Broken Pencil: Amidst overdose crisis, survival is an art

DECLAN KEOGH  

Amidst overdose crisis, survival is an art

WRITTEN BY DECLAN KEOGH • PHOTOGRAPHY BY DECLAN KEOGH AND JEFF BIERK

A few years ago, Les William Harper did what most people have done at one time or another: he sought his mother’s opinion.

The 46-year-old Cree harm reduction worker and artist, who works at a safe-injection site in Toronto, wanted to know how she thought the overdose crisis would end and what he could do to help it along.

Elder Pauline Shirt is a survivor of Canada’s residential schools for Indigenous children. She was forced to spend years away from her family, suffering abuse under a system many, including the Truth and Reconciliation Commission of Canada, call genocide.

“That was her world she was living in,” Harper says. “She never knew if it was ever going to end.”

But it did end, eventually, and she was finally able to leave and carry on with her life. She ended up in Toronto where, in 1976, she and her then-husband Vernon Harper opened Kapapamahchakwew, or the Wandering Spirit Survival School, the first Indigenous day school in Canada.

Shirt told her son to be steadfast in his commitment to the work, and to his heritage. Canada tried to erase her culture but, she said, Indigenous teachings and practices were precisely the things that kept her alive.

“It just showed that it’s not going to stay like this. If we keep on fighting and doing what we need to do, we will find that answer,” Harper says.

Today, his mother’s advice — to honour and practice cultural traditions — grounds Harper’s work as a harm reduction worker in drug user communities, as well as in his artistic practice, painting murals. Harper works with community members to paint murals around Toronto, 10 so far. He says it’s important to bring people in to create art together, whether they’re from community centres, housing co-ops, or safe injection sites. He says it allows each individual to express themselves in a shared social context.

“I’ve always believed in art,” he says. “I want to take everyone else for the ride too.”

Crisis wears on

As Canada remains in the deadly grip of an unprecedented overdose crisis, some are turning to art to raise awareness, cope with grief and trauma, or to bring power to the community. The slow drip of solutions from health and government officials have already forced those on the front line to take things into their own hands. In Toronto, illegal safe-consumption sites started popping up in 2017, eventually forcing the provincial government to fund and sanction many across Ontario.

Despite incremental progress, people are still dying at an increasing rate. There were 4,460 opioid-related overdose deaths last year, up from 3,017 in 2016 — nearly a 33 percent increase — according to the Public Health Agency of Canada. The statistics paint a grim picture: more than 11,500 Canadians died of an apparent opioid-related overdose between January 2016 and December 2018. Fentanyl or a fentanyl analogue were involved in nearly three-quarters of the deaths.

Harm reduction workers have been saying something has to give.

The two worlds, harm reduction and art, have long overlapped. But as the crisis wears on, art is emerging as its own form of harm reduction — from an individual level to a broader political response. For Harper, the connection is personal. He’s been working in harm reduction for over a decade and has a deep connection with the community.

“There are people that I’ve grown up with that come into these sites,” Harper says. “I have relatives that come into these sites.”

‘I work in my community;
my community is me’

Les Harper touches up Two Worlds, a community mural project at The Bickford Centre in Toronto. The centre of the piece is an outline of a syringe, swaddled in purple. This colour represents the deadly opioid fentanyl. Photo by Declan Keogh.

Les Harper touches up Two Worlds, a community mural project honouring Indigenous women’s role in the overdose crisis. The centre of the piece is an outline of a syringe, swaddled in purple. This colour represents the deadly opioid fentanyl. Photo by Declan Keogh.

Wandering Spirit, which continues to operate in Toronto’s east end, is where Harper’s artistic interest blossomed. Woodland Art, originally brought to Canadian consciousness by esteemed Ojibwe artist Norval Morrisseau, remains his favourite.

Harper has adapted the Woodland style for his mural projects, an approach to painting characterized by rich, vibrant colours portraying symbolism and spirituality drawn from Anishnaabe and other Indigenous traditions.

