUTING WRITERS
Cecilia Bloxom, Tadra Boulton, Judith Dyck, Dawna Freeman,
Mellissa Kraft, Carolyn O'Handley, Holly Regal, Carrie Rosa
CONTRIBUTING ILLUSTRATORS/PHOTOGRAPHERS
Laughing Dog Photography Inc., Stephen Wreakes
We welcome your story ideas and comments. Send your
comments to the Editor at dawnafreeman@cha.ab.ca.
Photos and articles may not be reproduced without the
written consent of the Editor.
HOW TO REACH US
Capital Health Public Affairs
1J2.51 Walter C. Mackenzie Centre
8440-112 Street
Edmonton, AB T6G 2B7
Capital Health Quarterly is printed by Ion Print Solutions
on 80 lb Chorus Art Silk (50% recycled, 25% post-consumer).
© Contents copyright 2008 by Capital Health.
4 CHQ ~ SUMMER 2008 www.capitalhealth.ca

IN FOCUS
Primary Care Networks focus on
chronic disease
management
It used to be that when you got sick, you would see
a doctor or go to the hospital. That traditional way
of treating illness and disease is beginning to shift.
LAUGHING DOG PHOTOGRAPHY
www.capitalhealth.ca SUMMER 2008 ~ CHQ 5

IN FOCUS
“We know that addressing
disease early saves
the system money, time
and most importantly,
keeps our residents healthier.”
DR. RICHARD LEWANCZUK,
MEDICAL DIRECTOR FOR CHRONIC DISEASE
MANAGEMENT, CAPITAL HEALTH
Sheri Fielding, nurse practitioner and nurse leader in
chronic disease management at the Edmonton Southside
Primary Care Network, takes the blood pressure of patient
Caroline Jodrey, 89, during a routine diabetes visit.
Capital Health, in partnership with
family doctors, is on the leading
edge of managing chronic diseases
and addressing problems before they
happen. The region is advancing
its ability to provide preventive
medicine and put care plans in
place for patients with chronic
health conditions.
“We know that addressing disease
early saves the system money,
time and most importantly,
keeps our residents healthier,”
says Dr. Richard Lewanczuk,
Capital Health’s Medical Director
for Chronic Disease Management.
The new approach to chronic
disease management started
when Capital Health redesigned
its diabetes program beginning
in 2001. The redesign aimed to
provide a standardized approach
to treatment for all patients and
included streamlining all referrals
through a single central intake line.
Since implementation, patients have
experienced reduced wait times
and now receive treatment and
education from a health team,
which includes a physician, nurse
and dietitian.
The learnings from this work, along
with an emerging focus on family
medicine through the 2003 Primary
Care Initiative, have positioned
Capital Health to better serve its
patients in the prevention and management
of chronic health problems.
The Primary Care Initiative
was formed between Alberta Health
Five years ago,
the health regions including Capital
Health, Alberta Health and Wellness
and the Alberta Medical Association
chartered a bold new direction for
delivering primary care – setting in
place the groundwork for Primary
Care Networks (PCNs). In partnership
with family physicians, Capital
Health implemented the first Primary
Care Network in Edmonton’s
Southside in May 2005.
There are eight Primary Care
Networks with one additional group
of family physicians developing
a business plan to create a ninth
network. Approximately 55 per cent
of family physicians in the region
are participating in a PCN, providing
care to 56 per cent of the region’s
population.
An overarching focus of PCNs
is chronic disease management –
and Wellness, the Alberta Medical
Association and Alberta’s health
regions, including Capital Health.
The Primary Care Initiative aims to
increase the number of Albertans
with ready access to primary care.
Primary care is the first point of
contact with the health system
helping residents manage conditions
like diabetes, obesity, heart disease,
asthma and chronic obstructive
pulmonary disease. Physicians
diagnose and treat the condition,
while other members of the team
complement that care by providing
ongoing assessment, monitoring,
education and support.
Primary care teams help residents
prevent chronic diseases by providing
care before problems develop,
which keeps residents healthier
with improved quality of life and
saves the health system time and
resources.
“We have been impressed with how
the PCN has brought the physicians
together to improve the quality
of care in the community,” says
Dr. Chuck Lortie, a Sherwood Park
family physician. The Sherwood
Park PCN has been in operation
since June 2007.
6 CHQ ~ SUMMER 2008 www.capitalhealth.ca

“We take the health of our
residents, including those with
chronic disease, very seriously.
We also want to be proactive
and prevent chronic disease
wherever possible.”
DR. RICHARD LEWANCZUK,
MEDICAL DIRECTOR FOR CHRONIC DISEASE
MANAGEMENT, CAPITAL HEALTH
LAUGHING DOG PHOTOGRAPHY
for everyday health services. It also
increases emphasis on health promotion,
disease and injury prevention,
care of patients with medically
complex problems and care of
patients with chronic diseases.
The agreement went even further
in fostering a team approach to
providing primary care by formally
establishing the Primary Care
Networks.
Local PCNs are a successful example
of using a team approach to help
residents manage chronic conditions.
PCNs are multidisciplinary teams
which include family physicians,
and may include registered nurses,
licensed practical nurses, chronic
disease nurses, mental health
therapists, social workers, dietitians,
pharmacists, and other health
professionals.
“It’s an important model that gives
patients access to a wide-range of
skills and information. For example,
an individual with a new diagnosis
of diabetes will have a care plan
built by a number of different health
professionals, working together,”
says Dr. Lewanczuk.
“The whole team is working together
to provide the best care possible,”
says Sheri Fielding, a nurse practitioner
and Edmonton Southside
PCN nurse leader. “It’s based
on what the patient needs and
who can best provide it.”
Initially, Capital Health has focused
its work on the following chronic
diseases: asthma, chronic obstructive
pulmonary disease, cardiovascular
risk, diabetes, heart failure and
obesity.
“We take the health of our residents,
including those with chronic disease,
very seriously. We also want to
be proactive and prevent chronic
disease wherever possible,” says
Dr. Lewanczuk.
“Capital Health is a leader in e-health.
We have the capability to identify
from birth who is at risk of developing
certain conditions based on a number
of factors. In the meantime, we use
risk-scoring procedures to keep an
eye on those individuals at risk of
chronic diseases and work to reduce
that risk,” he says.
Patients are also empowered to
take charge of their own conditions
through numerous programs offered
by Capital Health including workshops
on self-management and disease
specific education such as Weight
Wise and diabetes. A 24-hour
Capital Health Link telephone line,
staffed by registered nurses, is also
available for residents who have
questions about their conditions.
Physicians and multidisciplinary
staff also benefit from the chronic
disease management model. Health
providers have received increased
education and support as part of the
implementation of the model, allowing
them to screen for and manage
chronic disease more effectively.
“We know the benefits of managing
chronic disease. We know that
something needs to be done
and we’re working hard to make
a difference,” says Dr. Lewanczuk.
www.capitalhealth.ca SUMMER 2008 ~ CHQ 7

