November 1, 2011

Dear Northerners:

Looking out of my office window, most of the red leaves have fallen and the chill in the air is a reminder that winter is coming.

On my desk is a dog-eared copy of Dr. David Walker’s report about caring for those in the winter season of their lives. In Caring for Our Aging Population and Addressing Alternate Level of Care, Dr. Walker -- who met with our LHIN staff and hospital leaders in compiling his report-- explains that the acute care delivered by hospitals is not designed to meet the needs of the frail elderly and that it puts these patients at risk of infections, falls, and loss of mobility. 

For system change to occur, many of the institutional and organizational components of the current system will need to re-orient themselves to a priority of caring for seniors in ways not accomplished to date,” writes Dr. Walker. “A fundamental system redesign is required -- from changing the design of long-term care home programs to shifting more resources in the community.”

Interestingly enough, Dr. Walker’s report was released in August, but we had been hearing these same ideas echoed by Northerners at the 25 communities engagements we held across the region from May to August.  People told us time and again more community-based services are needed to help seniors live independently at home longer.  

The report on these community engagements, which drew in close to 700 Northerners and identified 12 common themes will soon be available.  I encourage you to take the time to read it and reflect on the voices heard to increase access to care in this part of the province. 

Already, we have started to bring the hundreds of these engagement voices to our NE LHIN decision making tables.  In late August, we announced additional funding for many community-based organizations offering assisted living and other services such as physiotherapy, cardiac rehab, and adult day programs.   

We have also invested $2.6 million to enhance services for seniors who have challenging behaviours associated with mental health, dementia or other neurological conditions. This region-wide investment will allow local health service providers to hire nurses, personal support workers and other professionals to provide care for these patients with dignity and respect and to support their families in caring for them too.  A Regional Behavioural Support committee has been struck to develop an action plan. You’ll hear more about its work in the coming months.

Not only does care need to be shifted to the community, we also need to consider the importance of chronic care prevention and management. Although our health care system was built around the delivery of hospital care, our aging population suggests we need to focus on care to manage chronic illnesses.  

I’m encouraged by the participation of Northerners at our first ever Chronic Disease Prevention Management Forum this past month. Close to 100 health care professionals from across the region came to learn and share best practices.  

Dr. Ian Cowan, a family physician and Board Director with the LHIN, told us he seldom deals with kids with sore throats but rather patients with chronic diseases. Keeping electronic records and a couple of other high tech tools has helped Dr. Cowan share as much information with them as possible during their visits.

Little wonder Dr. Cowan is treating so many Northerners with chronic illnesses when you look at our rates compared to the provincial averages:

  • Arthritis/rheumatism - 24% vs.17%;
  • Asthma - 10% vs. 8%;
  • High blood pressure – 23 % vs. 17%;
  • Hospitalizations due to heart conditions - 314 vs. 216 per 100,000 people

We received positive and encouraging feedback from the forum with many requesting that it become an annual event adding comments such as “good ideas - great discussion.” The only complaint was that perhaps there was too much information to be digested at once.

That’s a criticism we can live with.  As a LHIN our job is to help connect the health care system across northeastern Ontario and to make sure we’re making use of the latest technology to improve access to care in our vast region.

Right now our LHIN is exploring ways to help deliver through telemedicine and something called telehomecare –where nurses stay in touch with their patients, equipped with special monitoring devices, through daily calls to their home. You’ll hear more on this in the coming months.

The leaves may be disappearing but the workload and opportunities to increase care remain.  And, that’s a good thing!  I look forward to working with many of you in the coming chilly months.