It’s a natural fit. Woodland Style juxtaposes immemorial customs with a contemporary form; Harper, steeped in Indigenous teachings, uses them to guide his work amidst the concrete and steel of Toronto. Like his mom, he fights for life where there is death.

“My work, my passions and my personal life all connect together,” he says. “I work in my community; my community is me.”

A mural project at the Bickford Centre, in Toronto’s Koreatown, holds special significance to Harper. Two Worlds is a 20-foot-long homage to both the overdose crisis and murdered and missing Indigenous women and girls. The idea came to him during a fasting ceremony, where he prayed for guidance on how to get his message to the world.

It’s the only mural in Ontario that looks at the overdose crisis from an Indigenous perspective.

The piece depicts two faceless women in traditional pink dresses, framed by richly coloured flowers, strawberries, and a bird on a bright yellow background. In the centre is a syringe wrapped in purple. He chose purple to represent fentanyl and its role in the overdose crisis. The women represent strength and resilience.

“[Women are] why our culture is still here,” Harper says.

Harper, one of only a handful of Indigenous harm reduction workers on the front line of the overdose crisis, hopes his art will help foster dialogue between those inside and outside his community.

“People will walk by that mural and they’ll see that syringe and that Indigenous artwork and they’ll be a part of that now,” he says.

Nearly one million Canadians reported using illegal drugs in 2017, according to Statistics Canada — not including then-restricted marijuana. Yet, drug users are often imagined as a monolith. Harper hopes community art can disrupt commonly held stereotypes.

“When people first see people or think of people that are using drugs, they see them as one person,” he says. “They see them as a drug user, not as a person that’s an artist or … writer.”

“My work, my passions and my personal life all connect together,” says Les Harper, left. The harm reduction worker collaborates with community members like Bradley Nolan, pictured, on public art projects. Nolan says art helps distract them from thinking too much about loved ones who have died as a result of opioid overdose. Photo by Declan Keogh

Bradley Nolan, an Ojibwe service user originally from Garden River First Nation, helped Harper paint Two Worlds. Like Harper, 31-year-old Nolan has lost a lot to fentanyl: their brother, partner, and best friend.

“[Art] gets me out of the frame of mind of thinking about loved ones who have passed away from opiates,” says Nolan. They get a good feeling when they see the mural, because they know they contributed to something that stands out in the community.

“Somebody can make a piece of art and it can mean the world to them,” Nolan says. “A powerful piece of art makes people think.”

Honouring the lives of loved ones while they’re still living is an important part of Indigenous culture, Harper says, which is why the mural at the Bickford Centre is so meaningful to him.

“No matter what is happening in Indigenous culture and our lives, we’re still going on forward,” he says.

Grief and the canvas

On Jan. 7, 2019, Kira Hamilton cried throughout the night for no apparent

reason. “I didn’t have anything to cry about but I just knew something was wrong,” she says.

The next day, Hamilton, 38, went in to work at Sistering, an agency supporting at-risk women, where she does harm reduction and housing support.

I had a rough night, she thought. But I’m at work with my people. But people were staring at her, and no one said a word to her as she made her way to her office. What the hell is going on here, she asked herself.

Then she received the call. “You need to sit down,” the coworker said. “Crystal died. They found her last night. I’m so sorry.”

Crystal Papineau was found dead in a clothing donation bin. The 35-year-old’s death became front page news for months, as advocates demanded better housing and support for street-involved people — even sparking a public consultation in Toronto on the safety of donation bins.

Papineau was Hamilton’s closest client at work. “Every day … when she went off to use, or I would go home from work, she’d say ‘I love you.’” Hamilton recalls. “And, I said, ‘I love you back.’ Because she needed to hear that from somebody.”

“When you work that closely with somebody, they kind of become your family,” she says. “I cried, but I knew she wasn’t in pain anymore.”

Hamilton echoes what many in the harm reduction community describe: an impossibly complex relationship with their clients. One where the duty of care intermingles with human nature, emotion and camaraderie.

