Here's how patients want Ontario's primary health-care system to change

In the ongoing debate over how to improve health care in Canada, there's a new effort to find solutions by listening to the views of patients. 

The initiative — called OurCare — has surveyed thousands of ordinary Canadians about what they want from primary health care, which includes family doctors — most people's first point of contact with the health system.

A new report outlines several key recommendations to emerge from OurCare's first regional panel, which was focused on Ontario. Some of those recommendations include:   

• Improving patients' access to electronic medical records.
• Shifting more family doctors away from solo medical practices into team-based care.
• Creating a centralized, digital system for referrals to specialists.
• Significantly increasing the number of family medicine residency spaces.

"Change will be challenging, but our health-care system cannot survive without it," reads the document. 

Dr. Tara Kiran, a family doctor at St. Michael's Hospital in Toronto and the national lead for OurCare, says certain professional groups and health-system stakeholders tend to dominate discussions of health-care reform. 

"All too often the voice of the public is left out," Kiran said in an interview.

She says it's essential to hear "the perspective of the people who use the system and ask them what it is that they want to see in the future." 

Report identifies problems in health system

From the more than 4,000 Ontarians who responded to its survey, OurCare convened a panel of 35 randomly selected people to represent the province's demographics and geography. The patient panel gathered for a week's worth of discussions to come up with its recommendations. 

One of the panel members, Joshua McCoy, a dairy farmer in the Ottawa Valley, says he participated because he has frequently relied on the Ontario health system and has long wished to be asked for feedback.

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"I always wanted to have the system be better — more easily navigable, more responsive if possible," said McCoy in an interview with CBC News. 

George Babu, another panel member, is an engineer and entrepreneur living in Toronto. After moving back to Canada from the U.S., he and his family were struggling to find a family doctor.

"I don't want to be one of the people complaining. I would like to be part of the solution," Babu said in an interview. 

With the goal of solutions in mind, panellists identified the following five major problems plaguing Ontario's primary health system:

• It's fragmented, often leaving patients with gaps in their care and without clear answers on where to turn.
• It's inequitable, leaving vulnerable patients and those from diverse backgrounds without consistently high-quality care.
• IT systems are outdated.
• There's a human resources crisis.
• Public access to primary care is not a priority for investment.

Shift toward team-based care, report urges province

The patient panel is making a range of recommendations along six broad themes, including accountability, recruitment and public education. 

Another theme is "models of care" — how primary care is delivered to people. Kiran calls these recommendations some of the boldest in the report.  

Among those recommendations, the panel is urging the provincial government to increase the proportion of funding it directs to the primary care system. It also suggests moving the primary care system away from solo providers toward team-based care, such as family health teams — in which physicians work together with other health professionals. 

"Some people [on the panel] had experience with team-based care and they loved it. Most of us had not even known it was an option," said Babu.  

The recommendations also call on the province to fix Ontario's hodge-podge system of electronic medical records. The digital platforms chosen by different family doctors, specialists, hospitals and labs are rarely compatible with each other, and patients don't have consistent access to their own health records and test results. 

Province reviewing the recommendations

The panellists say they're optimistic that the government will act on the report. 

"We think these are good ideas, we think these are important, and we're the taxpayers paying for this [health-care system]," said Babu. 

"I have to believe that people [in government] are going to listen and that the right changes are going to be made," said McCoy. 

A spokesperson for Health Minister Sylvia Jones said the government is reviewing the recommendations. 

"Ontario is leading the country with 90 per cent of Ontarians having a family doctor or primary health care provider, but we know more needs to be done," said the spokesperson in an email to CBC News. 

"Our investments for new Ontario Health teams will provide further connected, convenient care across the province and we look forward to coming to an agreement with the federal government to build on the work our government is already doing to connect more people to family doctors."