“On the Margins and Not the Mainstream": Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC) to better meet the needs of the population. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select "appropiate" cases to study. In this commentary, this study reflect the difficulty in identifying "successful" models to study, the value of drawing on clinical and organisational networks and experts, and the association between policy context and ease of case selection. Such insights have important implications for case study methodology in health services and policy research. 

Operationalizing mHealth to improve patient care: a qualitative implementation science evaluation of the WelTel texting intervention in Canada and Kenya

Mobile health (mHealth) applications have proliferated across the  globe with much enthusiasm, although few have reached scale and shown public health impact. In this study, they explored how different contextual factors influenced the implementation, effectiveness and potential for scale-up of welTel, an easy-to-use and evidence-based mHealth intervention. WelTel uses two-way SMS communication to improve patient adherence to medication and engagement in care, and has been developed and tested in Canada and Kenya. 

Designing a framework for primary health care research in Canada: a scoping literature review

Despite significant investments to improve primary health care (PHC) delivery in Canada, provincial health care systems remain fragmented and uncoordinated. Canada’s commitment to strengthening PHC should be driven by robust research and evaluation that reflects our health policy priorities and responds to the needs of the population. One challenge facing health services researchers is developing and sustaining meaningful research priorities and agendas in an overburdened, complex health care system with limited capacity for PHC research and support for clinician researchers.

Impact of health care reform on enrolment of immigrants in primary care in Ontario, Canada

Health is driven by the conditions in which people live and work. Immigrant populations face many challenges and disruptions in living conditions during their settlement process, including the loss of regular health services. Establishing a direct relationship with a family physician is an important aspect of the settlement process for immigrant populations

In 2003, Ontario introduced a patient enrolment system as part of health care reforms, aimed at enhancing primary health care services, but it is unclear whether immigrants have benefited from this health care reform. Therefore, this article studied whether this reform changed the extent of immigrants’ enrolment in primary care services in Ontario between 2003 and 2012.

What is Important to Older People with Multimorbidity and Their Caregivers? Identifying Attributes of Person Centered Care from the User Perspective

Health systems are striving to design and deliver care that is ‘person centered’—aligned with the needs and preferences of those receiving it; however, it is unclear what older people and their caregivers value in their care. This paper captures attributes of care that are important to older people and their caregivers.

Patients’ perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study

Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients’ perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population.

The Generation of Integration: The Early Experience of Implementing Bundled Care in Ontario, Canada

By bundling services and encouraging interprofessional and interorganizational collaboration, integrated health care models counter fragmented health care delivery and rising system costs.
While research has been conducted on the facilitators and challenges of integration, there is less known about how integration is generated. This article explores the generation of integration through the dynamic interplay of contexts and mechanisms and of structures and subjects.

Developing family medicine and primary care worldwide through global collaboration and co-learning

The COVID-19 pandemic represents one of the rare health emergencies that all humans on our planet have experienced simultaneously.   Global news feeds provide us with near instantaneous updates regarding case numbers and disease impacts that not only affect our immediate community, but also other communities and contexts worldwide.  In this sense, COVID-19 has truly highlighted our experience as global citizens.

Primary care (in its various global iterations, such as family medicine and general practice) is increasingly recognized as a keystone for improving health outcomes worldwide.  Most certainly, we are beginning to see the converse impact that the pandemic has had on the practice of primary care.  Earlier this year the Canadian Family Physician blog highlighted this experience through a podcast series developed by Dr. Christine Gibson with the support of the Besrour Centre for Global Family Medicine.  Representing family physicians and primary care educators from 11 countries, these podcast narratives ...

Co-designing an Integrated Care Network With People Living With Parkinson's Disease: From Patients' Narratives to Trajectory Analysis

An integrated care model for people living with Parkinson's disease (PD) offers the promise of meeting complex care needs in a person-centered way that addresses fragmentation and improves quality of life. The purpose of our research was to co-design a care delivery model that supports both social and medical care from the perspective of patients and care partners. In the first step of our co-design approach, participants from five countries were invited to share their experiences of living with PD during a narrative interview. A qualitative analysis of these narrative interviews based on the Corbin and Strauss model was done to map out patients' trajectories. Three typical trajectories were identified: (a) the "unpredictable" trajectory, (b) the "situated" trajectory, and (c) the "demanding" trajectory. Based on the analysis of these trajectories, we were able to integrate various patient experiences into the design of an integrated care network.

Case study of an integrated health and social care initiative for geriatric patients in rural Alberta

Rural regions in Canada are aging faster than urban centers, but access to health and social care is limited. Integrated health and social care (IHSC) through collaboration across different health and social care organizations can support enhanced care for older adults living in rural regions. However, IHSC is not well understood within a rural Canadian context.