by Paul Sulkers

I read with interest your paper on a National Standard for Senior Care. Very well researched and expressed in terms of capturing the urgent requirements and path forward, building advocacy for healthy aging communities and aging at home. 

However, one aspect to your paper that perhaps needs emphasis is the need to build stronger primary care, integrated with home care and other community services. I believe that stronger primary care – as defined –  is fundamental to a shift to population health management and transformation of health services in Canada. Although the paper stressed the need for increased funding for senior care services, both at home as well as in LTC settings, it is also important to consider increased funding for stronger primary care that can be leveraged for both senior care as well as other segments of the population – improving and maintaining a healthier population. In fact, with proper investments in primary care, it is conceivable that future cohorts of seniors will be healthier due to prior primary care investments in wellness and managing chronic conditions. I use the term ‘primary care’ as defined above – integrating family practice with home care and a range of community services. Skills would include family practice, geriatrics, paediatrics, public health, mental health, home nursing a support workers, nutrition, and a range of other community skills.  I also use the term ‘enterprise’ to characterize a group of primary care locations based on shared technology, communication and management services. In addition, enterprise primary care – as defined – would maintain digital connection to seniors as well as their families (in other regions) via a single digital channel. Among other advantages, this digital channel is designed to increase the productivity of primary care service delivery for those populations where digital is warranted, saving in-person care delivery for those most in need, including  care delivery regardless of their place of residence – at home or in LTC. I also believe that private sector can be a key ally to finance and deploy the shared infrastructure referenced above, as well as develop a range of digital tools – tailored to population segment and condition – and enable Integration across silos in the care system.  This strategy and the inclusion of the private sector can be the catalyst to a digital health & AI economy in Canada – and jobs for our children! Net is, investments in stronger ‘enterprise’ primary including home care and community services, as well as healthy aging communities can be leveraged for an overall population health strategy, maintaining healthier populations so that our seniors are healthier, as well as providing the types of care services for seniors that your paper addresses. The following blogs that may be of interest. The first addresses six key capabilities that we must have in order to sustain transformation. Without all six, dozens of other key strategies are encumbered. With the six capabilities, we will be able to launch a range of transformative steps that ultimately are consumer-centric. https://drbobbell.com/integrating-ontarios-healthcare-system-a-point-of-view/ The second blog focuses on the concept of enterprise scale primary care – as above – integrated with home and community care services and based on a set of shared services that enable each group or primary care hub to be more capable and productive. https://ontariomd.blog/2020/04/13/integration-and-enterprise-primary-care-a-point-of-view/

Paul Sulkers is a Health Care Consultant and former Ontario Executive with IBM Health