Health Links launch to help streamline care

Yorkregion.com
Jan. 23, 2015
By Kim Zarzour

Seniors and those with complex medical needs in southwest York Region may soon find accessing their healthcare easier with the launch of a new program at Mackenzie Health today.

Health Link is an initiative designed to better coordinate healthcare plans for those with complex medical issues by bringing together the hospital, physicians, specialists, home care, long-term care and community services.

For people like Anthony Bontje, it means less time spent tracking and accessing much-needed services.

At 86, Bontje has several health challenges, including vascular disease, arthritis and high blood pressure, with several doctors providing medical care.

It often means waiting six to nine months for referrals, which, when they come too late, means he ends up back in hospital again, attended to by further specialists, said his daughter Kris Hurley.

Bontje is one of the first patients to use the Health Link service in southwest York Region. His care is now organized and tracked by a patient coordinator who met with them at his home and developed a comprehensive plan.

The Health Link process begins with a home visit to assess a patient’s needs and develop a plan that the patient’s health team can focus on.

Working together with identified patients, care providers develop personalized, coordinated plans with clear goals to ensure the right services and actions are matched to patients’ needs.

Carla Rodriguez, director of Southwest York Region Health Link, said the initiative should reduce avoidable emergency department visits, reduce the need to return to hospital shortly after discharge and reduce wait times to see specialists

“It’s less about what’s the matter with a patient, and more about what matters to the patient,” Rodriguez said.

Health Link, which is funded by the Ministry of Health and Long-Term Care, focuses on the five per cent of patients with the highest needs. These patients often have multiple complex conditions and account for two-thirds of Ontario’s health care dollars.

Mackenzie Health is the lead organization in the southwest York Region Health Link and will collaborate with 20 community partners, including Alzheimer Society of York Region, Canadian Mental Health Association, District Stroke Centre and CareFirst Seniors Community Services Association.

Health Link has also partnered with York University to advance an academic study focused on self-management for patients with complex conditions.

Twenty-three patients in southwest York Region, which includes Vaughan, Richmond Hill, Thornhill and King City, have enrolled in the program so far.

Similar initiatives are underway in North York, South Simcoe and northern York Region.

“Through health links, our patients can get the right care at the right time and in the right place, while making the most efficient use of our resources and improving the overall care experience,” said Kim Baker, CEO of the Central Local Health Integration Network.

Patients, families and caregivers who wish to know more about the program and how to become part of it may call Rodriguez at 905-883-1212 ext. 7847 or email SWYRhealthlink@mackenziehealth.ca