Ottawa Health Team a system ‘game-changer’
Community centres, not hospitals, will be focus of approved proposal
When Ontario overhauls the health system in coming months, Ottawa will buck a provincial trend by putting community health centres, not hospitals, at the centre of the new system.
The Ottawa Health Team, as it is known, is one of 31 groups across the province that have been given the green light to apply to become some of the province’s first health teams. A coalition of six community health centres are at the centre of the Ottawa proposal, which also includes The Ottawa Hospital, Bruyère, Ottawa Inner City Health, Carefor and Ottawa Public Health, along with other organizations.
Two other Ottawa-area teams have also received green lights to move forward: one focused on children’s health that includes CHEO and more than 50 other members, including Eastern Ontario hospitals; and one in the city’s east end that includes the Montfort Hospital.
The province announced last spring it would call for groups to form health teams as part of a major revamp of the provincial health system. The Ontario government is in the process of disbanding the LHIN (local health integration) system and has concentrated most health organizations in the province into a central agency. LHINs are to be replaced by health teams, which are meant to co-ordinate care among various health organizations.
Health Minister Christine Elliott has said the system will offer “seamless access to health services, including primary care, hospitals, home and community care, palliative care, residential long-term care and mental health and addictions service.”
But critics, including former deputy minister of health Dr. Bob Bell, have raised concerns about the lack of resources and planning for the complex new system and the fact that most teams that have been green-lighted to move ahead are led by hospitals.
“Ontario health teams seem at risk for becoming hospital-driven organizations, where the strength of the hospital board governs decisions in the region,” Bell wrote in a recent opinion piece in the Toronto Star. He also wondered whether hospital-driven health teams might be able to “resist the temptation to consolidate regional budgets to gradually provide better hospital funding.” He noted hospital budgets have been squeezed in recent years.
But those at the centre of planning for the Ottawa Health Team say there is genuine excitement about the prospect of doing things in a different, more streamlined way. Community health centres, which already work with numerous organizations, are well connected, said Simone Thibault, executive director of Centretown Community Health Centre and spokesperson for the project.
“If we are really wanting care to be mainly in the community, we feel that we are well connected. We don’t work in silos. We work with many health and addiction agencies. We also believe that not just the individual should be taken care of, but the whole community. We are about having the right care, at the right time, with the right provider.”
Thibault said the team would focus on primary care and preventive care and medicine, as well as acute care.
But the aim of the team is to help fill gaps in the transitions between different types of care, she said. Those transitions often become what Thibault refers to as “pain points.”
“As community health centres, if we can be a part of the solution that could address those pain points, then we can do something.”
Dr. Alan Forster, who is vice-president of innovation and quality at The Ottawa Hospital, said: “Philosophically we are supportive of the region leading this. It is really important for us that the community is leading this and they own it.”
Ongoing issues such as the number of alternate-level-of-care patients occupying hospital beds are about “how our community really supports people who are frail,” he said.
Trevor Eggleton, manager of communications at Carefor, a not-for-profit charity that provides home care and community support, says his organization is “really excited” about the possibilities of the new system, which he believes will streamline care, inspire innovation and create an environment of collaboration.
There are still more questions than answers regarding what the system built on health teams will eventually look like.
Among the looming issues is how teams made up of institutions with various electronic health systems will communicate with each other and share patient records.
Elliott has described it as being a system that puts patients first and moves with them through levels of care.
For now, the 31 groups involved in trying to set up health teams in Ottawa and around the province are rushing to meet the next deadline — Oct. 9 — by which time they must have full applications completed. Teams are expected to be announced this fall.
The Ottawa Team had 11 initial partners, but more are joining, Thibault said.
The CHEO team — which has 59 partners — is the only health team moving forward under an “innovation category.”
It is kicking off a social media campaign asking children and teens to help name it. Joanne Lowe, executive director of the Youth Services Bureau, said the children’s team would focus on the unique needs of youth and children.
“I think it speaks volume about how we see kids that we want to be at the front end of this new concept we think it can resolve some issues,” Lowe said.
Thibault acknowledged the task of trying to refocus and reorganize the health system is massive, but added: “It is a huge game-changer. We thought, if we had an opportunity to make change, we need to embrace it, to pull in our partners and to move it forward.” epayne@postmedia.com