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Onil Bhattacharyya, MD, PhD Frigon Blau Chair in Family Medicine Research

Overview. Onil Bhattacharyya, MD, PhD Frigon Blau Chair in Family Medicine Research Women ’ s College Hospital University of Toronto. Acknowledgements. Executive Committee Dr. Vicky Stergiopoulos Dr. Gary Naglie Dr. Onil Bhattacharyya. Dr. Wendy Levinson Dr. Lynn Wilson

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Onil Bhattacharyya, MD, PhD Frigon Blau Chair in Family Medicine Research

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  1. Overview Onil Bhattacharyya, MD, PhD Frigon Blau Chair in Family Medicine Research Women’s College Hospital University of Toronto

  2. Acknowledgements • Executive Committee • Dr. Vicky Stergiopoulos • Dr. Gary Naglie • Dr. Onil Bhattacharyya • Dr. Wendy Levinson • Dr. Lynn Wilson • Dr. Fiona Webster • Dr. Kaveh Shojania Key Partners: Ontario Ministry of Health and Long-Term Care – Health Quality Branch

  3. Schedule 8:15 Overview of BRIDGES Onil Bhattacharyya 9:00 Keynote Ed Wagner 10:00 Integrated Home-based Primary Care Tia Pham 10:20 BREAK 10:40 Coordinated Access to Care from Hospital ED Vicky 11:00 BRIDGES meta-analysis Dr. Fiona Webster 11:30 Lunch and Poster viewing 12:30 Leveraging Lessons Learned Jodeme Goldhar 1:00 Closing Remarks Dr. Wendy Levinson

  4. What is the most important problem in health care?

  5. What is the most difficult problem in health care?

  6. What is the solution?

  7. Objective • Create a platform for development of new models of integrated care for complex patients.

  8. Family Medicine Community Services Incubating Models of Integrated Care Medicine Psychiatry Primary Care Hospital Across Disciplines Across the Continuum

  9. Bridging Different Worlds Health Service Providers Academics Pragmatic Decision-Making Data-Driven Decision-Making Clinical Sciences Basic Sciences HSR Rigorous QI Methodology High Quality Health Services Research Shared Space for Innovation

  10. The BRIDGES Process

  11. 61 proposals, 9 funded • From Barrie to South Lake

  12. Reviewed on • Scientific rigour • System relevance

  13. Study design, data coordination and analysis • Qualitative evaluation • Economic evaluation

  14. Hypothesis Testing Framework

  15. Work with HQO and CAHO • Many potential partners • No firm results yet

  16. Collective Impact System Collaborative Project

  17. The BRIDGES Collaborative

  18. BRIDGES in Brief • 9 projects • 28 lead investigators • 23 Institutions • 2,300+ patients • 30 providers + their patients

  19. Integration Across the Continuum PIC COPD TEAM CATCH ED ICCT IHBPC SCOPE Communication between institutions Joint care delivery Joint management across institutions

  20. Building BRIDGES • Continuous testing and improvement • Co-leadership w/ psychiatry • Characterizing key elements of QI • Building trust and sharing

  21. Impacts • Tested model for incubating pilot projects • Adapted for provincial pilot initiative • Strong collaboration b/w departments and CCAC • All models sustained after funding • Synergy w/ Health Links

  22. Key Deliverables • Increase likelihood of project success in terms of effectiveness and learning • Assess impact of overall initiative and potential of models • Project results by 2015

  23. What have we learned?

  24. It’s Hard • Recruitment • Targeting • Making the intervention work • Management across institution • Outreach to primary care

  25. It’s Easy to get it Wrong Be ready to change • Zoom in/out • User segment pivot • User need pivot • Business architecture pivot • Channel pivot

  26. It’s Worth It • Patients appreciate the comprehensiveness • Providers appreciate being connected • Managers appreciate connection to other institutions • Policymakers like the coherence

  27. There’s Much More to Do • No magic bullets • No clear answers yet • More people are in the game • Growing potential for cumulative learning

  28. Thanks!

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