Chapter 2: The vision for health care in Ontario

There is a new bold vision for health care in the province of Ontario. The initiatives currently underway – such as Ontario Health Teams – will help create a system that is integrated, innovative, efficient and able to respond to the short- and long-term needs of our patients. There is a clear commitment from the government to end hallway health care by building a modern, sustainable and integrated health care system that starts with the patient.

This new vision for health care in Ontario is well-aligned with the ‘Quadruple Aim,’ an internationally-recognized framework that designs and delivers an effective health care system. The four objectives of the Quadruple Aim are:

  1. Improving the patient and caregiver experience;
  2. Improving the health of populations;
  3. Reducing the per capita cost of health care; and,
  4. Improving the work life of providers.

The recommendations included in this report are aligned with the new vision and will make a positive difference in each area of the Quadruple Aim. In addition to the work already underway at the ministries, these recommendations will provide a roadmap to a new approach to health care that will keep patients from having to go to the emergency department to access service and avoid an admission to the hospital, if possible.

What does an integrated health care system look like?

The Ontario Health agency, and Ontario Health Teams are important parts of building an integrated health care system in Ontario. When teams of health professionals work together to serve the same group of people, and when they are supported by common resources, performance expectations and planning tools at the provincial level, patients will receive coordinated and integrated health care.

In an integrated health care system, resources would follow the patient. There would be an emphasis on prevention and well-being, which would help divert patients from hospital-level care or from seeking care from the emergency department. Efficient processes, such as centralized intake and shared electronic medical records, are key features of a well-integrated health care system because they are tools designed to improve the allocation of services and connect patients with the right level of care at the most appropriate time. An integrated health care system will improve access and availability of services throughout the health care system, will have a positive impact on wait times and will help solve the problem of hallway health care.

In the current system, health care providers in different care settings don’t always work well together to provide coordinated care to patients. Transitioning between services can be difficult – especially for patients moving between youth and adult care. In an integrated health care system, patients could connect or visit their primary care provider’s office and leave with a clear and well-defined treatment plan. With the patient’s consent, integrated digital solutions would make a patient’s medical history easily and electronically available to a full team of professionals working together to support the best outcomes for the patient.

What will sustainable change look like?

Now After Transformation

The Patient and Caregiver Experience

  • Patients can’t always see their primary care provider when they need to.
  • Patients and families are using the emergency department to access services that might be better treated in other care locations.
  • Patients are repeating personal health information to many health workers.
  • There is confusion and uncertainty about who is responsible and accountable for the health outcomes of a patient.
  • Caregivers spend more time on the phone with providers scheduling appointments and advocating for the patient instead of spending time with the patient themselves.

The Patient and Caregiver Experience

  • Patients have access to their own personal health information and are making healthy choices by accessing preventative services in the community after talking with their primary care provider about their health needs.
  • Patients know there is a team of health care professionals working with their primary care provider.
  • Patients are confident they are receiving wrap-around care that will keep them out of a hospital unless they need to be there. If emergency services are needed, they are readily available.
  • Patients and caregivers have access to a comprehensive care plan with appropriate and flexible community services available to support the transition between hospital and home or community service.

Health of the Population

  • Patients have increasingly complex and chronic health needs that could benefit from more support in the community.
  • The current system waits until patients are in crisis or experiencing an acute episode rather than providing proactive and comprehensive health care.

Health of the Population

  • Patients of all ages can easily locate and receive services in community settings for their unique health needs, including mental health and addictions services and supports.
  • Ontarians are healthier and know how to access a full range of health care services at the right time and in the right place in the system.

System Sustainability

  • The current system does not have the right mix of beds, services or digital tools, and given the anticipated projections regarding population growth there will be significant capacity pressures in the near future unless the system adapts.

System Sustainability

  • A long-term capacity plan will be developed that identifies the right mix of services, health care workers, infrastructure and tools needed to ensure the equitable allocation of health care is attained in the province.

Provider Experience 

  • Providers can’t find available services in the community for their patients, and don’t feel connected to professional supports like training or access to specialists for patient referrals.
  • Providers are frustrated with spending too much time on administrative work that does not directly help patients.

Provider Experience

  • Providers are working in a team environment and have access to a full continuum of care for their patients, as well as continued professional development support and resources.
  • Overall stress is reduced, and more time, energy and resources are devoted to providing care to patients.