Eight more of Hamilton’s clients have died this year, many of them as a result of overdoses. When Broken Pencil reached out to Hamilton for this article, she was attending a funeral for a client. As a multi-disciplinary artist who studied fine arts at Georgian College, she feels somehow duty bound to use her paintbrush to eulogize Papineau. She envisions a darkly baroque and realistic image of a skeleton floating through the air, thick and textured like red velvet. In the skeleton’s stomach is a bright red balloon, representing “the person she was when she was alive, [and which] will keep her alive in my mind,” she says.

But when she sits down in front of her easel, Hamilton can’t bring herself to do what she had done hundreds of times: press the bristles into the paint, and gently apply it to the canvas.

Hamilton says she feels stuck, badly wanting use art to cope with the trauma of her work but, ultimately, being unable to do so. She likens it to the feeling she gets at work: spending every day trying to keep her clients alive, while faced with stagnating political action, funding cuts, and increasingly dangerous drug supplies.

Hamilton talks with a lot of her clients about art; what they’re working on, and her paintings that hang in her office. She’s planning to start an art group at work for some of her clients.

“It’s healing without realizing it, because when you’re putting the paint on the can- vas, you’re not thinking about the stuff that we have to deal with.”

Truth to power

Jimmy, pictured, often appears in the photography of Jeff Bierk. The Toronto artist has become a default documentarian for communities directly hit by the terrifying surge in overdose deaths. Photo courtesy of Jeff Bierk

The first time Jeff Bierk tried to get sober was after his mom died while he was in his early 20s. Shortly after, his partner at the time was in and out of the hospital.

“I felt new to the world because I was clean,” says Bierk, a Toronto-based photographer. “I had no idea who I was, I had not processed or even dealt with all the grief of both my parents dying at a young age.”

He needed a way to grieve without using drugs again. So Bierk, now 38, started to take pictures of hospital curtains between 2009 and 2010. The photos were mounted as an exhibit called Curtain at a gallery in Brantford earlier this year.

A decade after he took them, he says he’s happy to show the photos with the privilege of reflection. “I was able to re-contextualize it with all the time in between. All these ways I’ve been able to heal outside of an art practice,” Bierk says. “At the root of it was talking about my experience with death and addiction.”

Bierk is best known for his honest photos of people he knows. Many of these friends come from far-flung places but wound up in Toronto. Many struggle with housing or health; many are drug users. The images candidly depict life on the streets, a world many never experience. It’s easy for people to project assumptions onto the photos. When people see a picture of Jimmy, one of Bierk’s best friends who frequently appears in his work, they see a tough man, covered in blown-out DIY tattoos. They see salt-and-pepper hair and deep lines on his face that come with years of alcohol consumption and cold winters. It’s easy to simply read Jimmy as a drug addict or a homeless person. An undesirable.

Bierk sees beauty; he sees his friend.

“Jimmy is an example of how to be. He’s the example to me of all these beautiful things that I don’t see in a lot of other people,” Bierk says. “It’s just this freedom.”

Bierk emphasizes that the people who appear in his images are his friends and his collaborators, disavowing the term “subject.” Bierk is seen in the self-portrait Me and Jimmy in an intimate, stylized embrace with his most frequent collaborator. Photo courtesy of Jeff Bierk.

Bierk has worked hard to get away from the traditional way photographers interact with their subjects. Jimmy is not Bierk’s subject; they are collaborators, and they split any profits. Often, Jimmy will come to an exhibit of Bierk’s work and visitors will get to meet and talk with him.

The shows “offer the potential for people to see Jimmy in the fullness of who he is … the art is a conduit for this kind of connection,” Bierk says.

In late February, Bierk took part in an open panel discussion on addiction and homelessness as part of Curtain’s run in Brantford, a city that’s been hit hard by the overdose crisis.

Between July 2017 and June 2018, Brantford and the surrounding area had one of the highest rates of overdose deaths in Ontario. Mayor Kevin Davis and other local politicians listened from the crowd as Bierk used his time on the panel to call for the city to open a safe injection site. “I remember that feeling where I was like, ‘Oh, fuck. I actually have to speak the truth to the power in this situation,’” he says.

