Dr. William Ghali was featured in a column of “What’s up, Doc?”, a weekly column in the Calgary Herald written by SnapDx covering the most interesting doctors and health researchers in Calgary and in our wider global community.

April 7, 2014

Healthcare is part of the Canadian identity. We take it for granted like the air we breathe. The system just works. Most of the time at least.

I had a chance to chat with Dr. William Ghali this week for an inside view of how our hospitals work. Dr. Ghali is the Director of the Institute for Public Health and a Professor in the Department of Medicine at the University of Calgary.

“I began my medical residency training in 1990, and as a young person who rarely visited the doctor, I didn’t think much of how error-prone our healthcare system is,” says Dr. Ghali. “The minute I began working in the system, I was very unsettled by how things really worked. Things do fall through cracks.”

One thing Dr. Ghali noticed for example, is how care varies from doctor to doctor. There is little consistency in the system. Two heart bypass surgeons may perform the same procedure on a patient, but one may decide to insert an intra-aortic balloon pump to help the heart recover, while the other may decide this device is unnecessary.

“I was really humbled by how complicated healthcare is and a little nervous by the variability I was observing,” said Dr. Ghali. “People across the system were working really hard, but despite that, we weren’t necessarily getting things right.”

And this became the motivation of Dr. Ghali’s academic career: to measure inefficiences in healthcare systems and improve healthcare system performance.

His research included mining data to track outcomes of patients with cardiovascular disease. He also helped launch the Ward of the 21st Century at Foothills Hospital to prototype new hospital ward designs and innovations. One of W21C’s most important initiatives is Seamless Discharge. With Seamless Discharge, patients that are transitioned from the hospital back to their family physicians now have an electronic record that details what was done at the hospital and what the family physician should follow-up on.

“System change is incredibly complex,” says Dr. Ghali. “There’s a whole science to system change. Toyota has done it with cars, but healthcare is even more complex. Manufacturing a thousand identical cars is simpler than caring for a thousand patients, that are each unique.”

“If a study comes out today in the New England Journal of Medicine, a reputable journal, that says Drug A is better than Drug B for treating a disease…it can take up to 10 years before the medical community across the board adopts the approach.”

Dr. Ghali points out however, that thanks to the introduction of WiFi in hospitals and adoption of smartphones in the community, among other factors, things are moving more quickly today. Never before has up to date medical information been available to doctors as it is today.

“When you look at healthcare delivery over 5, 10, 15 year slices, the overall picture is a pretty encouraging one. Life expectancy is longer in North America than it’s ever been…the risk of dying from cardiovascular disease is lower, the risk of dying from heart attacks is lower, the risk of dying or having a bad outcome from stroke is lower. Some of the improvements arise from better drug therapies and diagnostics that make care better. Some also come from better decision-making and better delivery of information.”

Exciting times ahead.