{"id":31129,"date":"2017-05-23T07:41:18","date_gmt":"2017-05-23T11:41:18","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=31129"},"modified":"2017-05-23T16:58:41","modified_gmt":"2017-05-23T20:58:41","slug":"mahst-prototype-health-care-model-for-muskoka-and-area","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/mahst-prototype-health-care-model-for-muskoka-and-area\/","title":{"rendered":"Introducing MAHST’s prototype for a health care model for Muskoka and area"},"content":{"rendered":"

Click here for a larger image of MAHSTs prototype illustration above<\/a><\/em><\/span><\/p>\n

There\u2019s been a lot of talk about transforming health care as we know it in Muskoka and area, but what does it all really mean and what has Muskoka and Area Health System Transformation Council (MAHST) come up with so far?<\/p>\n

<\/broadstreet-zone><\/strong><\/div>\n

A bit of history<\/strong><\/p>\n

Muskoka Algonquin Health Care, which manages both the Huntsville and Bracebridge hospitals, has been struggling for years to try and make ends meet with the funding it gets. In May of 2015 its board recommended integrating all its services under one centrally located hospital, which it argued made the most financial sense. That recommendation was met with fierce opposition, particularly by residents, planners and municipal representatives.<\/p>\n

Then, during a joint Bracebridge and Huntsville municipal council meeting on Feb. 1, 2016, a recommendation was made to redistribute the services that each hospital site provides. One would focus on acute care services and conduct the bulk of surgical procedures with advanced diagnostic imaging services, while the other would focus on chronic care, contain all complex continuing care beds and offer select day surgery for things such as cataracts. But that too raised eyebrows, particularly with the medical community in North Muskoka, concerned that two fully functioning hospitals would cease to exist, with one hospital site being relegated to housing chronic and long-term care patients and referred to as a hospital only in name.<\/p>\n

The creation of MAHST<\/strong><\/p>\n

Fast forward to June 26, 2016 and the North Simcoe Muskoka Local Health Integration Network (NSM LHIN)<\/a><\/span>, which serves as a go-between the Province and publicly funded health service providers including hospitals in this area, announced the creation of the Muskoka and Area Health System Transformation Council (MAHST)<\/a><\/span>.<\/p>\n

MAHST has since created various focus groups and is moving quickly with surprisingly tight timelines. That\u2019s to ensure momentum does not wane, explained MAHST Chair Don Mitchell, who sat down with Doppler on May 12, 2017 to discuss its prototype model, which he said is slowly coming together. Coincidentally, Mitchell noted that the chair of the board of NSM LHIN received a mandate letter<\/a><\/span> from the Ministry of Health on May 1, 2017. That letter sets out priorities for the LHIN, priorities which Mitchell said are very much in tune with the vision MAHST has been formulating for health care delivery in Muskoka.<\/p>\n

\u201cWhat you\u2019ll hear from a lot of people is you would have thought the Ministry was sitting in our room,\u201d said Mitchell.<\/p>\n

What we\u2019re doing in Muskoka is very much aligned with what the province is asking everybody else to do. It\u2019s just we\u2019re six months ahead of everybody.
\nDon Mitchell, MAHST Chair<\/cite><\/p><\/blockquote>\n

What is MAHST\u2019s prototype?<\/strong><\/p>\n

First of all, said Mitchell, the community has resources and provides services, what it lacks is an overarching strategy. \u201cSo when you get the various different questions about acute care and long term care \u2013 there is no strategy. There are a lot of silos, there are a lot of services but we don\u2019t have, for a want of better terminology, a master plan,\u201d he said. \u201cThe goal is to see how we pull all those pieces together.\u201d<\/p>\n

MAHST is looking at four main drivers, which will make up its overall goal for health care delivery in the Muskoka area. They are: better health, better care, better provider experience and better value, explained Mitchel, who expanded on all four.<\/p>\n

Better health<\/strong><\/p>\n

He said better health means things like encouraging healthy lifestyles and more education on ways of staying out of the system, which in and of itself would save money. \u201cBy partnering with public health and becoming more engaged with public health we\u2019ll get the message out, we\u2019ll work on education, work with the school systems, work with the general public to try and get a healthier Muskoka.\u201d<\/p>\n

Better Care<\/strong><\/p>\n

Better care means moving to a person-centered system. \u201cIn the past it\u2019s been very hospital-centric. This is moving to a person-centric (system). So you or I and our relationship with the system and how things interact – the move has to be more user friendly,\u201d said Mitchell. That could mean having the flexibility to book after hours appointments, navigating the health care system through an app on your phone, much like the banking system. It could also be having the ability to interact with your primary care provider, perhaps via email or text message and book an appointment via the same.<\/p>\n

\u201cTwo common things around person-centric (care) is the concept of way-finding and care co-ordination,\u201d explained Mitchell. He said right now, if someone has a complex health problem, they will be seen by multiple health care providers. \u201cAnd there\u2019s no one really there to hold your hand as you walk through the system, so care co-ordination is about that.\u201d He added that often when people need to leave the area for specialized care \u201cthere\u2019s no one making sure that all of the information that goes with that person comes back. So the whole idea with care co-ordination is that one person is making sure that every person that you need to touch knows the story and the story is only told once.\u201d<\/p>\n

