Ontario is helping health care organizations provide better and more integrated care for patients and their families, with a new payment model called Bundled Care. This coordinated approach will help patients transition more smoothly out of hospital and into their home. It also builds on the success of St. Joseph's Health System's Integrated Comprehensive Care Demonstration Project where integrating funding across multiple providers and care settings improved the patient experience, reduced time spent in hospital and decreased the number of emergency room visits.
Over the next two years, Ontario will pilot different approaches to giving eligible Ontarians more choice over who provides services in their home and when these services are delivered. The goal is to empower patients and caregivers by giving them more flexibility and control over their care plans by involving them more in the planning, organizing and coordination of care they receive.
Caring for a loved one can be rewarding. It can also be challenging, both emotionally and physically. The government recognizes the important contributions of caregivers and will provide more support for caregivers, including training and education, improved access to information and respite care.
These are all great ideas that will only succeed if service providers, health care professionals, clients and family caregivers TALK to each other. Bundled care means multiple service providers across health and social service sectors will be involved with the same family. When important messages need to be shared within the larger group, who will be responsible for communicating across agencies? How will clients and families tell everyone in the circle of care about an important health event without spending hours on the telephone? Sunnybrook Hospital in Toronto has identified this challenge for its patients in the community and they’ve come up with an IT platform called MyChart.
· My Chart is an online website where patients can create and manage their personal health information based on clinical and personal information.
· Currently only Sunnybrook patients have access to MyChart™, but they can electronically grant access to family caregivers, hospital clinicians, primary care physicians, Community Care Access Centres (CCACs), and pharmacists.
· MyChart™ is accessible from anywhere at any time through the Internet. Once registration is complete users can go to and log in to review their medical records.
· Personal and family health details (including allergies and current medications)
· Online appointment requests
· Online patient questionnaires
· Clinic visit notes
· Personal address book, compiled by the patients – physicians, caregivers, labs, clinics, etc.
· Personal diary
· Test results (ie. labs, CT and MRI reports) which are gathered from Sunnybrook’s Electronic Patient Record (EPR) system.
· Links to relevant disease-specific information and online events
· Personalized health information (eg. FAQs on procedures, etc)
TYZE PERSONAL NETWORKS
For clients in the US and Canada who need a similar, secure web-based communication tool to bridge communications between home and medical professionals, there is Tyze PersonalNetworks. Tyze is free and it’s the product our family uses to coordinate the support for our son and for my Mom. I’ve written about Tyze many times before – I’m a huge fan. Teamwork can’t happen when people don’t talk to each other in order to share vital information. Caregivers need the changes that Eric Hoskins announced last week and we need the tools to manage those changes. Products like Tyze and MyChart have a role in ensuring the success of community care transformation.