Thought leaders envisage high-performing partnerships of engaged community practitioners, informed patients and non-professional caregivers collaborating continuously, and efficiently, to improve care and outcomes for whole patient populations. These primary care health social networks would be facilitated by needs-based training, meaningful measurements, sustained funding, effective leadership and integration with available resources and processes. Broadly voiced opinion supports such integrated, community-focused partnership and data-driven healthcare models, and a province-wide implementation of the model for acute and chronic cardiac diseases in Nova Scotia has conclusively demonstrated sustained improvements in clinical and economic outcomes. A reasonable hypothesis, then, is that such strategies will be rapidly adopted to effectively manage the primary care of our increasingly aged populations, with their large and recalcitrant gaps between usual and best care. However, there are impediments to widespread adoption in the short term, not the least being disparities in various key stakeholders' level of preference, commitment, resolve and clout in making the necessary decisions to adopt and sustain the strategies. Thus, while we know things can be better in Canadian healthcare, the answers to, will they? and, when? remain less certain.
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