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Co-Creating the Future of Integrated Health Care

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on 13 August 2018

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Transcript of Co-Creating the Future of Integrated Health Care

Co-Creating the Future of Integrated Health Care
Simple, Accessible, Understandable
Today’s challenges:

Many patients don’t have a doctor

The system is complex and fragmented

Our population has increasingly complex needs

It’s difficult for patients to navigate the system

Today we want to share about:

Our future vision

Patient Medical Home (PMH) and Primary Care Home (PCH) - differences and synergies

The essential role of physicians
Primary care has seemed like
systems in one space:

Disjointed care

Patients disappearing from the GPs' view when they entered HA services

HA service providers have had difficulty reaching GPs
Primary care
are improving, but it can seem like

Many HAs, specialists and GPs still operate as 2 separate systems in one space

Develop resources

Better link services

It’s still baffling for patients!

Policies, procedures, silos and bureaucracy are in the way

GP practices are being supported to become PMHs with 12 attributes including:

GP Networks supporting practice

GP Networks supporting communities

Primary Care Home = a system of integrated care

GPSC and Shared Care support Divisions of Family Practice to partner with HAs, specialists and service providers to better link services

There’s synergy - PMHs and PCHs both target comprehensive care AND link family practices with the broader system.

GP practices collectively provide the full scope of services needed

HA resources will be embedded, linked and integrated with GP and specialist practices and networks

HAs, GPs and specialty services will function seamlessly in
system of care

Patient priority:
My doctor's practice gives me an appointment when I need one

(GPs provide care)

Patient priority:
My doctor's practice provides the care I need
(GPs with team-based practices provide care)

Patient priority:
My doctor's practice coordinates the care I need
(GPs, specialists and HA interprofessional teams work seamlessly - virtually or otherwise - to provide care beyond the GP practice scope)

Patient priority:
My doctor's practice is closely linked to all the care I need
(specialized services and programs provide care)

The PCH encompasses the first
3 levels
of care
All paths and information

to and from the Patient Medical Home

My GP knows the whole story of my care!

I don’t need to worry about following where I am in multiple lineups or on waitlists!

Everything is linked! – my records, my care plan, my care providers.
We must:

Break down barriers
so patients experience one system of seamless care

so all patients have access to primary care

, so patients understand how to access all the care they need

Support physicians
in providing and coordinating the range of care their patients need
Full transcript