“I spoke about my experience in a really vulnerable way,” he says, telling the crowd he was lucky and privileged — he got out of jail and was able to do a detox program where many don’t have that opportunity.

Not long after the talk, a Brantford friend messaged him with news: Brantford was going ahead with a study on opening a safe-consumption site in the city.

“It’s not that [the announcement] directly happened because of me or the art, but the art and my experience was this conduit to potentially shift the consciousness of people in the audience,” Bierk says.

Councillor Joshua Wall, whose constituency includes downtown Brantford, also attended the talk. He says the talk was one of many factors that lead the health unit to explore a safe-consumption site.

“It absolutely impacted me,” he says. “Art has the ability to inspire and elicit such strong emotions.”

“It’s unbelievably important to speak with people who have been there, who have been through turmoil and who can speak firsthand on how they’ve overcome,” Wall says. “There are so many people involved with [drug use] who haven’t been through it. There’s merit in listening to somebody who’s actually been there.”

Still, Bierk says he remains skeptical about art’s potential to foster societal change. He notes that the art world can be inaccessible. But, towards the end of our long conversation, he seems more open to the idea that the work he’s doing is creating dialogue and making people happy — even if it begins as a something for him and his friends.

‘This is the Indian that saved us’

Les Harper’s favourite colour is pink — It always has been. He says it stems from the old saying that when the evening sky is pink, the next day will be better.

He moves with an ingrained, deeply held optimism in the face of an acute crisis. Just as his mother and her generation survived, so too will he and his.

“People go through so many hardships,” he says. “Hopefully tomorrow will come and it’ll be a beautiful day.”

Harper often quotes John Trudell, a Native American activist, author and poet from Omaha, Neb., who discussed the “Drunken Indian” stereotype.

“Without them [the Drunken Indian], we wouldn’t be here today,” Trudell said in a previous interview. He said that, after centuries of forced assimilation, genocide, and oppression, there were generations that simply had to survive, by any means necessary.

“This is the Indian that saved us, because this is the Indian that said, ‘I can’t be who I am and I’m not going to be who you tell me to be, so I’ll just be nothing” he said. “I’ll be something else. I’ll just do my time and get through it. I’ll erase the pain and get through it. But I will not become you.”

Harper applies this framing to the over- dose crisis and the drug war. “We, as Indigenous people in our activism, have a great debt that we owe to the Drunken Indian because they survived,” Harper says. “We thought that one day we would be annihilated … And we weren’t.”

Harper sees parallels in the drug user community, where people remain vibrant and resilient despite terrible odds. “In this crisis that’s going on, people right now are still being the wonderful, beautiful people that they are.”

Many people in Harper’s community have died.

There is deep heartache.

But, each night, he sees pink — even in the middle of a storm.

East Toronto Health Partners (ETHP) submit full application to become an Ontario Health Team for East Toronto

October 9, 2019

Hon. Christine Elliott
Ontario Deputy Premier and Minister of Health
Hon. Merrilee Fullerton
Ontario Minister of Long-Term Care
College Park, 5th Fl.,
777 Bay St, Toronto
ON M7A 2J3

RE: Ontario Health Team Submission from the East Toronto Health Partners

Dear Ministers Elliott and Fullerton;

In partnership with those who receive care and those who provide care in East Toronto, the East Toronto Health Partners (ETHP) are pleased to submit our full application to become one of Ontario’s first Health Teams. In your call for applications, you invited us to be bold in our thinking, and we have taken this to heart. We also recognize that with the changes envisioned
for health care in Ontario, there are both opportunities and inherent risks. We want you to know that we are fully committed to building a bolder, brighter future for the delivery of health and social care for our local communities, and we look forward to the support of your Ministry to help us transform our systems of care.

Our vision is to work with our community to co-design ‘A System without Discharges’: A seamless continuum of care focused on population health, with programs tailored to our 21 local neighbourhoods and communities. We have grounded our vision in the Quadruple Aim, with goals to improve quality of care and the experience of our patients and caregivers, enhance health and wellness for clinicians and other front-line providers, improve overall population health, and increase the value of investments in health and social care.