BEST PRACTICES
Accelerating Primary Care 2008 Conference
Primary Care Networks –
The Right Platform for
Chronic Disease Management
Defining Primary Care:
Primary health care is the
first point of contact with
the health system, where
people receive care from
family physicians, and
from nurses, pharmacists,
therapists and others for
most of their everyday
health care needs.
(Alberta’s Primary Care
Initiative)
Defining Primary Care
Networks (PCNs):
PCNs are a partnership
with family physicians,
the provincial government
and the health regions.
Groups of family physicians
with teams of health
professionals work
together to meet the
health needs of residents
in a specific geographic
area. Services include:
chronic disease management,
after hours clinics,
linking new patients to
physicians, mental health
services, home care and
geriatric care.
PRIMARY CARE NETWORKS (PCNs) ARE CHANGING
the way services get delivered and improving the quality
of care delivered by family physicians and the other health
professionals working with them. Perhaps nowhere is
this more striking than in chronic disease, where PCNs
are proving to be the right platform for supporting people
in managing their chronic conditions.
Chronic disease management
was a recurring topic at the recent
Accelerating Primary Care 2008
conference hosted by Capital Health
in partnership with the University
of Alberta this spring. Presenters
shared new approaches and spoke
about delivering effective responses
to chronic disease management (CDM)
through Primary Care Networks,
including more systematic follow-up,
a better understanding of population
needs and the ability to aggregate
resources and improve responsiveness.
PCNs offer the opportunity to
improve quality and access through
the use of the electronic medical
record, same day appointments
and working with patients to ensure
consistent follow-up and screening.
Dr. Ernie Schuster, Medical Director
for Capital Health’s Primary Care
Division and a family physician with
the Edmonton West PCN, talked
about the challenges of moving
from a culture that put the onus
on the patient to follow-up, to a
proactive health management culture
where screenings are paneled, tests
scheduled and follow-up is automatic.
The heart of being able to respond to
the needs of patients, Dr. Schuster
explained, is same day access. It
reduces the number of bad things
that can happen because problems
are caught earlier, lowering hospitalizations
and emergency department
visits. For patients with chronic
diseases such as heart failure and
diabetes, this can be the difference
between living well and deteriorating
health.
A PCN team also has the capacity
to identify high risk groups amongst
its patients, and plan new ways to
lower the incidence and severity
of chronic disease. Debbie Wilson,
general manager, St. Albert and
Sturgeon PCN, talked about the
PCN’s use of the diabetes registry
to determine patient interventions –
offering group sessions on diabetes
prevention, eating well and living
with chronic disease. Their PCN has
developed relationships with Capital
Health, the University of Alberta’s
School of Public Health and Physical
Education Faculty and Servus Credit
Union Place, among others, to
broaden and inform the group
initiatives, something that would
be difficult for a sole practitioner
to organize.
8 CHQ ~ SUMMER 2008 www.capitalhealth.ca

In another innovative approach,
Robin Anderson and Loreen Wales,
both registered dietitians with
Edmonton Southside PCN, described
the use of group appointments
to meet the demand for dietitian
services. In their presentation, aptly
entitled “So Many Patients… So Little
Time”, they described how group
appointments allowed them to see
more people (from an average of
five in a four-hour period to seven to
13 patients) and get better outcomes:
Patients were able to learn from each
other, were more satisfied with their
experience and were more likely to
make positive changes in their lives.
The common themes? Relationships
matter. Patients need to be brought
into the chronic disease management
paradigm and given more
control over treating their conditions.
And it’s critical to do things with
people, not to them – a common
approach will work for most people,
but not all. To paraphrase Dr. Mike
Donoff, Royal Alexandra Family
Medicine Centre and Associate Chair
and Professor, Department of Family
Medicine, University of Alberta, our
approaches need to mirror our
patients’ reality, not their disease
state or states.
Medication
initiatives
improve
patient
safety
Capital Health continues to
improve patient safety practices
with medication process
improvements and advice.
The Clinical Information Systems
medication management project
was initiated in 2003 at University
of Alberta Hospital and Stollery
Children’s Hospital to promote
and improve medication practices.
The initiative continues to improve
safe medication practices through
the implementation of new technologies
and workflow processes.
The project is defining, from a system
perspective, an ideal approach for
delivering medication – one that
makes the work of nurses and
pharmacists better today, but is
also forward-thinking enough to
adapt over time.
Medication errors are one of the
most significant safety issues for
health systems. To reduce the error
rates in administrating medications,
the medication administration record
(MAR) process, which involved moving
from a paper handwritten system
to a computer generated paper
MAR system, was standardized.
More Pyxis Medstations have been
added to three intensive care units,
bringing the total to over 55 across
the two hospitals. Pyxis MedStations
are automated medication management
systems that control access to
a small selection of frequently used
drugs through enhanced security
features. Pyxis Medstations in the
care units reduce delay times in
getting frequently used medications
to patients while still keeping the
medications as safe as they would
be if locked away in the hospital’s
pharmacy.
Another safety enhancement ensures
all medication orders are reviewed
by a pharmacist prior to the drug
being administered to the patient.
Called Profile, this ensures medication
orders are verified for appropriate
dosages, allergies are carefully
screened, and drug-to-drug or drugto-food
interactions are identified.
Patient safety has also taken another
step forward with the launch of
the Pharmacist Line. Patients with
questions about a drug interaction,
a missed dosage or potential medication
side effects can get medication
advice and information on the
Pharmacist Line, the newest addition
to Capital Health Link’s service. The
Pharmacist Line provides access to
pharmacists after hours, seven days
a week by calling Capital Health Link
at 780-408-LINK (5465).
This year, acute care facilities
will switch over to new infusion
devices called Alaris ® Smart IV Pumps.
The new pumps will improve the
safety of intravenously-administered
medication by helping health professionals
intercept and ensure accurate
dosages.
www.capitalhealth.ca SUMMER 2008 ~ CHQ 9
LAUGHING DOG PHOTOGRAPHY

