Jeff Green | Feb 17, 2016


Geographical challenges are only one of the issues of concern as the Ontario health care system works on finding ways to deliver better care, at a better price, to Ontario residents.

In a process that started with the development of 14 Local Health Integration Networks (LHINs) 10 years ago, attempts continue to break down barriers between health care service providers in order to provide seamless service for Ontario residents. Funding for ambulance service, long-term care facilities, hospitals, mental health and home care services all comes from the LHINs, although some primary care physician services are still funded directly by the Ministry of Health.

Three years ago, some of the LHINs, including the Southeast LHIN, which covers Hastings, L&A, Frontenac, Leeds Grenville, and Lanark Counties, established Health Links. Health Links are an attempt to coordinate services for patients suffering from chronic conditions such as Chronic Obstructive Pulmonary Disorder (COPD), Diabetes, and a number of cardiac related conditions. The idea is to get doctors, nurses, dietitians, and others to work together to keep patients in a healthier state, in their own communities and to limit hospital visits. Health Links are designed to improve the health of the segment of the population that uses the health care system the most, and save money at the same time by dealing with health issues, before they lead to expensive hospital visits.

The next phase of this evolution in care, according to advocates such as Richard Schooley, the chair of the board of the Perth & Smiths Falls District Hospital, is to develop Health Care Hubs.

“We would like to see Health Care Hubs do for the rest of the population what Health Links is trying to do for 5% of the population, those with what the health care system calls “co-morbidity” or complex chronic health care issues,” he said in a telephone interview with the Frontenac News this week.

Schooley was scheduled to address Frontenac County Council this week to talk about plans for a health care hub for Lanark, parts of Leeds and the Thousand Islands, and Central and North Frontenac.

“Rather than each of the health service providers being funded individually, the health hub would get all the funding and it would dole out the money. To a lot of providers this is threatening, I know, because what we are talking about is a whole new system. We would start to put some mandatory expectations in place for all providers to plan and work together, and a hub can morph from that,” he said.

While this is very early days for the hub, Schooley is buoyed by something that the Minister of Health, Dr. Eric Hoskins said at a conference in November.

“We must undertake structural change to our health system,” he said, and then added that to do this the system must be “deeply integrated at the local level, starting with strong local governance”. At the same time Hoskins announced the formation of the first rural health hubs.

The health hub idea has been supported by local MPP Randy Hillier, who is not normally supportive of Ministry of Health initiatives. But in this case he sees the potential for some planning to be done from the grassroots up rather than the other way around.

“It’s great to see it starting here in the communities and not just waiting for more decisions or policies from the province,” Hillier said.

The Perth & Smiths Falls District Hospital has decided to take the lead in organising a hub, and to do so they looked at creating geographical boundaries that fit with the travel patterns of people in the region with a view towards creating a hub with enough size, 100,000 people, for some economies of scale.

That meant expanding beyond the reach of the Perth & Smiths Falls Health Link to include all of Lanark County, including Mississippi Mills Township and the cities of Carleton Place and Almonte, as well as looking to Central and North Frontenac.

They made a pitch for support to the County of Lanark in December and Schooley was scheduled to come to Frontenac County this week, but the meeting he was set to attend on February 17 was canceled due to snow and he will have to wait until March 16 to make his pitch.

“Many residents of Central and North Frontenac are drawn to Perth for services, and that is one reason why we are approaching Frontenac County to send a representative to the health hub,” said Schooley.

The name and geographical boundaries of the hub also borrow from the watershed-based boundaries of conservation authorities, which is something that Schooley also pointed to.

“Watersheds determine communities of interest and travel patterns follow from that,” he said.

Some of the complications that the Mississippi-Rideau-Tay Health Hub will have to overcome relate to how funding and working relationships between health care providers are currently set up. The two family health teams that serve Central and North Frontenac - the Sharbot Lake and Lakelands family health teams - are affiliated with the Rural Kingston Family Health Organization, which is based in Verona and is within the sphere of the Kingston hospital system.

As well, Mississippi Mills is covered by the Champlain LHIN, which includes Ottawa. The rest of the Misssippi-Rideau-Tay territory is part of the Southeast LHIN, whose headquarters is in Belleville.

If Frontenac County decides to send a representative to the hub, it will be Mayor Frances Smith from Central Frontenac, who has been tapped to take on the role. She has been on the advisory committee to the Sharbot Lake Family Health Team since it was established.

Schooley said that once the six municipal representatives are determined, the hub will be looking for 12 community representatives from across the region.

Support local
independant journalism by becoming a patron of the Frontenac News.