The province of Ontario had been on the precipice of change in the healthcare domain for a long time before COVID-19 struck. With the creation of a new agency called “Ontario Health” in 2019 along with the creation of Ontario Health Teams, Ontario healthcare was ready to take off with a dedicated focus on coordinating care across different settings for patients. However, the onset of the global pandemic has had a major impact on the regional health care delivery including outpatient care, primary care and home and community care.
In a short period of time, healthcare experts form all over the province came up with urgent reforms which were necessary to tide the COVID wave and are now considered a critical embed for the long-term strategy of providing a coordinated and connected healthcare system in Ontario. The three major reforms and recommendations for the provision of care include:
1. The need for a long-term strategy for in-person and scheduled Virtual Care
With the sudden onset of the pandemic, maximizing services that appropriately reduced in-person visits using virtual care became the need of the hour. Virtual care is defined as any interaction between patients and/or clinicians or members of their circle of care, taking place remotely, using different means of communication including telephone or audio and video applications, with the aim of improving effectiveness of care .
Since virtual care is more than video visits and phone calls. It required a massive overhaul of the existing infrastructure in Ontario. It included digital supports for self-care (e.g., curated apps, wearables); online education and self-management tools; provider-to-provider supports using secure messaging, e-consultation, phone backup, and specialized platforms (for specialist to primary care provider communications); provider to-patient supports (e.g., email, messaging with patients over email, text, or other secure platform, real-time consultation at a distance); and remote home monitoring.
2. Upgrading policy and procedures for infection prevention and control
Since the world hadn’t seen a highly communicable disease like COVID-19 on such a large scale, the healthcare experts in Ontario had to come up with a risk assessment to overhaul policy and procedure in line with the high risk of exposure, something never seen before. Some new policies introduced for primary care in Ontario included:
- Training staff to reduce the risk of exposure through active and passive screenings for COVID-19
- Addition of personal protective equipment used in addition to engineering and system control and administrative control measures
- Creating distance between visiting patients through properly defined waiting areas, and plexiglass barriers at reception
- Use of virtual care systems to triage patients and only scheduling priority visits.
3. Collaboration with regional and local health service organizations
To deliver full breadth of services that support patients’ complete continuum of care, regional and local health collaboration is a must. Collaboration and integration of services between providers and across regions can have exponential effect in improvement of health outcomes. This type of collaboration can be possible if:
- Providers identify new partners upstream and downstream and gauge the impact that the gradual increase of services may have on their resources
- If applicable, providers work with their Ontario health team partners
- When possible, providers consider working with other organizations and other providers that provide overlapping services to establish team-based approaches
- Providers confirm that partners are available and, when required, care can be coordinated in a timely manner (e.g., assessment centers, community laboratory, pharmacy, home and community care, primary care, rehabilitation services, specialists)