Saturday, April 9, 2016 9:00 am ·  0 Comments
There is a tendency these days to dwell on the myriad of things that aren’t working, the sensational, all that is bad. In health care, news stories abound about long waiting lists, lack of adequate supports for caregivers. All of which is true. And yet, there is another side to this story. Positive strides are being made. Innovation is happening. There is a glimmer of hope.
Case in point are the formation of Health Links which essentially are mandated to serve the most complex patients, or what in health care circles are referred to as high cost users. Bear in mind, two thirds of all health care expenditures goes to 5% of the population which equates to thirty billion dollars. Hence, if you want to make a dent, this is definitely the starting point.
While the way Health Links are managed varies, there is one I have been involved with in North Simcoe which is having very significant impacts. Over the course of just its first year of operation, there has been a significant reduction in emergency room visits and hospital admissions resulting in net savings of 38% per patients! This far exceeds operating costs.
In terms of why they are generating such positive impacts, interestingly, it has little to do with case management. Instead, it has far more to do with the wholistic approach employed in working with their patients. During the initial intake, for instance, patients are asked questions about their ability to access food and transportation. How many family and friends can they rely on during times of need?
This information proved to be critical since the majority of high cost users live in poverty and are socially isolated. Armed with this information, the community nurse was then able to take immediate steps to link clients with appropriate services and supports.
Also noteworthy, the benefits of Health Links extend to multiple public services. Take the case of one elderly lady who called 911 over a hundred times in the span of one year. Each time a fire truck, ambulance, and/or police cruiser would have to show up. Why? Not because she had to go to the emergency ward, but rather, she needed help getting groceries. Felt lonely and would get panicky.
And so, what did this Health Link do? They did the smart thing which was to reach out to a voluntary organization that was in the business of providing social supports. Rather than be in a reactive mode i.e. send out the army every time to respond to her distress calls, they became proactive by focusing on her real needs which were essentially emotional and social.
Bottom line, necessity is the mother of invention. To which, Ontarians should take heart that there is ingenious work occurring right now in the health care field. Many of the Local Health Integrated Networks are facilitating the development of promising new programs without getting too prescriptive so that real innovation could occur.
Now, the stage is set to replicate and scale up Health Links to augment Family Health Teams and ease the burden of hospitals. Granted this will require ample courage, which is always the case when decisions are made to reallocate resources. And yet, if properly implemented, the savings could be in the order of billions of dollars within a year or two.