Innovations in team-based care essential to the solution
As the bedrock of our health care system, primary care is what supports all other areas of care. It provides Canadians with a reliable first point of contact for their health care needs, keeps our emergency departments caring for true emergencies, and ensures people’s health issues are managed so they don’t deteriorate.
But that solid foundation has been eroded over many years, and we’ve all seen the negative impact of this on our loved ones and those in our communities.
Last fall, our OurCare research team heard from more than 9,000 Canadians who responded to a survey about their experiences with their family physicians and teams, and how they want to see the system evolve to better address their needs. But because surveys often don’t tell the whole story, we’ve gone province-to-province to engage citizens directly.
Over the past six months, we engaged 31 British Columbians (our “citizen panel”) who collectively invested almost 1000 hours of their time learning about the health system and deliberating about challenges and opportunities to improve BC’s primary care system.
In their report released September 19th, they have described 25 clear, actionable recommendations that will transform the way we think about and deliver primary care in BC.
Unsurprisingly, access to care was the number one issue that our citizen panelists said had to be addressed. So, what are the solutions for the access crisis?
Several are already underway: BC recently developed an innovative new longitudinal family physician funding model to support family physicians and their offices. The data suggest there are already new family doctors practicing comprehensive family medicine as a result of these changes, and we’ve heard stories of family doctors moving from other places in order to practice here.
While this is good news, we simply don’t have enough physicians in BC to meet the demand of all the primary care we need. We are stretched, not just in BC but everywhere in the world.
And because we don’t have enough doctors, we need innovation not just in physician funding models, but also the development of robust primary care teams that include nurse practitioners, nurses and mental health clinicians to ensure that we can actually provide the care that we all need and deserve.
The citizen panelists made clear recommendations that innovations in team-based care are key to addressing the issues they face trying to stay healthy.
Our citizen panelists specifically called out increased investment in Community Health Centres (CHCs), which are community-governed, multidisciplinary teams that include family doctors and other health professionals, who work together in a coordinated fashion to provide primary care. They felt that these CHCs should be deployed with equity in mind: they should first be expanded into remote, Indigenous, and low-income communities where we see the most challenges with access to care.
There was recognition that there are some patients who struggle to understand how to navigate mulitple appointments, book their own lab tests, and coordinate the many aspects of their care. Our panel felt that a valuable addition to health care teams would be the introduction of patient advocates who can ensure that no patient is left behind due to their health literacy, language barriers, or challenges navigating our complicated health system.
Our panelists have also advised major improvements to the technological aspects of primary care, from accessible electronic medical records to expanded virtual care options.
They also recognized that no new investment or change can be adequately spread or scaled without evaluation to understand its impact, outcomes and return on investment. They believe that there needs to be a system of robust and independent evaluation of primary care initiatives in BC, and that efforts should be made to quickly spread and scale effective programs and community-level interventions.
We have an opportunity to build a truly world-class primary care system in our province that can be the envy of Canada and the world. The citizens of British Columbia have shown us where we can start.
Photo courtesy of DepositPhotos