PARTNERSHIPS
Capital Health pilots chronic disease managem
Capital Health and
Calgary Health Region,
in partnership with
Alberta Health and
Wellness and with
funding from Canada
Health Infoway, are
piloting new chronic
disease management
information tools.
The tools, part of the Alberta Infoway
Chronic Disease Management (CDM)
initiative, are being piloted at two
clinics – one in Edmonton and one
in Calgary – for the better management
of patients with diabetes and
hypertension.
Interactive graphs
quickly identify
high-risk patients
The goal of the initiative is for
primary care physicians and
clinical teams to use CDM registries.
The Alberta Infoway CDM initiative
provides primary care clinics with
additional functionality, not available
in the regional CDM registries,
to better identify patient care
requirements.
CDM registries have been implemented
in Edmonton and Calgary
and help identify patients with
diabetes and hypertension and
ensure patients are attached to
family physicians and regional
support programs. Many patients
with chronic conditions are not
linked to a family physician making
it difficult for them to receive
properly-coordinated care. The
registries help triage patient care
needs to provide patients with
the appropriate level of care and
education. The registry triggers
patients needing follow-up appointments
and services.
The Alberta Infoway CDM initiative
takes the registries one step further
by providing web-based summary
COURTESY ORION HEALTH
10 CHQ ~ SUMMER 2008 www.capitalhealth.ca

ent information tools
tools that help health providers
proactively tackle chronic disease
management.
It uses the patient information
in each of the registries to create
a “patient profile viewer” and
a “population-based dashboard.”
These web-based tools provide
accurate, real-time health summaries
for patients with chronic conditions.
The summaries help providers easily
identify patient care needs and
develop effective care plans. The
summaries include, for example,
information on the most current
lab test results, complications,
and smoking status.
Donna Strating (top left),
Vice-President, Information
Systems and Equipment
and Chief Information
Officer for Capital Health,
and Pat Reader, Director,
Continuum of Care for
Advanced Technology for
Calgary Health Region,
are heading up the pilot
for the chronic disease
management information
tools at clinics in Edmonton
and Calgary.
The tools also help improve patient
care by allowing clinicians to monitor
care against clinical standards based
on best practices. These web-based
tools give care providers insight into
how patients with chronic conditions
are managing and how well their
practice is providing care and services.
Other benefits include increased
communication between care
providers who share one information
source for a patient and better
coordinated patient care. The Alberta
Infoway tools also provide indicators
and alerts that allow care providers
to focus attention on high-risk
patients. The indicators may include
whether the patient has a selfmanagement
plan in place, or is
due for an eye or foot examination
according to clinical practice guidelines.
This proactive approach to
care can decrease or prevent
complications, increasing a patient’s
quality of life and decreasing the
need for acute care services.
Plans are underway to start implementing
the Alberta Infoway tools
in the broader primary care community
in both Edmonton and Calgary
by the end of the year. The long range
goal of the project is to implement
the tools across the province.
Canada Health Infoway is a
federally-funded, independent,
not-for-profit organization
whose members are Canada’s
14 federal, provincial and
territorial Deputy Ministers
of Health. Infoway supports
the growth of electronic
health information systems
and fosters collaboration
in the development and
implementation of these
systems.
For more information, visit
www.infoway-inforoute.ca
www.capitalhealth.ca SUMMER 2008 ~ CHQ 11

RESEARCH
Diabetes research supports chro
Researcher Dean Eurich (left) and Dr. Jeffrey Johnson
AAlthough the incidence
of diabetes in Alberta
(4.7 per 1000) is slightly
below the national
average (5.4 per 1000),
the number of Albertans
living with this chronic
disease has doubled in
the past decade.
“We have a lower prevalence of
diabetes here than in eastern Canada,
but the rates in the province – and
around the world – are going up
quickly due to obesity and aging,”
says Dr. Jeffrey Johnson, a researcher
and professor in the School of Public
Health at University of Alberta.
As a Canada Research Chair in
Diabetes Health Outcomes and
the leader of the Alberta Diabetes
Surveillance System (ADSS),
Dr. Johnson works with Alberta
Health and Wellness and the health
regions to monitor the trends of
diabetes, its regional variations
and its complications over time,
to help health providers and policy
makers understand the scope of
the disease and how to deal with it.
According to a 2006 report by ADSS,
more than one in every 20 people
in Alberta has diabetes.
People with diabetes are over twice
as likely to have a heart attack, heart
failure or stroke. Almost half of those
who have kidney disease also have
diabetes. Eye disease and mental
health disorders such as depression
are also more likely in people with
diabetes. The surveillance system
captures how many Albertans with
diabetes have a heart attack, stroke
and eye disease, and it measures
the outcomes and complications
of the disease.
“My goal is to improve the quality
and efficiency of care for people
with diabetes, to find new ways
to support primary care,” he says.
“We look at the economics of
chronic disease management,
including assessing the cost and
“Capital Health is staying on the leading
edge by collaborating with PCNs and
researchers to bring research findings
into everyday practice.”
DR. JEFFREY JOHNSON, PROFESSOR AND CANADA RESEARCH CHAIR
IN DIABETES HEALTH OUTCOMES, SCHOOL OF PUBLIC HEALTH,
UNIVERSITY OF ALBERTA
STEPHEN WREAKES/CAPITAL HEALTH
12 CHQ ~ SUMMER 2008 www.capitalhealth.ca

