D O N B U T L E R , O T T A W A C I T I Z E N
Ottawa-area health authorities are scrambling to massively scale up a new approach to caring for highneeds patients that could determine whether current health-care services in the region are sustainable.
According to the Champlain Local Health Integration Network, five per cent of patients are responsible for 65 per cent of all health-care costs in the Champlain region, which includes Ottawa and much of Eastern Ontario.
In 2011-12, 26,744 patients with high needs — just 2.5 per cent of all patients — accounted for 37 per cent of $2.7 billion in health-care costs in Champlain.
In an effort to reduce costly hospitalization for those patients, the Ontario government introduced an initiative called Health Links nearly four years ago.
It creates care plans for patients and assigns them care co-ordinators, who orchestrate what the patients’ other health- care providers do.
At present, 560 high-needs patients in the Champlain region are participating, and the LHIN is on track to more than double that to 1,325 patients by the end of the year, Cal Martell, senior director of healthsystem integration, told the LHIN’s board last week.
But that’s just the start. By the end of 2019, the LHIN aims to have 10,000 patients receiving coordinated care through Health Links.
“The level of ambition for scaling up Health Links is quite incredible,” Martell told the LHIN board. “It is by far the most ambitious plan for Health Links in the province.”
Failure is not an option, said the board’s chair, Jean-Pierre Boisclair, who called scaling up and sustaining Health Links “a critical must-succeed strategy.
“Ask me what keeps me awake at night,” Boisclair said. “It’s Health Links, and can we get there. We have to land this thing. There is no Plan B.”
Chantale LeClerc, the LHIN’s CEO, said the 10,000-patient goal was necessary. “We really feel strongly that to sustain health-care services in our region and meet the growing demand, this has to work.
“The strategy of continuing to hope for additional money and adding more money to what we’re already doing, it’s just not realistic anymore. There’s just not enough new dollars to address all of the pressures and all of the demand for services that are out there.”
If the Champlain region doesn’t “aggressively pursue” money-saving strategies such as Health Links, LeClerc said, “we’re going to be year over year over year dealing with rationing of existing services to meet an ever-growing demand.”
Adding to the challenge, the LHIN must rapidly expand Health Links largely using existing health-system resources.
To this point, 156 family physicians are participating in Health Links. But that needs to rise to more than 900 — two-thirds of all family doctors in the Champlain region — by 2019.
The LHIN also must find 102 care co-ordinators over the next three years. Hiring them would cost $11 million the LHIN doesn’t have to spare, so the aim is to fill 75 per cent of the positions by redirecting staff already doing care co-ordination for organizations such as the Community Care Access Centre.
Even if that works, the LHIN would still have to find $2.7 million to hire the remaining co-ordinators, Martell said.
For this year, the provincial government has promised — though not yet delivered — one-time funding of $2.1 million to get Health Links up and running in Champlain. Those costs will likely have to be absorbed by the LHIN in future.
Meanwhile, in the absence of the promised provincial funding, some health-care providers participating in Health Links “have yet to be paid this year,”Martell said. Even so, “they haven’t wavered.”
Health Links is expected to save money by providing co-ordinated primary home and community care and services that will keep people out of hospitals or long-term care, LeClerc said.
“When we’ve looked at what services these high users of health-care services are using, 70 per cent is hospital-based services,” she said.
A report presented to the LHIN board this summer showed that Health Links reduced the average number of days of hospitalization per patient by 28 per cent at the Hawkesbury General Hospital. Health Links patients might have 19 different specialists and be taking up to 3o0 different medications, LeClerc said.
“They’re not falling through the cracks. They’ve got lots of people looking after them. But there’s no way at the moment for all of these different people who are part of that person’s care team to connect and co-ordinate their efforts in a really organized way,” she said.
“What Health Links does is not that complicated, but in real life, it’s hard to organize under the way the system currently operates.”
As Health Links expands, the LHIN hopes to demonstrate that its approach should be the standard of care of anyone with multiple chronic conditions, LeClerc said.
“I hope that, in four or five years, we might not have to speak about Health Links. It would become embedded in how we do care in this region.”
October 3, 2016
Note: Arnprior Regional Health is proud to be the co-lead on this project
For more information: Wendy Knechtel, Mgr. Communications 613-623-7962 x293