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Trent Hills Independent article published on Apr. 5, 2016. 

Article in full pasted below. Sue Dickens, Trent Hills Independent

Campbellford – Campbellford Memorial Hospital could become a regional electronic health records (EHR) hub. That is the vision of President and CEO Brad Hilker, who updated hospital board officials at their last meeting on the progress being made in this area.

Providing a context for this plan, he talked about the Geriatric Assessment and Intervention Network (GAIN) clinic located across the street, where the Trent Hills Family Health Team is situated in the Campbellford Memorial Health Centre at 119 Isabella St. The clinic opened June 2015.

The GAIN clinics are established in each of the four largest hospitals in the Central East Local Health Integration Network (CE-LHIN), the closest being at the Peterborough Regional Health Centre. The clinics also include eight community-based teams such as the one in Trent Hills.

The GAIN teams serve seniors, typically aged 75 plus, living at home or in retirement residences, who are frail and require comprehensive assessment.

“Our GAIN team has worked very closely with our IT vendor to build customized screens that facilitate the documentation of the comprehensive geriatric assessment,” Hilker told the board.

“The consulting geriatricians have praised the completeness and accuracy of the documentation and assessment record, and our team finds the system easy to use,” he added. The system has been designed to easily track indicators for monthly reporting.

“Based on our success, the Seniors Care Network is exploring the use of our system as a regional documentation system for the other GAIN teams,” Hilker explained.

This puts the system front and centre, in terms of it becoming the regional EHR hub for the GAIN program “to assist the Seniors Care Network to a common software solution utilizing our existing relationship with our vendor.”

Hilker noted, “Further details will come, as we explore this opportunity.”

The Seniors Care Network is “a group of dedicated health professionals, who share expertise and hard work, to provide the best healthcare experience for frail older adults in the CE-LHIN.”

It covers an area of 17,000 square kilometres of mostly rural geography.

The Network’s statistics indicate that 15 per cent of the CE-LHIN’s 1.6 million residents are seniors, “who may require additional support to remain living at home.”

The LHIN’s population of frail older adults is estimated to grow by 27 per cent in the next decade and double in the next 20 years.

All of this is happening while the province’s eHealth blueprint is being used as a framework for EHR planning and delivery.

Click here to access the article on Trent Hills Independent website.

Montreal Gazette article published on Apr. 1, 2016. Article in full pasted below. CNW News Release, Montreal Gazette Adults with intellectual and developmental disabilities (IDD) have more health issues than other adults, but they are less likely to receive preventative care. A new toolkit, developed by Health Care Access Research and Developmental Disabilities Program (H-CARDD), will help family health teams provide better, more proactive care for this vulnerable and underserved population. “Right now too many people with developmental disabilities are not getting the routine care they need and this can lead to crisis and emergency room visits,” said Dr. Yona Lunsky, clinician-scientist at the Centre for Addiction and Mental Health (CAMH) and director of the H-CARDD program. “If you can improve the quality of care upstream at the primary care level, then you can address health issues early and prevent more serious health issues from emerging.” Despite current Canadian guidelines that recommend adults with IDD receive an annual comprehensive assessment, including a physical exam, the majority of adults with IDD in Ontario are not receiving Health Checks. “Guidelines are not necessarily a product ready to be used in practice,” said Dr. Lunsky. “We needed something to help bridge that gap and make it easier for busy family health teams to implement these guidelines into everyday practice and improve care.” The toolkit, launched today and available online, was developed as part of a larger research study led by CAMH and Dr. Ian Casson, associate professor in the Department of Family Medicine at Queen’s University, which analyzed how two Ontario family health teams implemented Health Checks for adults with IDD. The two clinical teams were St. Michael’s Family Health Team based in Toronto with 70 staff physicians, and Queen’s Family Health Team in Kingston with 25 staff physicians. Detailed study results were published today in Intellectual and Developmental Disabilities. “Health Checks are like annual physicals, but they take into account the special needs of adults who have intellectual and developmental disabilities,” said Dr. Casson who is also a family physician with Queen’s Family Health Team. “They help such people get better access to health care, equivalent to people without disabilities, and they help family doctors recognize this population in their practices and serve them more effectively.” The toolkit includes a four step process to implement health checks, along with resources to help clinicians screen for IDD, clinical tools to assist with the exam itself, resources for patients and families, and examples of how the tools can be embedded into Electronic Medical Records for easier access. “Family physicians have the ability to provide excellent, guideline-directed care to adults with developmental disabilities but have been hampered by ways to identify this population in their practice,” said Dr. Laurie Green physician with St. Michael’s Family Health Team in Toronto. “Using this tool kit is a big step towards improving the physical health and well-being of adults with developmental disabilities. The H-CARDD program, led by Dr. Lunsky at CAMH, has been studying the health and health care of over 66,000 adults with developmental disabilities in Ontario since 2010. In addition to describing health disparities faced by these adults, H-CARDD works closely with provincial stakeholders to translate research findings into changes in practice. The Health Check toolkit is the latest resource developed by the team to improve the health and healthcare of Ontarians with IDD. “These are evidence informed, clinically relevant tools that can help change practice and improve lives,” said Dr. Lunsky. “We hope to see the Health Check toolkit go province-wide.” The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca or follow @CAMHnews on Twitter. Click here to access the article on Montreal Gazette website.