nic care
“Working with the University of
Alberta and Capital Health, the PCN
health promotion and prevention
coordinator will facilitate the developefficiency
of care. What is the
most cost effective way to provide
the most efficient care to people
with chronic disease?”
Dr. Johnson has been using the
information gathered from ADSS
to work with Capital Health and
the Primary Care Networks (PCNs)
to implement and evaluate new care
programs. He says the PCNs’ team
approach is a great model for
chronic disease management.
Diabetes information line supports
health workers and patients
Many local PCNs are now using
the region-wide diabetes patient
registry to identify their own diabetic
population and pre-diabetic groups.
The St. Albert and Sturgeon PCN
is the first PCN group to allocate
resources to develop a program for
their pre-diabetes patient population
group.
D I A L
in for Advice
An information and advice line for those with diabetes, and their health
providers, may soon become available for other chronic diseases.
Capital Health started DIAL (Diabetes Information and Advice Line)
to provide a clinical support line to primary care physicians, nurses
and dietitians. The service, offered by the community diabetes team of
nurses and dietitians, provides guidance in the management of diabetes,
fielding questions from medication management and insulin adjustment
to nutrition counseling.
Calls to the advice line, offered to health workers in central and northern
Alberta, have increased 100 per cent since it piloted in May 2005.
“It absolutely makes sense to expand this kind of real-time support
to providers managing other chronic diseases,” said Dorothy Smolek, of
the Regional Diabetes Program. “We want to increase support to health
providers in the community by providing them with timely information
so they can manage patients with chronic disease proactively.”
Patients who are registered in the Regional Diabetes Program at Capital
Health also have direct access to the DIAL line. Smolek says the line
helps people with diabetes set goals they can work towards as they
become more independent in the management of the disease.
The DIAL line is available weekdays to patients and caregivers. Anyone
wanting information on diabetes can call Capital Health Link 24/7 and
speak to specially trained nurses. Those needing additional assistance
are referred to DIAL and the Community Diabetes Team.
Call Capital Health Link at 780-408-LINK (5465) or toll-free
1-866-408-LINK.
ment, implementation and evaluation
of a program for this high risk
group of patients,” said Debbie
Wilson, general manager of the
St. Albert and Sturgeon PCN.
“It will be important to meet with
this select group of patients to gain
a better understanding of what
would be helpful to them to prevent
the onset of diabetes. The registry
will provide a means to help the
PCN begin to measure outcomes.”
“Organizations like Capital Health
are ahead of the game in terms of
identifying people with diabetes
(Capital Health has identified more
than 90 per cent of people with
diabetes in the region) and the
PCNs are a very forward thinking
model,” said Dr. Johnson. “Capital
Health is staying on the leading
edge by collaborating with PCNs
and researchers to bring research
findings into everyday practice.”
But to drive system efficiencies, he
says, “we need health professionals
providing the right type of care –
and PCNs are perfect for that – and
people taking more responsibility
for their own health.”
Dr. Bill McBlain, interim Vice-President,
Research, Capital Health, says
research on chronic disease is one
of Capital Health’s priority areas.
“Research – be it basic, clinical,
population- or outcomes-based, or
health services-oriented – that leads
to better prevention, diagnosis and
treatment of various chronic diseases
will result in improved long-term
management strategies for these
diseases.
“All Albertans are affected directly
or indirectly by chronic disease,
so advances in this area of research
will have major societal and economic
impacts within this region, the
province, and beyond.”
www.capitalhealth.ca SUMMER 2008 ~ CHQ 13

