Abstract
Overview: The Burlington Ontario Health Team (BOHT) is a consortium of health care provider organizations responsible for health system planning for a population of ~230,000 residents in the Burlington area of Ontario (Canada). Since its inception in 2019, the governance structure of the BOHT has evolved from a loose network of providers working together on common health system goals to a formal legal entity incorporated by ten health and social/community system, and local government partners. This has been achieved despite the fact that the BOHT has no formal authority to compel participation amongst its health system providers. Our oral paper aligns with International Conference on Integrated Care (ICIC24) theme one: Partnerships, Collaborations, and New Alliances, and will seek to offer an innovative perspective on Integrated Care Pillar Six: System-Wide Governance and Leadership.
Context: Canada is a decentralized federation of ten provinces and three territories. While Canada is known for universal health care, Canadian provinces and territories retain responsibility for health care decision-making and the majority of system funding resulting in variation of health care service delivery between different provinces and territories. The health care system in Ontario is currently in a state of flux. In 2019, the Ontario provincial government dismantled existing regional health care networks, and introduced more localized planning bodies entitled Ontario Health Teams (OHTs) with provincial government guidance of creating a fit-for-purpose collaborative decision-making structure.
OHTs have no formal legal / legislative authority nor funding accountability (as yet) to compel participation amongst local health care providers. Despite these limitations, the BOHT has successfully brought together a diverse partnership of health and social system providers to create a new legal incorporated not-for-profit entity that will serve to direct planning from a population-health based approach for the Burlington and area community.
System-Wide Governance and Leadership: The BOHT Journey
Our ICIC24 oral paper will focus on the elements listed below. The intended audience for our oral paper will be: system planners, implementers, and researchers.
i.Influencing without Authority: How the BOHT established trust, leadership, and a shared vision and values amongst providers without formal authority / funding oversight.
ii.Future-Ready Governance: How the BOHT has implemented a governance structure that is built to last, but also nimble and adaptable.
iii.Ongoing Challenges: What ongoing challenges is the BOHT facing, and how have we effectively mitigated against them (e.g., regional silos, data integration, physician participation, unrealistic expectations).
iv.Integrated Care Initiatives: Evolving providers toward integrative thinking and system-level problem solvers through examples of integrated care initiatives successfully enacted or planned under the BOHT governance model.
v.Future Opportunities: Future health system funding integration and its implications for the BOHT governance model.