The Globe and Mail article published on Mar. 28, 2016. Article in full pasted below. Mahnoor Yawar, The Globe and Mail

At a clinic for Syrian refugees at Toronto’s Women’s College Hospital last month, a team of doctors met their first challenge: A family of 10, including eight restless, hungry children, stepped in for their first check-up.

A simple question, one of dozens – “Was your child immunized against measles?” – went through a series of steps. First, the question was input to a smartphone app, which translated the question for the patient in Arabic. The father, with limited Arabic knowledge, answered as best he could. The app translated it to English, and finally, the resident on hand could input the answer.

With more than 26,000 refugees already in the country, the potential bottleneck of casework for health-care providers is huge, and there is no easy way to integrate newcomers with already strained resources. It presents the kind of time crunch that clinics can’t afford in the long term, especially in cities where the demand for interpreters outstrips their numbers.

A new initiative by Canadian company CognisantMD hopes to reduce those waiting times. It has created a Syrian Refugee Medical Intake Tool, providing newcomers with a way to complete a full patient history and mental-health screening in their native tongue.

With the help of a simple online form, the patient can answer a series of questions in Arabic, Armenian or English. Their responses are then automatically translated to English and compiled into a full medical history, so that the physician can narrow in on specific health needs without the use of a professional interpreter.

It’s a novel approach to helping newcomers integrate in a global crisis of this proportion, with millions of people displaced to places where their languages are not spoken but their health issues cannot wait.

“Some of them have not had health care in five years,” explained Sharon Domb, a family physician with the Sunnybrook Academic Family Health Team that led February’s clinic. “They have no idea what immunizations the kids have had, if any.”

Dr. Domb said the team’s members were lucky to have an Arabic-speaking resident on duty that day, but they normally go through a translation smartphone app, or call for a paid interpreter to facilitate the process.

“We’re a teaching hospital at Sunnybrook, so because we were trying to allot an hour per patient, we’re limited by the number of people that we have on staff,” Dr. Domb said. “We had one supervising physician supervising three residents, each of whom could probably see three patients in a half-day.”

CognisantMD co-founder Doug Kavanagh, whose Ocean tablets are already widely used in Canadian hospitals, wanted to provide a free tool for health-care providers across the country to address the needs of refugees.

“These are people with unique needs, from a uniquely difficult situation,” he said. “They have a cursory exam when they arrive in Canada, which has less to do with care, more to do with screening them for diseases like tuberculosis. But just like any other Canadian, they may have chronic diseases. These routine things need treatment like anything else.”

A 2015 Statistics Canada study showed that language barriers play a part in self-reported long-term health for newcomers, who tend to arrive in better health than most Canadians, but experience a decline over their first four years here.

Dr. Kavanagh is confident that their care is a manageable problem, once clinicians get over the initial intimidation of its scope.

The tool was built with pro bono translation help from the likes of Faisal Al-Sani, a clinical fellow at Toronto’s Hospital for Sick Children who helped sift through culturally irrelevant references as basic as “common-law marriage” or “eczema.”

A native Arabic speaker, Dr. Al-Sani was moved by the Canadian welcome to refugees and decided that helping to build the tool would be his way of contributing.

He believes that overcoming cultural barriers to communicating more sensitive issues, such as details of sexual history or drug use, becomes a lot easier with a direct form, without bringing a third person into the loop.

“I find that when you fill up a form, you lose that ‘in-the-spotlight moment’ that you sometimes get when asked a sensitive question in a usual face-face interaction,” Dr. Al-Sani said.

Translation services were also provided by volunteers at the Armenian Family Support Services (AFSS), part of the Holy Trinity Armenian Church, which has processed almost 1,800 refugees in Toronto alone, many of whom suffer from hypertension, diabetes or serious dental-care issues.

Rita Odjaghian, chair of AFSS, believes that the tool will show its true advantage as refugees settle down in permanent housing, jobs and schools and long-suppressed mental-health issues begin to crop up.

“They talk about the fact that they have lost their houses in Syria. I had one saying that they left Syria, and in the bus they had a sniper going through. Or maybe sometimes the militants come and they ask them for money and they are still in fear. Or they were in jail, taken by the militants to do some repair work, and they weren’t sure whether they would come out alive or they would be killed,” Ms. Odjaghian said.