LEADERS IN HEALTH
Be Your Own Boss
Learning to manage
a chronic disease
can be challenging,
especially for teens.
“There are few supports available for
youth living with chronic diseases,
and as this population continues to
grow, we’re looking for new ways to
meet their needs,” explains Marianne
Stewart, Vice-President and Chief
Operating Officer, Primary Care division
for Capital Health. “The Be Your
Own Boss program was developed
to fill a gap in self-management
support and to give youth the tools
to manage their health conditions.”
Be Your Own Boss is the first official
adaptation for youth of the Stanford
Chronic Disease Self-Management
program. The program is designed
for teens and young adults with
chronic conditions such as diabetes,
multiple sclerosis, asthma and cancer,
who are moving from pediatric to
adult health services.
“All teens have a lot to deal with in
their transition to adulthood,” says
Stephanie Donaldson-Kelly, Director,
Chronic Disease Management for
Capital Health. “If teens have a
chronic illness, they are facing many
additional challenges such as how
to manage the symptoms of the
disease, how to book appointments
and monitor medications, how to
succeed at school, relationships
with friends and family and how
to manage the difficult emotions
of living with a chronic illness.”
Young adults with chronic diseases
who have received training and
effectively made the transition
themselves volunteer their time
to mentor their peers.
Jenn Fearon, a fourth year Education
student at the University of Alberta
has been a diabetic for 18 years.
Fearon, a youth leader with the
program, explains her involvement,
“I volunteer for Be Your Own Boss
because I know how difficult it is
to transition from the pediatric clinic
to the adult clinic. It’s a scary time.
Often you feel alone, like you’re the
only one who is going through this.”
The workshops were developed by
an interdisciplinary team at Capital
Health including registered nurses,
a registered psychologist, Stanford
Master Trainers and leaders with
the assistance of teen champions.
The workshops are flexible to meet
the needs of the participants, but
generally participants meet for
two and a half hours each week
for six weeks.
Fearon explains, “The workshops
focus on goal setting and how to
work with medical professionals.
We provide tips to develop coping
strategies and talk about the importance
of eating right and exercising.
We’re helping teens with chronic
conditions become aware of the skills
they already have to manage their
illness. Plus, we have a lot of fun!”
Other health regions across Canada
have approached Capital Health
about the program. Capital Health
is pleased to share the knowledge
and experience in order to help
youth manage chronic diseases.
For more information about
Be Your Own Boss workshops
call 780-482-8527.
Jenn Fearon, Be Your Own Boss youth
leader, with another youth facilitator,
Joel Tiedmann.
The Stanford Chronic Disease
Self-Management program
was developed by the Division of
Family and Community Medicine
in the Department of Medicine at
Stanford University. The program
is a series of workshops for people
with different chronic health
problems. The six-week workshops
are offered in community settings
and are facilitated by two trained
leaders, one or both of whom
are peers with a chronic health
condition.
Capital Health’s adult version of
the program, Live Better Every Day,
and Be Your Own Boss for youth,
cover such topics as how to
manage symptoms, how to work
more effectively with the doctor
and health team, and include tips
on exercise and activity, nutrition,
relaxation and stress management
techniques.
Live Better Every Day and Be
Your Own Boss self-management
programs are designed to enhance
regular treatment and disease
specific education.
14 CHQ ~ SUMMER 2008 www.capitalhealth.ca

IN THE COMMUNITY
Chronic Disease Management Registry
makes positive impact on patient care
Karen Kastelic, RN, and chronic disease management nurse at the Edmonton West Primary Care
Network, reviews a patient record in the CDM registry with Dr. Harvey Sternberg.
A
STEPHEN WREAKES/CAPITAL HEALTH
A region-wide registry that identifies
people with chronic conditions
is helping health teams and their
patients to better manage and monitor
their illness.
“Chronic diseases are a huge burden
on health systems worldwide,” says
Marianne Stewart, Vice-President and
Chief Operating Officer of Capital
Health’s Primary Care division. “Our
regional Chronic Disease Management
(CDM) Registry ensures clinical
information is shared and care
providers have the most up-to-date
patient information to make
informed and safe decisions.”
In partnership with the region’s
Primary Care Networks (PCNs),
Capital Health developed an
electronic patient registry to assist
with chronic disease management.
The initial phase of the registry
focused on identifying all the people
in the region who have diabetes.
To date, more than 85,000 people
with diabetes have been identified
through lab results in Capital Health’s
electronic health record. As physicians
confirm the diagnoses, these patients
are then placed on the registry. In
its first year of implementation,
the registry contains information
on more than 12,000 patients with
diabetes. More than 130 physicians,
practising in 22 clinics in four PCNs,
are using the registry.
“As a family physician, the registry
expands my capacity to manage
patients with chronic conditions,”
says Dr. Harvey Sternberg, family
physician, and Co-Chair Edmonton
West PCN. “The registry enables the
team to identify those patients who
require specific services and follow
up care.”
Karen Kastelic, a chronic disease
management nurse with Edmonton
West PCN, has noticed the difference
the registry is making to patient
care. “We are able to view all of the
components of a patient’s condition
including diagnosis, medications,
blood sugar management and most
recent blood work. The registry helps
ensure all these areas are reviewed
at each clinic visit. We instantly know
if a patient is due for blood work, an
eye exam or a kidney function test.”
The information included in the
registry ensures continuity of care
and allows individuals to monitor
and become proactive with their
chronic disease.
The registry will also provide actual
information on disease prevalence in
the region. For example, according
to the Canadian Census Health
Survey (2005/06), 4.4 per cent of
the population in the Edmonton
area has diabetes. However, clinical
information collected from the
health record shows the prevalence
is actually over eight per cent. This
information will help the region plan
services to better meet the needs
of people with diabetes.
While the registry currently focuses
on diabetes, work has begun to
expand it to support individuals with
or at risk of asthma, heart failure,
obesity, cardiovascular disease
and chronic obstructive pulmonary
disease. Dr. Sternberg notes,
“By managing patients better, the
long-term risks and hospitalization
associated with diabetes and other
chronic conditions are reduced.”
www.capitalhealth.ca SUMMER 2008 ~ CHQ 15

