About I CAN!
Neuroplasticity – the ability of the brain and spinal cord to heal itself – has changed the way we understand the nervous system and disorders affecting it. Contrary to longstanding teachings in neuroscience, we now know that the brain and spinal cord are capable of finding new pathways and new ways of working such that people can regain valuable function and quality of life.
I CAN! will provide clinical, educational and research services based on neuroplasticity principles focusing on this new paradigm for people with neurodisability. It will utilise innovative models of care, teaching and research to empower people with serious disability of the brain and spine, research the state of the art of care, and educate health and disability professionals in the principles of neuroplasticity.
The Program
Based on 7 years of consultation (through the Queensland Health State-wide Committee for Neurodisability and Ministerial I CAN Task Force) with stakeholders in health and disability in Queensland plus extensive consultation with national and international experts, this programme establishes an evidence based model of care combined with academic rigour and partnerships with key stakeholders and Centres of Excellence. This programme is also based on an important health economic study of long stay patients in Queensland Health and two comprehensive literature reviews of Complex Care patients with Young People in Nursing Homes and Australian Universities of both Models of Care and of Health Economics of treating this population.
How We Started
I CAN! started as a joining of forces of the Academy for Health Equity and Disability (AHEAD) and the Interactive Health Network (IHN), charities known for their international work with the World Health Organization and World Bank Institute along with other international NG)s.
Successful programmes have included the Maputo Declaration for HIV, Malaria and Other Related Diseases, a highly successful continent wide policy implemented through collaboration with the African Union, the WHO Director General Debates, the World Health Channel, The Leadership in Global Health Technologies (LIGHT) Initiative, the Epilepsy Educational Initiative and innovative telehealth programmes and policies in Kenya, Sri Lanka, and Papua New Guinea.
I CAN! works closely with Integrated Health and Disability Services, Universities, NGOs and other Centres of excellence to offer state-of-the-art clinical educational and research services.
I CAN! Services
I CAN! is seeking to commence offering an alternative to hospitalisation as well as a community based integrated care centre co-located with medical and rehabilitation services for people with neurological disabilities. This will be accomplished as a Centre of Excellence integrating teaching and research with clinical and disability care in a one-stop-shop Centre of Excellence. I CAN! Will provide servies for people with autism, congenital CNS disorders, metabolic disorders, acquired brain injuries, spinal cord injuries, epilepsy, movement disorders and stroke.
It will encompass the following services:
- short-term diagnostic assessment and second opinion service
- polypharmacy and pharmacological restrictive practices review
- complex need medication review implementation and de-prescribing service
- comprehensive health services including medical, neurological, disability, dental and psychiatric review
- complex restrictive practice review
- activities of daily living (ADL) optimisation
- neuroplasticity-based active rehabilitation and mobility training using an innovative programme proven overseas.
It will offer these services for all individuals with neurological disabilities including acquired brain and spinal cord injury, congenital and developmental disorders as well as degenerative disorders affecting the nervous system offering an integration of disability, medical, mental health and community support services with a focus on wellness using neuroplasticity principles.
Principles of treatment
Four major principles of treatment will form the basis of START
Integration: the ‘One-Stop-Shop’
There is a high level of evidence for the use of such an Integrated Healthcare model where the patient can go to one place to obtain both health and disability care needs. This includes:
- Integration of Disability Care with Healthcare and the Community
- Integration of Rehabilitation, Medical, Mental Health, Surgical care and Interdisciplinary care
- Integration of primary care with tertiary and community care, working closely with GPs
- Integration of clinical care, research and teaching
Excellence: The use of a Tertiary/ Quaternary Centre of Excellence Model of Care
This model is the standard model of care at most major university centres e.g. Harvard, Oxford, Institutes of Psychiatry, Neurology and Epileptology in London and Montreal Neurological Institute. This promotes a ‘shared care’ model to work closely with the GPs and primary care teams who are able to implement the expert recommendations.
Values: An underpinning of the principles of values-based medicine
Values-based medicine and ‘Slow Medicine’ are two movements popular in the UK and North America respectively, which put an emphasis on the role of ethics, professionalism and humanity of health professionals. This will be a focus of START. An ethical approach to care emphasizes:
- Taking time with patients
- Compassion, and
- Transparency
- Clear Communication
- Patient Empowerment
Innovation: new ways of approaching healthcare
This will include:
- Using neuroplasticity-based treatment and rehabilitation principles
- Cognitive and Physical rehabilitation and the use of immersion and virtual reality
- The Digital hospital, ePrescribing and joint health, mental health and disability electronic medical records
- Use of Telehealth technologies
- Innovative financial and governance models, as well as new models of philanthropy that are interactive and participatory
- Patient-focus: A model putting the patient at the centre of care at all levels, with the professionals coming to the patient and their carers making time more efficient for everyone
- Emphasising continuity of care, community integration, and START as an alternative and proven healthcare model to avoid inappropriat
I CAN! Director
Professor Harry McConnell MD FRCPC FRANZCP
Professor McConnell is an American Neurologist and Psychiatrist living in Australia. He has worked at a senior level in Centres of Excellence in the USA and UK and has also consulted to the United Nations, National Institutes of Health (USA) and to many national and state governments.
Professor McConnell has authored many key textbooks and international guidelines in his field and was an editor at BMJ Clinical Evidence, the most widely used source of evidence-based medicine internationally, and of the Maudsley Prescribing Guidelines, the most widely accepted international guidelines in Psychiatry.
He has pioneered new services and lead Specialist Academic Clinical Services in the USA, UK and Australia as well as achieving important work in Public Health and Global Medical Education with the World Health Organization (WHO) and World Bank Institute (WBI), consulting to many countries.
