Is public health ready to participate in the transformation of the healthcare system?

The healthcare system in Canada is undergoing significant transformation in response to three major interrelated pressures: the overall burden of illness is rising, patients are getting poor quality of care and healthcare costs are inexorably rising. One idea to guide this change is to transform the primary care system into a community-based primary healthcare (CBPH) system. This paper discusses, in particular, the readiness of public health to participate in the transformation to a CBPH system.

Millar J ，Bruce T ，Cheng SM ，Masse R ，McKeown D ... -  《-》

Improving collaboration between public health and primary healthcare.

This paper responds to the ideas set forth by Millar et al. in their exploration of whether public health is ready to participate in the transformation of the healthcare system. In this commentary, the author proposes a number of novel solutions to address these challenges, categorized into four areas: experimenting with joint planning, using innovative ways to share and analyze data, employing joint training and networks and facilitating how primary healthcare engages in health promotion in the local community. The author asserts that, ultimately, no single solution will address the multiple barriers to collaboration, but the implementation of some of these ideas can move Canada forward in this area.

Pinto AD 《-》

Public health readiness and role in transformation to a community-based primary healthcare system.

Millar et al. provide a high-level vision for transforming primary care into a community-based primary healthcare system, arguing that public health involvement is critical to the success of this transformation. The authors discuss a number of approaches to mitigate challenges to public health's readiness to participate. In this commentary, the author addresses selected points encouraging the avoidance of high-level conceptual language, a focus on specific value-added linkages and addressing the complex range of critical success factors needed to effect this transformation.

Moloughney BW 《-》

Public health in health sector reform.

In this edition of Healthcare Papers, Miller et al. make the case for greater engagement of the public health sector in healthcare system reform. Although I agree with many of the points made, I challenge the premise that public health is unwilling and/or unprepared to lead or participate in system change. Ontario's public health sector is not only ready to participate in transformation of the healthcare system, provincial and local involvement is well under way. Public health has been actively engaging colleagues in both the healthcare and non-health sectors to discuss health system evolution and transformation. Make No Little Plans - Ontario's Public Health Sector Strategic Plan sets out the vision, strategic goals and collective areas of focus for the next three to five years, and includes an immediate emphasis on establishing collaborative mechanisms within the sector and with others in the health sector and non-health sectors. As an initial step, public health is identifying and analyzing key intersection points between public health and primary care to enable better alignment and integration. In Ontario, public health is not only participating in health reform, we are in a position to help drive it.

King A 《-》

Reorienting the healthcare system: population and public health need to step forward.

It is suggested by Millar et al. that many public health leaders across Canada have been somewhat reticent to fully engage in health system transformation initiatives, including those in primary care, despite their support of the concept of collaboration. Public health leaders and staff should bring their unique population health perspective to these initiatives by applying health promotion strategies, which include methods to "reorient the health system" to better apply this perspective across the spectrum of health services and work in partnership with other sectors to support the needs of individuals and communities to lead a healthier life. Healthcare transformation efforts across the country would benefit from a more balanced approach between the Triple Aim goals: containing costs, enhancing the patient experience and improving population health.

Neudorf C 《-》