How We Help
Central OHT for Specialized Populations brings expertise in specialized services through an individual’s lifespan with a focus on mental health and addictions, seniors, and Indigenous populations.
We Strive To:
- Provide support to Priority Populations
- Build a strong framework for patients, families and caregivers
- Implement an improved Digital Health strategy to transform the way care is delivered
Our Plan for Integrated Health Care Services
We are starting with 3 priority populations for our clinical care initiative. These populations were chosen after a review of data and are based on input from clients and care partners. Below are our three priority populations and how we plan to assist each;
1. Seniors starting with Specialized Geriatric Services (SGS)
- Implement the SGS hub and spoke model with sub-geographical OHTs
2. People with Mental Health and Addiction conditions, starting with Child and Youth
- Evidence based integrated pathways for treatment of depression or anxiety
- Access to full continuum of substance use disorder treatment
- Immediate access to a full continuum of evidence based mental health services
3. Indigenous populations
- Reduce opioid related harms
- Integration of MHA into Primary care with a lens of culturally safe services
- Champion cultural adaptations of evidence based interventions
Central Ontario Health Team for Specialized Populations will build a strong framework for patients, families and caregivers that encourages partnership & engagement among our members. We aim to build this framework through respect, trust, transparency, empowerment and learning.
The chart below outlines how Central OHT for Specialized Populations will continue to engage our partners, patients, families and caregivers.
- Focus Groups
- Public Meetings
- Social Media
- Network Communities
- Working Groups
- Steering Committees
“Digital Health means the coordinated use of digital technologies to electronically integrate points of care and transform the way care is delivered, in order to improve the quality, access, productivity and sustainability of the healthcare system.”
- Per HSAA/MSAA Agreement definition
This is Mary’s Experience. Mary is a 85 year old female (Frail Senior) in Long-term Care experiencing new responsive behaviours.
Learn how an improved Digital Health strategy can transform the way care is delivered, from the initial contact with the health care provider through till the client is at home and during follow up.
At the Long-term Care (LTC) home
- LTC staff make eReferral to Specialized Geriatric Services (SGS) due to increasing challenges meeting Mary’s care needs
- During on-site visit to LTC home, SGS staff assess and offer advice including specialist consult
- LTC MD eConsult with Geriatric Psychiatrist to confirm next steps
With Regional Specialist Support
- Geriatric psychiatrist virtual visit consult with Mary at LTC via OTN
- Psychiatrist follow-up with LTC MD via secure messaging
- Geriatric psychiatrist eConsult with Gerimedrisk program to gather best practice treatment advice
- Timely communication between specialist and LTC MD to achieve consensus on proposed treatment changes via secure messaging
- LTC staff review On-line Regional Resource Repository for best practice information to better care for Mary
- LTC staff attend a Responsive Behaviours workshop hosted by SGS via OTN
At Follow Up
- During an OTN virtual visit follow-up visit with LTC MD and staff, agreement reached no further specialist follow-up required at this time
- Geriatric psychiatrist and SGS team members updates Mary’s digital health record in near real-time, meaning the LTC MD will receive a discharge summary via HRM, and future providers will be able to access Mary’s care history via Connecting Ontario
Care journey supported by an OHT Digital platform — public facing website offering "digital front door“ and regional resource repository for users (e.g. self care, apps, patient portal, caregiver information), and healthcare professionals (e.g. care standards, evidence based resources, on-line education).