About Our Population
Collectively, we serve the approximately 300,000 children, adults and seniors who live in the multiple communities that comprise East Toronto. Our boundaries span from the Don River to the West, to Warden in the East, and from South of Eglinton Ave to Lake Ontario; and include priority neighbourhoods such as Thorncliffe Park and Flemingdon Park. We also serve Ontarians across the Greater Toronto Area and beyond for a total attributed population of 375,000. When our Ontario Health Team reaches maturity, we will have a full population health and integrated care model that supports our entire population; however, in Year 1 we will focus on integrating care for the following three populations:

1. Seniors with chronic care needs and caregivers: East Toronto has a significant population of seniors (53,712) and heavy burden of chronic illnesses including Chronic Obstructive Pulmonary Disease (3,937 people) and Congestive Heart Failure (2,734 people). Seniors with chronic care needs experience high levels of hospital admissions, and long lengths of stay, contributing to hallway medicine pressures. We selected this population because of the risk factors within the East Toronto seniors’ population with chronic care needs, including high rates of caregiver distress (up to 47% in some of our communities). The redesign of care for this population will build on what we’ve heard from patients, families, caregivers, and health care providers about the current challenges they face with fragmented services and poor transitions of care.

2. Youth Mental Health and Wellness: As rates for mental health issues in youth are rising across Toronto and Ontario, some neighbourhoods in our region such as Taylor Massey have three times higher Emergency Department (ED) use for youth mental health than the Toronto average. East Toronto has approximately 7,977 youth living with mental health conditions. Our initial work with youth in East Toronto has identified several opportunities for us to co-design improved access to care and better support youth mental health and well-being.

3. Substance Use and Health: East Toronto providers serve significant numbers of people with issues of substance use. The Canadian Institute for Health Information identified 7,288 people in our attributed population with diagnosed Drug/Alcohol Dependency; often these individuals are disconnected from basic primary care, have significant issues related to the social determinants of health, and have high rates of emergency room use and hospital admission. We have identified opportunities with patients and providers to coordinate harm reduction, treatment, and crisis supports to improve health for this population.

Our work with our priority populations will be grounded in a neighbourhood approach; starting with the five “Neighbourhood Improvement Areas” as defined by the City of Toronto. This neighbourhood-based approach is intended to help us address some of the priority equity considerations facing our population; a high proportion of newcomers and immigrants, patients who are uninsured, individuals and families with lower incomes, and engagement of Indigenous and Francophone populations. Of our total attributed population of 375,000, the 178 family practice physicians who have joined the new East Toronto Family Practice Network (EasT-FPN) care for approximately 200,000 patients. In addition, the priority populations for Year 1 aggregate to roughly 69,000 people.

Through our members and the scope of services we provide, ETHP will provide actively coordinated care for roughly 20% of the total Year 1 population: a total of 13,800 individuals. In addition, the 200,000 residents who access primary care through family physicians who are part of EasT-FPN will have access to integrated care through our SCOPE program, interprofessional care teams, fall/winter community surge investments and other existing programs in East Toronto.

About Our Team and How We Will Work Together
The ETHP are building on a 25-year history of collaboration to improve the health of our local population through collaborations such as Partners for Health and the Solutions Network. In late 2017, the CEOs of five organizations that represent the continuum of healthcare came together to form the foundation for an integrated care network (ETHP). Over the past two years, the ETHP has been working with patients, families, community representatives and a range of partner organizations towards this goal.

In October 2019, the ETHP welcomed our newest Anchor Partner, the East Toronto Family Practice Network (EasT-FPN) which was created to be the representative voice of the over 260 family physicians in East Toronto. EasT-FPN has established an Interim Board of Directors, Interim Executive and a Memorandum of Understanding for engaging with family physicians. Over the next few weeks, EasT-FPN is hosting a series of engagement sessions for family physicians to learn about the work of the ETHP and encourage physicians to participate in the design and development of our Ontario Health Team. To date, 178 family physicians have joined the EasT-FPN, who care for approximately 200,000 patients as part of the ETHP.

