Welcome to the Mississauga Halton LHIN Governance to Governance Session: Health Links October 3, 2013 Please enjoy something to eat and introduce yourselves to others seated at your table. The session will begin at 6 P.M.
Mississauga Halton LHIN Governance to Governance Session October 3, 2013 Guest Speaker: Helen Angus, Associate Deputy Minister Transformation Secretariat, MOHLTC
Agenda Agenda Item Lead Time Welcome Graeme Goebelle 2 minutes Chair, MH LHIN Board of Directors Introduction of Guest Speaker Bill MacLeod 3 minutes CEO, Mississauga Halton LHIN Provincial Overview of Health Links Helen Angus 20 minutes Associate Deputy Minister, Transformation Secretariat Ministry of Health and Long-Term Care Local Approach and Development Liane Fernandes 15 minutes Senior Director Health System Development & Community Engagement, MH LHIN Our Health Links, Our Opportunity – Carie Gall and Susan Swartzack 55 minutes Facilitated Discussion (including Break) Senior Leads, Health System Development, MH LHIN Report from Community Governance Jeannie Collins-Ardern 20 minutes Consultation Group Co-Chair, CGCG Chair, Links2Care Closing Remarks Graeme Goebelle 5 minutes Chair, MH LHIN Board of Directors 3
Welcome Graeme Goebelle Chair Board of Directors Mississauga Halton LHIN 4
Introduction of Helen Angus Associate Deputy Minister Transformation Secretariat Ministry of Health and Long-Term Care Bill MacLeod CEO Mississauga Halton LHIN 5
Health System Transformation Mississauga Halton LHIN: Governance to Governance October 3, 2013
The Fiscal challenge Health care spending since 2003 50 45 40 $Billions 35 30 25 A C T U A L P R O J E C T E D 20 03/04 04/05 05/06 06/07 07/08 08/09 09/10 10/11 11/12 12/13 13/14 14/15 2
Current State Too many people relying on Emergency Rooms instead of receiving the right care in the community Too many people are having trouble navigating the system Too many ALC patients Too many people being readmitted to hospital within days of leaving hospital 3 3 3
Our Vision To make Ontario the healthiest place in North America to grow up and grow old A system focused on wellness Faster access to family health care that serves as the hub of their health care system Better integration and accountability 4
The Opportunity Health care is overflowing with opportunities for reform • Providers and organizations in the system are ready for change and eager to • contribute Transforming Leadership Enabling System from Environment theSector (Government) (Together) What does it mean for the patient? What does it mean for the system? Better experience Fiscally sound system Improved outcomes Better quality of care Healthier lifestyles 5
Transforming the System Health System Redesign allows for more flexible models of health care delivery which promote access and quality but also allows for services to be provided in a fiscally sustainable manner . 6
Health System Funding Reform is a Key Component of Improving the System Health System Funding Reform (HSFR): Promotes quality, value and efficiency Better reflects needs of the community Promotes more equitable allocation of health care dollars Optimizes health care investments Adopts and learns from approaches used in other jurisdictions 7
What are the Components of HSFR? Health Based Allocation Model (HBAM) Inform funding allocations to health service providers Management tool to assist with health system service planning Quality-Based Procedures (QBP) (Price x Volume) + Quality - evidence based clinical Knee Cataract pathways ensure quality standards Opportunity for process improvements, clinical re- design, improved outcomes, Hip Chronic Kidney Disease and enhanced experience 8
Better Use of Delivery Channels Specialized Clinics: Community Services: ♦ Building on successful community Creation of Birth Centres ♦ clinics (e.g. Kensington Eye Providing women with more choice Institute), the Ministry will shift on where to have their babies certain procedures (cataracts, through two new midwife-led birth colonoscopy, dialysis) into the most centres appropriate setting to get the best Care transition for Seniors: ♦ results for patients by expanding Helping seniors transition home community-based Specialty Clinics sooner from the hospital while also providing higher levels of care to ♦ Leverage competitive pricing long-term care residents with model and quality-based complex needs ♦ procedure alignment through Repositioning some Long Term Care Health System Funding Reform capacity as short stay centres to (HSFR) where funding is based on manage complex care conditions in the services provided through the short term before resuming patient-centered care home care 9 9
Making Community Health Links Happen 10
Health Links: Partnering Around Patients • New model of care at the clinical level, to improve patient outcomes, charging Model providers with improving care coordination & integration at the patient level of Care • Initial focus on improving patient care and outcomes for people with complex Target health conditions and seniors. Group • Regions are already exhibiting a high degree of collaboration; aim is to have Initial coverage across Ontario. Success • LHINs will continue to assist identifying Health Links, supporting their Role of development, and providing oversight for Health Links in their regions. LHIN’s • Health Links will evolve to cover the entire province and expand beyond complex Looking patients. Forward • Greater coordination of care, improved outcomes, and better value for investment. • Individual care plans, improved access, improved satisfaction / experience. Success 11
Initial Focus • High cost users are a small but diverse group; typically have 2 key characteristics: – They receive treatment from multiple health care sectors; and/or – They have long lengths of stay in inpatient settings. • The average number of episodes & cost per episode is similar for high cost and all users. However, high cost users access a larger number of health care sectors • Seniors represent the largest percentage of Proportion of patients/expenses & have the highest Proportion of Ontario Patients Costs average cost per patient. • Acute care, physician visits, & long-term care represent the largest percentage of expenses. 12
Health Links Today • The response to Health Links in year 1 has exceeded expectation • There is at least one Health Link in every LHIN and some LHINs have already submitted proposals to ensure full coverage within their boundaries. • Future: 80+ Health Links, providing full coverage across the province Population Coverage: 5,827,660 37 Total Number of High Health Users: 523,230 Links Over 650 Partners 13
What Will Change Look Like? Alignment of Care Coordination Patient Engagement Initiatives and EMR / IT and Care Plans Resources • Developing • Strong • Making use of • Leveraging common principles involvement of existing resources provincial assets for coordinated patients, families to strengthen and for local solutions care plans so all and caregivers in align work complex patients all stages • Working with in Ontario have the • Working with electronic health same experience • Making the patient agencies and providers to align a part of the associations to current assets with • Creating care plans development of strengthen Health Links needs for complex his/her individual outreach and patients through care plan champion the the expertise of an Health Links model interprofessional • Incorporating health team patient, caregiver • Funding to support and/or family existing perspectives into infrastructure and the coordinated assets, and build care design on existing process innovations 14
Bringing Partners to the Table • Increased collaboration among partners to work together to identify new complex care patients, and provide support within the circle of care • Of 37 Health Links, diversity in the leadership and participation: – 9 led by hospitals – 14 FHT led and 1 FHO led (primary care) – 6 CHCs – 3 CCACs – 4 Community Service Organizations • As Health Links develop, the cross-section of providers will increase, providing many potential access points for users of the health care system 15
Governance and Accountability in Health Links • Flexibility for health care providers to work together based on needs of patients and communities • Health Links are accountable to their LHINs • Leadership, governance and degree of integration is flexible and based on local requirements and relationships 16
Coordinated Care: the Heart of Health Links Hospital Consistent Long-Term Province Home Care Care Homes Wide Principles Health Patient Others Engagement Links Coordinated Care Community Specialists Support Services Primary Care Allied Health Professionals Physicians Mechanisms EMR/IT and Tools 17
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