<\/broadstreet-zone><\/strong><\/div>\n

The idea, Mitchell said, would be to move the health care co-ordinator out of the hospital and have them form part of an inter-professional health care team. He said the idea behind such a team is to \u201cget access to your health care when you need it. So a classic example would be same day or next day. So the fact is if you phone up and your doctor is not there, you\u2019re not going to wait five or ten days to see a doctor,\u201d he said, adding that a patient who belongs to an inter-professional health care team could have access to a doctor or nurse practitioner sooner and such a team would also benefit those who are not currently connected to a primary health care provider.<\/p>\n

Better provider experience<\/strong><\/p>\n

Better provider experience involves trying to make the system work in a way where physicians, nurse practitioners and other health care providers want to come to Muskoka to work.<\/p>\n

Mitchell said what\u2019s different from past initiatives to retain health care professionals here is actually putting together a system that works. He said one the complaints he\u2019s heard from physicians is that they spend a great part of their day trying to find help.<\/p>\n

\u201cIn other words, I have to step away from the front line and go and do the administrative stuff and call and chase and whatever. Yes they have office staff that does that but a lot of times they have to engage themselves. If we can automate that process or if we can create an environment where the primary care provider is really focusing on that front line interface and take the rest of the stuff away, that will get people in many cases to want and come,\u201d he said, adding that identifying growth strategies in the system would also form part of a more positive experience for providers.<\/p>\n

Better value<\/strong><\/p>\n

Mitchell said there are several different ways that MAHST is considering as a way of getting better value from the system. One approach is preventative education. \u201cIf we can do something for better health that will keep people out of the acute care setting, we\u2019ve created value,\u201d he said. Other initiatives involve centralizing expenditures such as buying in bulk.<\/p>\n

\u201cIf we have, let\u2019s say 26, 27 service providers and they\u2019re all buying differently, there\u2019s no real savings sort of speak. It may be economies of scale. It may be economies of scope,\u201d said Mitchell, who also noted that getting appropriate funding is key.<\/p>\n

Where do the hospitals belong in MAHST\u2019s plan?<\/strong><\/p>\n

\u201cRight now the plan is we need to design the primary care piece first because, remember what I said, it\u2019s moving from hospital-centric to person-centric, which means that the hospital will be a service provider. So based on how the model for primary care and this inter-professional disciplinary team get designed, it will dictate what services we need within the hospital setting.\u201d<\/p>\n

He said the hospital is just one more service provider in the big picture. \u201cWe want the hospital to be the place you have to go when you can\u2019t get care anywhere else. But if you\u2019ve got the sniffles and you call up your doctor and your doctor is not available so you go to the emergency ward, that\u2019s not a good use of the emergency ward. So if we have an inter-professional health team, somebody is going to get you looked after for the sniffles. But if you\u2019ve been in a car accident or you have something that\u2019s made you really sick and you need surgical intervention, then we want you to be able to get to the hospital.\u201d<\/p>\n

Mitchell also said it is important to look at what happens to people once they leave the hospital. Is there enough follow-up care to keep them out? He noted that the responsibility of Community Care Access Centres, which deliver community and home care in the province, will now fall under the direct responsibility of the local LHINs. \u201cSo if it\u2019s part of the LHIN… we\u2019re expecting that they\u2019re going to be able to step up and provide Muskoka with the home and community care services that Muskokans need.\u201d<\/p>\n

Mitchell reiterated that hospitals are just a piece of the whole health care puzzle. He said the number of hospitals and their location in Muskoka is a decision that has yet to be made.<\/p>\n

We only have one hospital in Muskoka, but we have two sites. So that is what\u2019s going to be up for discussion in the future. Where does the hospital need to be? We may find that based on the future, the hospital may be in five different places, as opposed to two. So that\u2019s why I am saying it is too early to tell because we don\u2019t know what the future of the hospital looks like. From a technology base, hospitals are changing dramatically. MAHST chair Don Mitchell<\/cite><\/p><\/blockquote>\n

Mitchell said MAHST is fortunate to have many physicians from Muskoka actively engaged in the discussions and much to the Ontario Medical Association\u2019s chagrin, because of the contract talks currently taking place with the province. \u201cThere are so many people from Muskoka that are volunteering their personal time, if we had to pay for it we could not do it,\u201d he said. They\u2019re doing it \u201cbecause they believe in creating the health care system that works for the people in Muskoka.\u201d<\/p>\n

What now?<\/strong><\/p>\n

The next step will be coming up with a governance structure that would move the plan into place. Mitchell hinted that that leadership may be physician-led. Remarkably, MAHST is hoping to come up with a governance model sometime in June. \u201cWe need to get everybody heading in the same direction, but we don\u2019t have the same direction yet, and so somebody in Muskoka has to stand up and say \u2018this is our direction.\u2019\u201d Mitchell said the prototype health care delivery model that MAHST has come up with will continue to be developed with formal talks among all stake holders as well as public forums.<\/p>\n

Don\u2019t miss out on Doppler! Sign up for our free, twice-weekly newsletter here<\/u>.<\/a><\/strong><\/p>\n

<\/broadstreet-zone>\n","protected":false},"excerpt":{"rendered":"

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