The ETHP is governed through an Anchor Partner model, with each member of our anchor organizations representing a different care sector. Our starting point for governance has been a ‘network of networks’ model which has enabled a small group of trusted partners, which represent the full continuum of care, to facilitate change and improve care through a streamlined decision-making process. The current members of the East Toronto Health Partners are:

  • Patients, Families and Caregivers** East Toronto Family Practice Network – EasT-FPN
  • Michael Garron Hospital (Toronto East Health Network)
  • Providence Healthcare (Unity Health Toronto)
  • South Riverdale Community Health Centre (on behalf of East Toronto CHCs)
  • VHA Home HealthCare (liaison to home care providers)
  • WoodGreen Community Services (representing home and community care, community mental health, addictions and developmental services, community support services and housing)

The organizational members above will be formal signatories to the Joint Venture agreement and to the eventual accountability agreement with the Ministry of Health. Our Joint Venture agreement, which will be signed by the Anchor Partners in October 2019, outlines our shared principles, how we will work together, and how our partnership will evolve over time.
In addition, the ETHP network of providers includes two other levels of partnership:

  • Engaged Partners, actively involved in the planning and delivery of specific initiatives; and,
  • Supporting Partners, who remain informed and involved, but may not be active in planning or delivery.

A letter of support from our partners is included in the supplemental information of our application. Together, all of our partners deliver the full range of services needed to support our Year 1 populations.

**Over the last 6 months, the ETHP has hosted a number of community engagement sessions to involve patients, caregivers and providers in helping us co-design the future of care for our priority populations. To help guide our ongoing work, a Patient and Caregiver Engagement Planning Team consisting of advisors from existing Patient and Family Advisory Committees from several East Toronto organizations was established to advise on different approaches to patient, family, caregiver and community engagement for the ETHP. Our Patient and Caregiver Engagement Planning Team is assisting us with next steps in this work, including a process to identify ongoing membership at the Governance level to ensure patient and caregiver involvement in strategy, priority setting and decision making.

We will continue to work with all our communities as we redesign the future of care in East Toronto. To support this work, the ETHP has developed a Community Engagement Framework; a best practice guideline for current and future engagement activities within the OHT planning context. Patients, community members and providers were engaged in a joint working group with representation from the East and Downtown East OHTs to develop this framework.

How We Will Transform Care
The ETHP see significant opportunities to improve care for our population and health system performance as we create an integrated health system. Our shared vision is centred on creating ‘a system without discharges’; one connected system of health care and support for all residents in East Toronto. Our most important improvement opportunities are fully aligned to this shared vision:

1) Create a one-team approach with patients, caregivers and providers: This includes engaging with care recipients to design care transformations that meet their needs, supporting all our staff to work to their full scope, and building stronger networks between providers who deliver similar and complementary services. For our Year 1 focus, we will expand our existing integrated, interprofessional team-based care models and simplify access to community support services. For our youth and adults with mental health needs, our focus will be on building skills, relationships and trust, to support them with their goals.

2) Coordinated Care tailored to Local Neighbourhoods; scaling up our early successes: This includes evaluating and expanding our existing integrated care initiatives and shifting more care from hospital to community. We will co-design tailored solutions for our 21 neighbourhoods to address their distinctive needs, ranging from designated improvement areas to higher income communities. For our Year 1 focus, we are targeting improvements to three Neighbourhood Improvement Areas; Thorncliffe Park, Taylor-Massey and Oakridge. We will also expand our Home 2Day program to support a broader range of patients with cardiac and respiratory conditions, increase our community investments during the flu season, and expand our interprofessional care team models to other neighbourhoods in partnership with our primary care partners.

3) Support the Success of our New Primary Care Network – The ETHP is very excited to welcome our newest Anchor Partner, the East Toronto Family Practice Network (EasT-FPN). Full engagement of primary care at every level of the ETHP is critical to the success of an integrated model of care in East Toronto. Together, the ETHP will develop multiple ways to engage and connect with local family physicians so they can continue to be an integral part of the design and evolution of integrated care. The ETHP are also working on a financial plan as part of our shared commitment to develop and sustain our partnership.