Despite a limited availability of Arabic-speaking or Armenian-speaking health-care professionals, she believes that the tool will help ease the transition significantly.

“One of our board members [pointed out] we need this for the Armenian-speaking population, not only for the refugees but also for the existing community,” Ms. Odjaghian said. “If a patient goes into the emergency room and that information is available, it will be very good.”

Click here to access the article on The Globe and Mail website.

Daily Xtra article published on Mar. 22, 2016. Article in full pasted below. Arshy Mann, Daily Xtra Sherbourne Health Centre is expanding the way it will deliver care to trans patients. The health care provider will be creating a comprehensive trans care hub that will add four beds to their 10-bed recovery suite. “This expansion will allow us to open up new beds with specialized clinical staff to support trans clients after their transition-related surgeries,” says Graeme Imrie, a spokesperson for Sherbourne Health Centre. The program is focused on people who are homeless or under-housed and need a place to recover after a transition-related surgery. Sherbourne Health will also be providing more mental health support for trans clients and providing help with navigating various bureaucracies that many trans people encounter regularly. Imrie points to helping clients coordinate with their benefits provider or assisting with arranging transition-related travel as examples of what they’re aiming to do. Funding will come from the Ontario Ministry of Health, which has pledged $2 million a year to increase access to trans health care. Much of that funding will go to Sherbourne Health Centre. “ It’s tremendous. It’s going to have a positive impact on a lot of trans people for years to come we hope,” Imrie says. The centre currently serves around 600 trans clients and operates Rainbow Health Ontario (RHO), a program that provides training to medical professionals to provide appropriate care to trans people. In November 2015, the provincial government announced that primary care providers would be able to provide assessments and referrals for OHIP-funded transition-related surgeries.  Since that announcement, RHO has gotten more interest from health care providers in Ontario, according to Imrie.  “Those inquiries are coming from providers who are either interested in learning more or anxious to learn more so that they can serve their clients properly,” he says. According to Imrie, interest hasn’t just been coming in from large cities, but also smaller urban centres and rural parts of the province. However, he cautions that people who are already on the waiting list at CAMH should not remove themselves until there’s more certainty over who can provide the referrals. For now, the increased government funding is allowing Sherbourne Health to do more for trans people in Toronto. “We’re excited about our ability to grow and do more for trans clients,” Imrie says. Relevant Links:

• “Sherbourne Health Centre to expand trans care”, Daily Xtra, Mar. 22,2016
• News Release, Sherboourne Health Centre

Huntsville Forester article published on Mar. 16, 2016. Article in full pasted below. Alison Brownlee, Huntsville Forester

A smile spread across Lynn Sharer’s face.

“Happy Birthday, everyone,” said the executive director of the Algonquin Family Health Team to a room of more than 20 health-care professionals at the organization’s Huntsville offices off Frank Miller Drive on March 2. “We have been in this town, working so hard with patients, for 10 years.”

The anniversary celebration included cake, reminiscences by staff, and a slideshow presentation of the non-profit primary care and preventative health team’s accomplishments since opening its doors in 2006.

“It’s great to know that we’ve got longevity,” said Sharer.

The organization works in concert with area physician offices toward patient wellness by providing related programs and services, many of which are offered from its wellness hub at the Canada Summit Centre, which it now plans to expand.

The Ministry of Health and Long-Term Care chose Huntsville as one of the first 52 sites to establish a family health team in the province in 2005. Family physicians soon expressed an interest in moving forward with the initiative and the first staff members were hired once ministry funding was secured in 2006.

“We’ve come a long way,” smiled Sharer. “We started out in a closet (at Huntsville hospital) and today we have three separate locations. Not bad.”

Palliative and geriatric care programs were the first established. But the team’s programs have since grown to cover Nordic pole walking, smoking cessation, COPD and asthma, heart health, healthy active aging, nutrition, diabetes prevention, mental health, primary care nursing and nurse practitioners, as well as information and education sessions.

Sharer noted the team also plays a significant role in various other health-care related initiatives in the area, including Hospice Huntsville’s palliative care residence and the region’s newly established health hubs.

“We have helped over the years a large number of people in our town, who are very thankful for the care they get everyday from our team and, of course, from our physicians, too,” she said. “I’m very proud of the work we have done.”

Dr. Melanie Mar, lead physician for the team, said in a submitted statement that the family health team was tasked with developing interdisciplinary primary care services to meet the needs of residents when first established.

“I am very honoured to be a part of a team that puts 100 per cent and more into providing our patients with excellent, comprehensive and compassionate care in our offices and in the community,” said Mar.

Gayle Mackay, former executive director, added she has a soft spot in her heart for the work team staff has done.

“I am delighted that the ministry is now seeing that primary care is the place to be,” said Mackay. “I think you are going to have a wonderful future ahead.”

Click here to access the article on Huntsville Forester website.