Abstract
In Ontario, the creation of Primary Care Networks (PCNs) within the larger framework of Ontario Health Teams (OHTs) is central to addressing the primary care physician (PCP) shortage in Canada. PCPs are joining together to form PCNs, in order to implement practical initiatives to address the growing shortage of PCPs and address the administrative burden on PCPs.
The integration of digital solutions, particularly AI-powered scribes, into PCNs within OHTs is a promising strategy to help alleviate the administrative burden on PCPs in Ontario, and is part of broader efforts to support PCPs to remain in practice.
To effectively address the PCP shortage, especially in underserved areas, digital tools like AI scribes must be scalable, thus investments are directed to multi-sectoral partnerships, to implement AI scribe initiatives. This has fueled the development of integrated and robust governance and accountability structures that are necessary to implement digital solutions quickly, effectively, and at scale.
As one of the PCNs in a multi-sectoral partnership for an AI scribe initiative, the East Toronto Family Practice Network (EasT-FPN) played a pivotal role as the lead integration partner- stewarding critical functions to enable system wide governance and leadership, and cross-organizational project planning, implementation, and evaluation.The EasT-FPN established a distributive leadership and multi-sectoral governance and organizational model, made up of strategic, executive and operational leaders from each partner organization. This includes PCN and OHT Executive Leaders; an academic institution; an organization that holds expertise in customizing and implementing digital solutions in family practices; and a medical technology company.Following a rapid plan-do-study-act (PDSA) cycle approach, the EasT-FPN established the formation of: 1) an inter-organizational governance structure, (2) operational structure, and (3) a funder- accountability structure, that is far from a command and control leadership and governance structure. Embedded within each of the 3 structures are clear decision-making processes, two-way communication channels, and clear project roles and responsibilities, to bring the project to full implementation within 6 months.
Far from command and control leadership, the EasT-FPN established a collaborative framework for the project that facilitates shared decision-making; the co-creation of project roles, two-way communication channels; a shared project vision; collective accountability mechanisms; the coordination and sharing of resources and expertise among project partners; and the co-design of the project’s implementation and evaluation strategies.Establishing multi-partner and sectoral governance and leadership structures, for implementing integrated care initiatives is a complex and challenging task. The success of these initiatives relies on aligning diverse stakeholders with varying interests, organizational goals, expertise, responsibilities, and resources. This oral presentation will share key learning points from the EasT-FPN’s journey of developing network governance structures for integrated initiatives, and share insights into challenges and solutions that can help refine governance in integrated care healthcare systems.