4) Streamline Access and Navigation, enabled by Digital and Virtual Care: This includes providing easier access to information and access to services, reducing the burden of chronic disease, and improving coordination of care to support patients and their caregivers. For our Year 1 focus, we will: finalize our asset maps of services that support our Year 1 populations; create digital navigation tools for local services such as Youth mental health and wellness programs; and, establish patient navigators to support seniors with chronic disease and caregivers with health system navigation, service planning, care plan accountability, and one touchpoint for hospital to community transitions. For individuals who access the Emergency Department related to substance use we will coordinate access to community services based on similar models implemented at peer hospitals.

5) Improve population health and health equity: This includes reducing gaps in care and improving coordination of services for vulnerable, marginalized and under-served populations. For our Year 1 focus, we are targeting improvements for seniors living in Toronto Community Housing buildings, youth with mental health concerns, and adults with substance use issues.
Our overall vision for care redesign is centred on creating integrated, community-based health and social care teams across our 21 neighbourhoods that will support 24/7 access, and link to acute care, specialty care and other regional services as depicted in the graphic below.

Unlike our current siloed health care system, through our neighbourhood-based model of integrated care, people will experience one local system that provides simple access to health services and social supports, navigation and care coordination, inter-professional/ interorganizational teams, and streamlined communication of health and social care providers. This model focuses on simplifying the system for patients and frontline staff, maximizing current system investments and enhancing efficiency and effectiveness. Key enablers of this model of care are:

  • A simplified model for care transitions, with established care pathways that support patients to move easily from hospital to home;
  • Integrated, neighbourhood-based care teams, that align interprofessional teams from home care and community support services with primary care;
  • Care Coordinator/Navigators aligned to neighbourhoods / specific geographies using existing staffing resources from organizations that currently provide these services;
  • Access to regional supports including, but not limited to; acute care, specialty care, 24/7 call centre support services for patients and caregivers, virtual care and remote monitoring; and,
  • Digital communications and integrated information systems to support care teams, patients and caregivers with real-time access to patient health information and care plans that address the full social determinants of health.

Digital Health

The ETHP Digital Health Team has created a vision and a strategy for advancing virtual care, access to health information, information sharing, and quality improvement. Our overarching goals for the ETHP Digital Strategy are:

1. Achieving Digital Connectivity – to allow for the exchange of information and open communication that is fundamental to an integrated system of care

2.Digital-First Customer Service – to prioritize solutions that support health equity, positive experiences and flexible virtual care options

3. Fostering an Intelligent Learning System – to optimize our use of population health and care data, advance predictive capabilities, provide centralized supports and enable innovation

Specific solutions included in our Digital Strategy include expanding the use of the MyChart application across our partners, testing a patient-oriented portal, leveraging existing app-based technology to facilitate 24/7 access to support for patients and caregivers, expanding use of virtual visits, and enabling secure messaging between providers (and eventually patients and caregivers). The ETHP are in the process of developing a data-sharing agreement as well as common policies for privacy, security, cyber-security and data governance.

The Province’s policy shift to the Ontario Health Team model has provided a substantial opportunity for East Toronto to spread and scale the work we have already started, as well as creating new platforms for change and innovation across all our provider partners. In our application we have identified specific actions the provincial government can take to help us accelerate our efforts (including addressing policy barriers, providing resources and funding support in specific areas, and supporting provincial digital solutions), which we would be pleased to discuss further. We are excited to submit our full application and are confident that we are ready to be one of the province’s first Ontario Health Teams.

Sincerely,

Anne Babcock
President and CEO, WoodGreen Community Services
On behalf of the East Toronto Health Partners

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Dr. Rueben Devlin, Special Advisor and Chair of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine
Helen Angus, Deputy Minister, Ministry of Health
Marie-Lison Fougère, Deputy Minister, Long-Term Care
East Toronto Health Partners

The Full Application for ETHP to become an OHT can be read here.