Abstract
Introduction:In 2019, Ontario’s Ministry of Health (the Ministry) introduced Ontario Health Teams (OHTs) to provide population-based integrated healthcare. Primary care was foundational to this approach. We sought to identify factors that impacted primary care engagement during OHT formation from different perspectives.Methods:Interviews with 111 participants (administrators n = 80; primary care providers n = 17; patient family advisors = 14) from 11 OHTs were conducted following a semi-structured guide. Interviews were transcribed, coded, and thematically analyzed.Results:Participants felt that primary care engagement was an ongoing, continuous cycle. Four themes were identified: 1) ‘A low rules environment’: limited direction from the Ministry (system-level), 2) ‘They’re at different starting points’: impact of local context (initiative-level); 3) ‘We want primary care to be actively involved’: engagement efforts made by OHTs (initiative-level); 4) ‘Waiting to hear a little bit more’: primary care concerns about the OHT approach (sector-level). Thirteen factors impacting primary care engagement were identified across the four themes.Discussion and Conclusion:The 13 factors influencing primary care engagement were interconnected and operated at health system, integrated care initiative, and sector levels. Future research should focus on integrated care initiatives as they mature, to address potential gaps in the involvement of primary care physicians.
Highlights
In 2019, Ontario’s Ministry of Health introduced Ontario Health Teams (OHTs) to provide population-based integrated healthcare
The structure and aims of OHTs fit within the World Health Organization’s (WHO) working definition of integrated care: “a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion
Two themes described initiative-level factors: 2) ‘They’re at different starting points’: impact of local context, and 3) ‘We want primary care to be actively involved’: engagement efforts made by OHTs
Summary
In 2019, Ontario’s Ministry of Health (the Ministry) introduced Ontario Health Teams (OHTs) to provide population-based integrated healthcare. To support integrated care within the Canadian province of Ontario, the Ministry of Health (the Ministry) introduced Ontario Health Teams (OHTs) [3]. “...groups of healthcare providers and organizations that are clinically and fiscally accountable for delivering a full and coordinated continuum of care to a defined geographic population.” (p.1) [3]. OHTs include multiple healthcare sectors, from primary care to social services [3] and aim to increase connectivity between health services across care settings by providing care through a single, cohesive team and improve outcomes linked to the quadruple aim: patient and population health outcomes, patient/caregiver experiences, provider experiences, and overall cost [4]. “a concept bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. Integration is a means to improve the services in relation to access, quality, user satisfaction and efficiency.” [1]
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