IN THE COMMUNITY
Capital Health tackles chronic disease manage
When someone is
diagnosed with a chronic disease,
his or her world is suddenly filled
with an overwhelming amount of
information he or she is expected
to remember. A little education
can give people the support and
confidence they need.
“The best way to manage any
chronic disease is to empower
patients to manage it themselves,”
says Dr. Richard Lewanczuk,
Medical Director of Chronic Disease
Management (CDM) with Capital
Health.
Capital Health provides numerous
patient education sessions to do
just that. Live Better Every Day,
a six-week workshop series led
by people who live with chronic
conditions, includes topics such as
how to carry out normal activities,
emotional changes, dealing with
limited mobility and managing
stress. Capital Health offers a similar
program for teens called Be Your
Own Boss (see story on page 14),
which is the first official adaptation
for youth of the Stanford Chronic
Disease Self-Management program.
Other education initiatives are
targeted to specific conditions.
The diabetes program offers classes.
Taught by a nurse, dietitian or
diabetologist, people learn how
to manage their disease and avoid
diabetic episodes by keeping their
blood sugars under control.
Similarly, Weight Wise has developed
some new group education sessions
in conjunction with their adult clinic
to help people manage their obesity.
These sessions are also taught by
an expert team, including a dietitian,
psychologist, physician, exercise
specialist and nurses. These sessions
are a more comprehensive version
of their two-part workshop series
on healthy living, which is offered
to the public. The pediatric side
of Weight Wise also provides
education sessions for parents of
overweight children.
A wide range of cardiac programs
teach people how to take care of
their heart at 13 sites, including the
Mazankowski Alberta Heart Institute
and Royal Alexandra Hospital.
Cardiac rehabilitation programs,
workshops on heart health, and
an online heart school are just some
of the initiatives designed to give
heart patients the best knowledge
and skills possible to improve their
quality of life.
There is also a variety of educational
programming aimed at people
with chronic respiratory conditions.
Asthma clinics and workshops help
develop Individual Asthma Action
Plans, and the COPD (chronic
Sneak-peek at
What does the future
hold for chronic care
in the Edmonton area?
Here is a sneak-peek
at some plans for
the next year.
New Chronic Disease
Community Network
Based on the success of the Weight
Wise Community Network, Capital
Health is now looking to create an
overarching chronic disease network
that will connect residents to programs
in the community that help people
with chronic disease prevention and
management. All members will be
carefully screened and accredited by
Capital Health. The network included
resources for individuals with
heart disease, diabetes, respiratory
problems and other conditions.
The development of standards
and criteria for this new network
is underway.
16 CHQ ~ SUMMER 2008 www.capitalhealth.ca

ment through patient education
obstructive pulmonary disorder)
Rehabilitation Program helps
individuals remain independent
and stay out of hospital. Offered
in Leduc, Fort Saskatchewan and
Stony Plain, the six-week program
consists of group exercise and
in-depth education. There is also
a TelePulmonary COPD clinic that
provides remote care to COPD
patients and provides education
sessions via telehealth, which uses
videoconferencing technology.
Capital Health also works with staff
in Primary Care Networks in the areas
of diabetes and self-management
support skills. Training in other
disease areas will be added in
the near future.
To learn more about educational
chronic disease management
programs offered through
Capital Health or Caritas,
visit www.capitalhealth.ca
or call Capital Health Link
at 780-408-LINK (5465).
future plans for chronic care
Changes for Weight Wise
In partnership with University of
Alberta and the Canadian Obesity
Network, Capital Health’s Weight
Wise program aims to make
Edmonton a leading centre for the
prevention and treatment of obesity.
Changes to existing services for the
adult program have already begun
and will continue over the next year
or two. Priorities include: improving
access to treatment by streamlining
referral, assessment and triage
processes; developing and delivering
comprehensive group education
sessions for clinic patients; and
acquiring new, state-of-the-art
diagnostic equipment for the clinic
which will help clinicians to better
diagnose the cause and severity
of obesity in each patient. Weight
Wise will also develop a rehabilitation
program (weight management)
for obese surgery patients.
In the pediatric program, the
Stollery Children’s Hospital’s
Pediatric Centre for Weight and
Health, Life Skills for Kids at the
Misericordia Community Hospital,
outpatient dietitians and the
community sector will work more
closely to share knowledge and
best practices. Educational healthy
living workshops for parents are
being created so that they have
the tools and information they
need to support their children
in adopting healthy habits.
And finally, Weight Wise will use
Telehealth to offer community
education sessions/workshops,
as well as some clinical services to
patients who live a long distance
from Edmonton.
Expansion of the
Chronic Disease Registry
The Chronic Disease Registry will be
expanded to include patients with
hypertension, cholesterol problems,
asthma, COPD (chronic obstructive
pulmonary disorder), and obesity.
The registry now keeps track of
patients with diabetes, which allows
health professionals to better manage
their care.
Increasing support
to Primary Care
Capital Health has been working
with Primary Care Networks (PCNs)
in the Edmonton area to help them
increase their capacity to manage
patients with diabetes and will now
offer support for other diseases.
This includes integrating specialist
support and back-up, providing
materials, as well as training and
education.
www.capitalhealth.ca SUMMER 2008 ~ CHQ 17

IN THE COMMUNITY
Weight Wise Community Network
sees local businesses join forces
to support healthy lifestyles
G
Getting active and eating right are
key when it comes to preventing
and managing obesity and other
chronic diseases. So Capital Health
has brought in local reinforcements
to help promote and support
healthy lifestyles.
“We needed to branch out and
connect with existing resources
to create a pool of groups and
businesses in the community
that we could rely on and that
the public could trust,” says Dawn
Estey, Regional Manager of Chronic
Disease Management with Capital
Health.
This concept grew into the Weight
Wise Community Network – a
resource aimed at connecting
residents in the Edmonton area
with qualified weight management
and healthy living groups in their own
communities. Health professionals
refer patients to network members
for additional support.
A team of experts, including an
exercise specialist, psychologist
and dietitians, regularly review
expressions of interest from fitness
clubs, nutrition consultants, weight
loss programs, lifestyle change
programs and chronic disease
management groups. To be accepted
into the network, staff must be
properly trained and certified,
programs must be evidence-based
and demonstrate results, and
equipment and facilities must
be up to standard.
Since its launch in June 2006,
the network has grown to more
than 20 members including the
YMCA, Weight Watchers, Club Fit,
University of Alberta facilities,
Coronary Health Improvement
Program (CHIP), Strathcona County
(Recreation, Parks and Culture),
and City of Edmonton facilities.
The members meet quarterly with
Capital Health to discuss promotion,
new members, amendments to
standards and criteria, and how
to better serve patients with
weight-related health issues.
Diane Pyne, Community Liaison
Coordinator, says that partnerships
are beginning to flourish between
individual members. “Businesses are
inspired to collaborate on projects
that might not have been conceived
if it hadn’t been for the network,”
says Pyne. “They’re all coming
together with the goal of building
a healthier community.
“The sky’s the limit for what we
can accomplish here. We know that
by getting the whole community
working to be part of the solution
to address obesity we have a
greater chance of succeeding,”
says Pyne.
Capital Health’s Weight Wise targets
both the prevention and treatment
of obesity in men, women and
children in the Edmonton area. The
program plans to take the network
to the next level over the next six
months by developing an online
tool for health professionals to refer
patients to network members.
Based on the success of the Weight
Wise Community Network, Capital
Health is now looking to create
an overarching chronic disease
network with groups that help
individuals with heart disease,
diabetes, respiratory problems and
other conditions. The development
of standards and criteria for this
new network is underway.
Visit www.capitalhealth.ca/
weightwise or call Capital Health
Link at 780-408-LINK (5465) for
more information on the Weight
Wise Community Network and
a full listing of members.
18 CHQ ~ SUMMER 2008 www.capitalhealth.ca

