A Multi-Stakeholder Approach to Health Care Design

February 6, 2023 annieparkerfoundation

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By Patricia Thangaraj

The release of “Your Health: A Plan for Connected and Convenient Care” last week Thursday ahead of Prime Minister, Justin Trudeau’s meeting with provincial and territorial leaders in Ottawa tomorrow to discuss a new health care funding agreement can be viewed as a positive step forward in moving forward fruitful discussions towards finding solutions to the issues which continue to plague the Canadian health care system including Ontario.

Building a health care system that benefits Ontarians is the hallmark of this plan which seeks to ensure that people can access the health care services that they need in places where it is more convenient for them from more hospital and long-term care beds to accessing to more diagnostic tests like MRIs and family physicians, all within in their own communities.

The Plan states that when Ontarians can access the health care services that they need in their communities, they are more likely to seek the treatment that they require while also ensuring that health care providers can detect and treat diseases earlier, thereby reducing wait times in hospital emergency rooms and doctors’ offices and relieving the pressure on long-term care facilities.

The Ontario Government hopes that by providing a roadmap of their lower-cost innovative solutions by zeroing in on available resources to deliver a new level of care to Ontarians and their families, they can successfully acquire funding from federal officials for these initiatives.

Providing Innovative Low-Cost Solutions To Improve Patient Care Experiences

The start of this year signalled a positive outcome for Ontarians in that they can now visit their local pharmacy to get prescriptions for 13 common ailments such as pink eye and insect bites, which means that family physicians can now spend their time on treating more serious illnesses.

People can also renew their prescriptions without having to visit their family doctor as pharmacists are now able to renew prescriptions for chronic medications and they would not be charged any extra fees in cases where they do have to visit their family physician or a walk-in clinic once they show their OHIP card.

These measures would ensure that pharmacists, nurses and other frontline workers can use their expertise to provide Ontarians with the health care services that they need in their own communities.

There is also the nurse practitioner led clinics, 25 of which currently support approximately 80,000 people who previously had issues getting access to the health care services that they needed. In many of these cases, people are able to book same-day or next-day appointments.

The Ontario Government has invested $46 million annually to fund these clinics, which comprises of a nurse practitioner, a doctor and a team of interdisciplinary practitioners that include nurses, registered dieticians, pharmacists, social workers and health educators.

Ontario is the first province to adopt this model of care and they hope to expand this primary care initiative to make it accessible to more people across the province.

Supporting Communities Through Connected Care

In an effort to ensure Ontarians can have health care services within their own homes, the Ontario Government invested more than $1 billion to expand home care services over the next three years. About 700,000 families who rely on home care annually will benefit from these services, where they would be able to have access to home care workers, thereby reducing hospital and long-term care admissions.

They will also recruit and train more home care workers, which will help prevent unnecessary hospital and long-term care admissions and reduce hospital stays. Most importantly, it will provide people with the choice to stay in their homes longer.

They will also work with Ontario Health Teams and home and community care providers to establish new home and community care programs, which would increase access to front line workers in the convenience of their own homes as soon as possible.

Additionally, they would work on enhancing home care services in rural and remote areas so that families living in these areas can also have the same rights as those living in urban areas of Ontario.

The Ontario Government will also expand the paramedicine program so that people with chronic health conditions can live independently in their homes. This would be facilitated by ensuring that paramedics can use their knowledge beyond their traditional roles to include providing a range of services to seniors such as educating them on managing their chronic conditions more efficiently, ensuring that they are taking their required medications and making referrals to necessary local community services like home care. 55 communities have already benefited from this 24/7 non-emergency project, which brings together home care, primary care and home and community care.

To date, over 30,000 Ontarians have benefited from Ontario’s Community Paramedicine for Long-Term Care Program.

Providing Mental Health And Addictions Solutions

The Ontario Government is investing $3.8 billion over the next decade to develop and implement a wide-ranging and connected mental health and addictions system for Ontarians. It would be driven by the Mental Health and Addictions Centre of Excellence established within the province whose goal is to expand on the Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System, which is aimed at improving mental health services for communities across Ontario based on the four main pillars of expanding existing services, enhancing quality, implementing innovative solutions and increasing access.

They will also add eight new youth wellness hubs to the existing 14 that are already operating in communities across Ontario. Five of the new hubs are already providing services to youth while in its expansion stages. These sites support youth from 12 to 25 years in Kingston, London, Sarnia, Sault Ste.Marie and Toronto. Three remaining new hubs in Sagamok First Nation, Sudbury and Thorncliffe Park (Toronto) are in development.

