Integration of care in Northern Ontario: Rural health hubs and the patient medical home concept.

Abstract

Primary care reform in Ontario that provides accessible, comprehensive patient-centred care has been a work in progress for more than a decade. With the recent emergence of Ontario Health Teams and the conclusion of the Rural Health Hub (RHH) pilot project, insight into the philosophy, culture and expectations of rural and remote centres with regard to primary care delivery is required. The concept of the patient medical home (PMH) and the RHH offers frameworks that emphasise positive attributes towards quality care systems - continuity, accessibility, comprehensiveness and localisation of services and funding for system efficiency. The application of these frameworks to rural and remote centres was explored via semi-directed face-to-face and phone interviews with physicians, patients and healthcare administrators at six rural centres in Northern Ontario. Continuity of care, local integration and healthcare culture reform were cited by participants as the most important aspects of optimisation of primary care in their environments. These concepts support the RHH and PMH models and their further implementation as part of healthcare system transformation in Northern Ontario.