Falls Prevention a priority
for Capital Health
Resident and health care aide at the
Edmonton Chinatown Care Centre.
One in three seniors living
in Canada will fall this year.
In 2007, Capital Health
established a regional
falls collaborative to
prevent falls.
The regional falls collaborative has
members from various sites and
health sectors, academic institutions,
and community agencies including
Emergency Medical Services (EMS).
It is working on a pilot project with
EMS, a future public awareness
campaign, an ambulatory falls
clinic opening at the Glenrose
Rehabilitation Hospital in May 2008
and Safer Health Care Now! National
Falls Collaborative in Long-Term
Care.
The national Falls Collaborative
in Long-Term Care is being offered
with the Registered Nurses’ Association
of Ontario which has developed
a best practice guideline on the
prevention of falls and fall injuries
in the older adult. The collaborative
consists of improvement teams
from across the country who will
meet four times over the year,
supplemented by teleconference
calls. Between the learning sessions,
individual teams will work on testing
what they have learned using a PDSA
(Plan, Do, Study, Act) approach.
“It has long been recognized that
falls are an issue in continuing care
and there are initiatives in place to
reduce the number of falls and the
injuries resulting from falls,” says
Marguerite Rowe, Vice-President and
Chief Operating Officer, Community
Care, Rehabilitation and Geriatrics.
“By participating in the collaborative,
we hope to gain greater knowledge
with a goal of developing a more
comprehensive approach to falls
prevention and management which
we can share with all of the continuing
care facilities in the region.”
The ambulatory falls clinic at the
Glenrose Rehabilitation Hospital will
provide interventions to decrease fall
risks and fall rates and will address
numerous factors that cause falls
including home environment,
strength, vision, balance, medications,
risk taking behaviours, and footwear.
For example, if the risk for falling
is because of strength – a strength
training program will be established
in conjunction with a physiotherapist.
If the risk is because of vision – an
appointment with an optometrist
will be recommended.
There is a multidisciplinary team
involved in this clinic including an
occupational therapist, a physical
therapist as well as a nurse practitioner.
Some of the interventions
and care will occur in the client’s
home.
Another falls initiative is a six-month
pilot targeting two Pioneer Housing
Foundation lodges in Sherwood
Park that frequently call 911 for
fall-related events.
Capital Health, Strathcona Emergency
Services and Pioneer Housing
Foundation will provide residents
at Clover Bar and Silver Birch
lodges an opportunity to participate
in physical activity, healthy eating,
attend falls education sessions
for individuals and groups to raise
awareness about falls and falls
prevention, and continued support
through recreation activities at
the lodge.
www.capitalhealth.ca SUMMER 2008 ~ CHQ 19

NEWS AND NOTES
Women’s Health growing at Grey Nuns
The Grey Nuns Community
Hospital has opened two new
nursing units for moms and babies.
Completion of the new units has
freed up space for a major renovation
for Women’s Health. Work is
underway to expand labour and
delivery, postpartum and neonatal
nursery. Renovations planned for
the third floor include:
• Adding five Labour and Delivery
Rooms to the current seven,
• Adding a bereavement room
to the Labour and Delivery
Unit for patients and families
experiencing loss – this room
will also be used as an additional
labour room,
• Increasing the number of postpartum
beds from 40 to 55
across two newly renovated,
family-centred nursing units
Grey Nuns Women’s Health Patient Care Manager, Gail Cameron (right), with newborn
Ella and staff of the Women’s Health program at a preview of the newly renovated
Post Partum Unit.
offering single-room care and
sleeping benches for dads.
Each unit will also have four
new theme rooms supported
by the Caritas Hospitals
Foundation,
• Adding a new nursery that will
have 32 incubators, up from 21,
and will move from an intermediate
care nursery to a neonatal
intensive care unit.
Capital Health supports community-based
chronic pain programs
Work continues in developing
community-based education and
exercise programming to support
clients with chronic pain, and
telephone consultation services
for primary care physicians. By
increasing the level of community
supports available Capital Health
aims to improve early intervention
and secondary prevention opportunities
and reduce the number
of severe chronic pain cases.
“As an example of physician
education, a group of physicians
from East Central Health expressed
interest in expanding their chronic
pain assessment and treatment
abilities. Representatives from the
UAH Multidisciplinary Pain Centre,
LifeMark Health Institute and
Capital Health designed an interactive
education event,” says
Marguerite Rowe, Vice-President
and Chief Operating Officer for
Community Care, Rehabilitation
and Geriatrics.
Identification of the risk factors
for chronic pain development,
with available tools and strategies
for conducting comprehensive
chronic pain assessments, were
provided and a presentation of
current evidence for commonly
prescribed treatments. The East
Central clinicians also spent two
days at the University of Alberta
Hospital and LifeMark clinics to
gain practical, hands-on skills
for chronic pain management.
On April 11 and 12, 2008, Capital
Health and LifeMark Health
Institute co-hosted the Taking
the Pain out of Complex Pain
Management conference at the
Westin in Edmonton. The successful
event attracted over 120 attendees
from across the country.
The conference is part of a longterm
strategy to increase the availability
of current, evidence-based
pain education to providers.
20 CHQ ~ SUMMER 2008 www.capitalhealth.ca

