Insights (Essays)

Insights (Essays) March 2019

A Personal Best for Ontario's Healthcare System

John Yip


It’s 5:33 a.m. on Wednesday. Training for a marathon during the Canadian winter is not without its challenges. It’s dark and cold but I am out here because my training plan says I need to be. I work my way through the snow and ice, sliding and slipping. For some reason, I have an unusual clarity of thought for this hour. I ponder the weight of the Bill 74, The People’s Health Care Act, to transform our healthcare system…

Preparing for a marathon requires a good training plan. At the heart of a runner’s plan is to figure out the ideal pace that can be sustained evenly across the length of a running event. If a runner can figure out their ideal running pace, a runner can set themselves up for a personal best.

Our healthcare system needs a personal best but our plans haven’t been well-paced and have never gone the distance. At times our province has run faster than our healthcare system has been prepared to do, forced by a pace set by an election cycle. At other points in time, our healthcare system has just shuffled through.

Lately, it feels more like a shuffle and the time is right to pick up the pace but with the right training plan and goals. A primary goal of the proposed structural reforms is to go from six agencies and 14 LHINS to one “super-agency” but the goals of healthcare have never changed: let’s provide the best healthcare to people living in Ontario. Period.

To fulfill this goal, our healthcare system needs to mirror the attributes of a runner: discipline, resiliency, constant improvement, courage and sacrifice in order to execute effectively.

I continue to plod along the dark streets. I check my watch. The data shows that my heart rate is too high. My stride is off. I can feel my frustration rising but it is never good to run angry. I resist the urge to quicken my pace and think of what a runner tells oneself in these moments: in order to go fast, you have to slow down.

Let’s pace the scale of the change to make sure we collect the appropriate data points to go the distance and to get it right. It might feel slow at first, with few concrete results in the early days, but what we will see in the long-term is a well-functioning, integrated system of care, rather than one that has hit that proverbial “wall”.

Over the short-term, it is best to focus to improve the form and function of our local healthcare system. The Ontario Health Teams are our system’s best opportunity to have a positive impact to the people we serve. It sets the stage for real integration of services. Let’s get concrete on three specific goals to ready our local delivery of healthcare services for transformation:

Goal 1: Get the governance structure right

A streamlined, collaborative model of partnership will need a clearly articulated governance and accountability structure that incorporates the system versus a single organization without losing sight of the individual. Decisions on how resources get allocated across the Team will require some tough discussions that will have an impact on the greater good of the community.

Goal 2: Let our community leaders lead

Encourage and provide the necessary supports and tools for community-based providers to take on a leadership role in coordinating the Health Teams in areas like mental health and addictions, palliative and end of life care, indigenous health and ambulatory care. Help our communities understand the “why” of Health Teams and engage our communities to co-design with our community providers.

Goal 3: Commit and invest in building a digital ecosystem

Health Teams in this day and age will not be able to operate without digital health tools.  Let’s not just say we need digital tools but act to build on existing innovations and quickly deploy them within the Team and across Teams to allow for the portability of care and to expand the virtualization of care.

It is lonely at this time of day. I wish I had my training partners with me. It is always better training with others.  The street lights flicker and the sun is starting to come up. A new day is beginning. A feeling of comfort and warmth fills me as I hit the runner’s high. I am confident that our healthcare system will too.

About the Author(s)

John Yip is the President and CEO of Kensington Health, a community-based not for profit based in the heart of the Kensington Market in Toronto. John has had a front row seat to previous transformation mandates in Ontario including working on projects ranging from the Health Services Restructuring Commission, the Ministry’s Health Results LHIN Team, Health Links and as an executive with Health Quality Ontario. As you can tell, John is also a recreational runner and triathlete.

Twitter: @Skippyho8, LinkedIn: @JohnYip


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