Living Our Lessons: The Roadmap for the Healthcare System of Tomorrow
We’ve known for years that Canada’s diverse communities, aging population and climbing demand for healthcare will force us to adopt a more sustainable path to help all patients and communities access support. The COVID-19 pandemic has accelerated the urgency to fix the fundamental pain points in our system and implement a vision for the future of healthcare that meets patients’ needs. It’s also armed us with a new frame of mind for accomplishing just that by generating real-world opportunities to pressure-test concepts, forge dynamic collaborations and expand existing approaches for wider adoption.
This new, hard-earned, real-world experience has given us the tools to clearly answer a question that Canadian healthcare leaders have been considering for years: What do we need to place at the core of our healthcare system now to set it up for success tomorrow and beyond?
Improving Canada's healthcare system starts with focusing on overall health and wellbeing, [and] not just on care delivery. When we do that, we can rethink the future of work, which includes rethinking the work itself, who performs it, where it is done and the model of delivery. This will lead to an opening up of the workforce, create greater access to services and improve overall productivity so [that] we can support health and wellbeing more effectively within available resources. (Lisa Purdy)
Among the many lessons that we've learned to inform the system we need, one key element stands out: we need to enhance our ability to deliver healthcare outside the hospital so that patients receive a continuity of care in their homes and communities.
This implies a shift in perspective – for individual citizens trying to access care, for practitioners adapting to a team-based approach and for those who shape the digital infrastructure required to bridge connections between people and care. Effectively moving care into the community will ensure a stronger future for the health of Canadians, aligned with the Quadruple Aim: better outcomes, better patient satisfaction, improved provider experience and better cost effectiveness.
To achieve this, primary care should be collectively understood as the foundation of the healthcare system and focal point of integrated care delivery. Activating the Patient’s Medical Home model – wherein a comprehensive, interprofessional team led by the family physician delivers high-quality care – is key to making all the other pieces work together.
The ability of primary care to adapt to an emerging issue like COVID-19 is really a response to the social accountability that primary care has to the communities that we serve. It’s about responding to the needs of the communities, pivoting to virtual home visits, supporting long-term care, working in assessment centers and adapting the way we work in the clinic to be able to optimize the care that’s delivered. (Sarah Newbery)
Home healthcare is another important component. We need to further enhance its role so that it's more robust, responsive, thoughtfully structured and seamlessly linked to the Patient’s Medical Home. Deploying strategically designed home healthcare models – which encompass the engaged involvement of families and patients – will ease pressure elsewhere. That's a win/win: helping people live with dignity and safety in the setting of their choice benefits patients and supports others in the system – like professionals in acute or long-term care – to efficiently focus on what they do best.
We need to design home healthcare solutions that are strategic, sustainable and reflect the true value of the service, which goes far beyond the sometimes-outdated view of the sector currently. Today, promising interprofessional programs are being delivered thanks to high-intensity new funding. Patients and families love being engaged in these programs and having a direct role [in] setting and achieving recovery goals. (Chris Wilson)
Integrated community care is another crucial part of this connected ecosystem. For example, community paramedicine programs are an excellent and critical example of how taking a mobile approach to care and expanding scope of roles can deliver better results by helping to prevent unnecessary emergency department visits, reduce hospital admissions and expand long-term care options for the vulnerable and underserved. With so much of our population made up of small rural communities separated by vast distances, enhancing remote health will also improve efficiency of care delivery for those patients, use of resources and, ultimately, create more accessible points of entry into the care system.
Taken together, these integrated elements will remove obstacles and increase patients’ access to a continuum of care.
However, still other aspects are needed to make this vision work.
It’s about being clinician-agnostic and getting care to people at the right place at the right time. We’re really encouraged to see the momentum and acceleration of mobile integrated health. In an uncertain time, it's brought stability and continuity to patient care and allowed us to build out collaborative teams. It's also allowed us to appreciate how digital tools and virtual channels can work in tandem with face-to-face healthcare delivery. (Erik Sande)
We must prioritize building partnerships, actively cooperate and leverage our shared interest in the patient’s wellbeing to operate as a fully functioning, integrated system of care. Otherwise, needed change will stall.
Finally, we must focus on our north star: patients. Adopting these approaches as fundamental pillars of the healthcare system will not only benefit its operations, mechanics, the public purse and our professional lives as those who deliver care — it will ultimately support all patients and their families, enabling them to live better-quality lives and thrive in the settings that best suit them.
Making it Work
Our pandemic experience reinforces promising solutions for addressing the needs of patients today and tomorrow, while emphasizing how care is an action, and not a place.
Our shared COVID-19 challenges have shaped our roadmap and given us the confidence to believe that our path will lead us where we most need to go. The next step is tactical: synchronizing primary care so that it's fully integrated into all of our health services, expanding proven scalable solutions (such as integrated home healthcare and paramedicine programs) and taking the initiative, as healthcare professionals, to champion these needed changes.
As health solutions partners and leaders, we must ask hard questions about the future of healthcare in Canada – especially if we are to come out of the pandemic stronger. We must find ways to help people stay healthy and in their homes as long as possible, help them navigate the healthcare system when they do need it and ultimately ensure they receive the right care at the right time. (Bernard Lord)
It’s up to all of us to ensure we put this collective insight to good use and embed it into our healthcare system for the benefit of our health, our resources and our patients. We must ensure that Canadians have the kind of high-quality, integrated care that enables them to choose and helps them thrive. Let’s get to work.
About the Author(s)
Lisa Purdy is a senior partner at National Health Practice in Deloitte Canada. She brings extensive experience delivering strategy, governance, operations and digital solutions to individual, regional and provincial health organizations.
Sarah Newbery is the assistant dean of Physician Workforce Strategy in Northern Ontario School of Medicine. She has been a rural physician in comprehensive community practice in Marathon since 1996.
Chris Wilson is the senior vice president of Home Health Eastern Canada, CBI Health Group. She began her career as a home visiting occupational therapist and has been working in the sector for 30 years in increasingly senior roles.
Erik Sande is the president of Medavie Health Services. He has significant experience and expertise leading high growth technology and healthcare service companies across Canada, the US and International markets.
Bernard Lord is the chief executive officer of Medavie. Prior to this role, he spent eight years on the Board of Medavie and was president and CEO of the Canadian Wireless Telecommunication Association of Canada. He sits on boards of several companies and organizations, and was past chair of the Board of the Ontario Power Generation.
For more information about the authors, please visit:
Marc Pelletier wrote:
Posted 2021/03/30 at 12:01 PM EDT
Great start on your roadmap ... I would have liked you to draw a much stronger link from your core thought: "Improving Canada's healthcare system starts with focusing on overall health and wellbeing, [and] not just on care delivery." ...to the delivery system changes you bring emphasis to. What changes in PC teams integrated with home and paramedic care need to be of priority if we are going to have a significantly healthier population?
Personal Subscriber? Sign In
Note: Please enter a display name. Your email address will not be publically displayed