New institute to support geriatrics
Capital Health, CapitalCare, the
University of Alberta and NorQuest
College signed a Memorandum
of Understanding to create the
Institute for Continuing Care,
Education and Research (ICCER).
The institute will have an impact
on healthy aging and geriatrics in
the Edmonton area and Alberta,
enhancing the quality of life for
those served by the continuing
care system.
“In the Capital Health region alone,
the number of seniors is expected
to double in the next 20 years.
Given this shift, we need to ensure
that seniors have access to the care,
support and services they require to
maintain a high quality of life,” says
Marguerite Rowe, Vice-President and
Chief Operating Officer, Community
Care, Rehabilitation and Geriatrics.
The institute will focus initially
on research in the continuing care
sector, knowledge transfer, clinical
practicum experience, and promotion
of the continuing care sector.
The ICCER Steering Committee meets
monthly to discuss opportunities
as this institute gets developed.
The knowledge created through
the institute’s research activities
will ensure that care is delivered
innovatively and in the safest and
most appropriate manner.
Students in related programs at the
University of Alberta and NorQuest
College will be able to learn and
work together, moving smoothly
into careers in their chosen field,
and jobs offered by CapitalCare,
Capital Health and other agencies.
The institute will provide many
opportunities for interdisciplinary
activities that will generate increased
interest in continuing care as a career
of choice.
Edmonton III conference
NorQuest LPN students
interact with patient at
CapitalCare Dickinson
continuing care centre,
with training mannequin
in the background bed.
In February, Capital Health and
CapitalCare hosted over 450 delegates
from around the country at
Edmonton III, Enhancing Safety in
Home, Community and Long-Term
Care conference.
The conference included tours
of various sites around the region,
such as the Mazankowski Alberta
Heart Institute and CapitalCare
long-term care facilities. The twoday
event covered infection control,
medication safety, the future of
technology and ended with a session
on increasing communication.
As part of Edmonton III, the Canadian
Patient Safety Institute (CPSI) released
a background paper that calls for
a stronger research push to identify
the best practices to optimize the
safety of residents in long-term care
settings. The paper, jointly funded by
CPSI, Capital Health and CapitalCare,
reviewed the current scientific literature
on resident safety in long-term
care and surveyed long-term care
stakeholders from across the country –
including frontline staff, senior
management, policy makers,
researchers, and family members.
University of Alberta
course in continuing care
The Faculty of Nursing at the
University of Alberta with Capital
Health is offering a course focusing
on specific care needs and issues
in continuing care and community
leadership. This course will encourage
future continuing care leaders to
interact with residents and families
in continuing care effectively.
www.capitalhealth.ca SUMMER 2008 ~ CHQ 21

THE BACK PAGE
Primary Care – the cornerstone of chronic
disease management and prevention
Chronic disease care in the western world is becoming the single
greatest driver in health systems. In Capital Health, it’s estimated
that it already consumes 60 to 80 per cent of our health resources.
There’s an even greater cost when the personal and economic toll on
people, their families and employers is taken into account. So it’s clear
that as a health system, and as a society, we have to build a system that
can support the health of every individual living with a chronic disease.
More than that, our system needs to address the factors putting people
at risk of developing a chronic disease.
It’s a tall order, but not an impossible
one if everyone who has a stake in
the game can become connected
and part of a system, including
primary care networks, specialists,
hospitals, recreation and fitness
providers, schools and postsecondary
institutions.
Here at Capital Health, we’re
putting in place the tools that will
help people take an active role
in achieving an optimal quality
of life… knowing that the person
with the illness is the best source
of knowledge on how the disease
is impacting them and how it can
be managed. At a population level,
we’re tracking the health status of
people living here and developing
proactive ways of reaching people
at risk, including patient education
and follow-up. Care maps, guidelines
and protocols help ensure
that people see the right provider
at the right time.
At the heart of these changes is
the relationship with primary care,
which is the cornerstone of chronic
disease management and prevention.
It makes sense. Primary care is the
first point of contact people have
with the health system. If people are
able to connect with their family
physician, see a dietitian, get access
to mental health services, be tested
regularly and supported in maintaining
drug therapy if required,
they’re going to be able to lead
lives that support their own health.
That means fewer emergency department
visits, and less hospitalization,
and better outcomes all around.
We’re very fortunate that in
Capital Health, the majority of
family physicians are in primary
care networks (PCNs) and are
beginning to put in place teams of
providers to help meet the needs
of their patient population. Capital
Health has been able to build on
this opportunity to better organize
its services, strengthen relationships
with the community and learn from
each other. In the near future, we’re
going to build on the early successes
of our comprehensive disease
registry, improve linkages with
regional initiatives such as Weight
Wise, and better support electronic
medical records so PCNs and
patients have access to the
information they need.
It’s a win, win, win situation – for
patients, providers and Capital
Health.
Guest column by Dr. R. Lewanczuk,
Medical Director for Chronic
Disease Management, and
Marianne Stewart, Vice-President
and Chief Operating Officer,
Primary Care division.
22 CHQ ~ SUMMER 2008 www.capitalhealth.ca

Your career. Your life. Your choice. At Capital Health, you choose the
way you want to work and live. With such a vast array of roles, disciplines and
locations available, you can find your perfect balance. Within our integrated
health care model, we offer rewarding positions in a wide variety of areas,
from nursing to nutrition, allied health to administration, and IT to research.
Whatever your career focus, Capital Health is a great place to work.
Choose to live in a rural, small town or big city location, while contributing
to public health, acute, long-term or community care. As Canada’s largest
academic health region, we’re leading the way in quality of care, medical
advances and career opportunities. Discover career fulfillment and get more
out of life, right here at Capital Health in Edmonton.

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