These facilities once completed, will increase their efforts at ensuring that these young people can access the mental health, substance use support, primary care, social services, vocational support, education services, housing and recreation and wellness support, and other services that these young people need

Furthermore, they have invested $4.75 million to support a new virtual walk-in counselling service for children, youth, and families. The service – One Stop Talk/Parlons maintenant, which provides access to mental health care with a clinician by phone, video, text or chat, will expand to more agencies and their waitlisted patients and will be available to all children, youth and families across Ontario once the program is fully implemented.

Capitalizing On Digital Health Assets

The Ontario Government will also expand on the services that Health811 provides. Formerly known as Health Connect Ontario, it was rebranded to Health811 to more accurately reflect the services that they provide and how it benefits its clients.

The service was launched last Spring to help people call or chat online with a registered nurse and access the health care services and information that they require such as getting answers to their health care concerns or finding community health centres, mental health support, walk-in clinics and other services that they need 24 hours a day, seven days a week, all through one, easy-to-use website.

These services would now be expanded to allow Ontarians to create a confidential profile, schedule video visits with clinicians and manage their health more easily through integrated records that can be shared with Ontario Health Teams, mental health and addictions support facilities, and other health care providers.

The Ontario government will also replace fax machines, still available at some hospitals, doctors’ offices and other health organizations, with digital communication alternatives at all Ontario health care providers within the next five years.

This move to implement digital health assets for the province will reduce delays in diagnosis and treatment, promote safer patient care and increase patient privacy and security via an Ontario e-health records information management system, thereby showcasing their willingness to move forward with change management.

Leveraging Thought Leader Expertise to Create Community Based Solutions

The Ontario Government is also reviewing applications for four additional Ontario Health Teams. Once approved, these remaining teams will ensure that the province reaches their goal of full provincial coverage so that everyone has the support of an Ontario Health Team.

One of the ways they will accomplish this goal is to invest over $106 million in digital and virtual care options so Ontarians can easily connect with a health care worker when they need one from their homes.

Ontario Health Teams will start by offering a range of services to Ontarians who have non-communicable diseases like congestive heart failure, chronic obstructive pulmonary disease, stroke and diabetes. These services would support these people throughout their treatment journey, from screening and prevention to community support and recovery at home. A major focus of this will be ensuring that these people can receive the support they need in their homes or communities.

Prioritizing chronic disease management in Ontarians’ homes and communities will reduce hospital wait times and free up hospital beds for those patients who need them.

Enhancing The Continuum Of Care Via Large-Scale Primary Care Initiatives

The Ontario Government is also working with primary care providers to build collaborative networks and increase access to team models of care. Every Ontario Health Team will consist of practitioners with varied expertise to be a part of the decision-making process. These teams include family physicians, nurses and social workers among others.

They are investing $30 million to establish up to 18 new teams aimed at reducing the barriers that underserved populations face in accessing interprofessional primary care. This expansion will support primary care integration within Ontario Health Teams and strengthen direct service delivery in current interprofessional primary care teams that are experiencing increased operating costs.

The Ontario Government will also increase the number of spots for clinicians to join a model of care team by expanding on current family health organizations and allowing new ones to form.

Up to 1,200 interested doctors will be allowed to become a part of this model over the next two years beginning with an additional 720 spots for clinicians who want to join the family health organization model in 2022-23 and 480 spots in 2023-24.These family health organizations will deliver comprehensive primary care services, increase evening and weekend hours of practice and offer more weekend coverage so Ontarians can access a family physician when they need one.

Building Strong and Collaborative Partnerships To Acquire Funding

The Ontario Government aims to rally and unify diverse stakeholders including federal and territorial policy makers, health system leaders, clinicians and other frontline workers, designers, thought leaders, funders and other industry stakeholders to create solutions that would meet the needs of patients, their families, caregivers, communities and other clients that would break down barriers to accessing the health care services that they need, thereby enhancing the way that seniors, children and youth with mental health issues and other groups experience care.

By presenting their large-scale, complex, multi-stakeholder health care and social innovation ideas and initiatives within the public sector environment that meet the needs of both end-users as well as systems-level issues and requirements, the Ontario Government hopes to drive fruitful discussions that would lead to new ways of thinking among both federal and territorial leaders, which would result in generating funding from policy makers at the federal level for their projects.