On May 31st, over 140 health stakeholders, including physicians, nurse practitioners, nurses, pharmacists, patient advocates, physician assistants, health-care administrators, and other allied health professionals gathered at the Primary Care Summit, to learn about the patient medical home (PMH) model of care and outline actionable steps to move New Brunswick toward a more organized, efficient and sustainable patient-centred health-care system.
A Patient Medical Home is a setting where people can access a range of primary health-care services, providing a sense of community belonging. It includes a variety of health professionals who bring different competencies, skills, and experiences to meet the diverse needs of patients. The PMH model offers flexibility, reduces administrative burdens for health-care professionals, provides autonomy for practitioners, and fosters increased collaboration and growth. Its ultimate aim is to provide patient-centered care, ensuring patients have quick and easy access to the right health service at the right time.
The Summit opened with a panel discussion ‘what is a patient medical home’ (PMH) model. Health leaders from the College of Family Physicians of Canada, Horizon Health Network, Vitalité Health network, Department of Health, and the New Brunswick Medical Society provided context on current team-based care models operating in the province.
Following the panel, representatives from Nova Scotia and Prince Edward Island presented the models they have adapted. While these provinces have made significant strides in adopting the PMH model, New Brunswick has been slower to adapt and still has a high number of solo practitioners. To date, New Brunswick has not established a comprehensive team-based primary care network, but progress is being made.
New Brunswick has seen success with several initiatives under the leadership of the following organizations:
- Horizon Health Network: established 46 community health centers with 400 full-time equivalents (FTEs) providing care to 100,000 New Brunswickers. This initiative uses a “covered bridge” approach, immediately improving existing services while building for the future.
- Vitalité Health Network: provides integrated service networks in 13 communities, involving 153 physicians and seven nurse practitioners. These collaborative practices offer a full suite of services, focusing on improving access and managing complex needs.
- Family Medicine New Brunswick (FMNB): launched in 2015, this collaborative model focuses on timely access to care. FMNB 2.0, launched in 2023, includes 11 groups with 61 physicians serving 58,000 patients, and has improved support provisions and stipends for hiring additional staff.
- NB Health Link: developed in collaboration with the Department of Health in 2022 as a temporary home for unattached patients, it currently serves 90,000 patients, providing patient-centric, ongoing health care supported by a centralized health record.
The morning presentations set the context for current state and as one participant noted “overall great presentations and great engagement from NB stakeholders and others from PEI/NS. Hoping this is a great start for change!” All presentations can be viewed here.
The afternoon focused on breakout discussions where the attendees discussed what a patient medical home model could look like in an RHA-led, community-led, and clinical-led setting, and what these models would need to integrate i.e. administration and funding, infrastructure, connected care, accessible care and team-based care with physician clinical leadership.
Team-based care offers numerous benefits for both clinicians and patients. For clinicians, it promotes a better work-life balance, fosters opportunities for collaboration, and provides a supportive environment that enhances professional growth. For patients, it ensures improved access to care, more comprehensive health services, and a continuity of care that is vital for managing chronic conditions and overall health maintenance.
The overwhelming response from health professionals indicates a strong preference for working in team-based practices, especially among new graduates entering the system.
Following the Summit, a report and draft framework will be presented to the stakeholder for their input. While this framework is intended to establish an approach to team-based primary care in alignment with the Patient’s Medical Home (PMH) model developed by the College of Family Physicians of Canada, it’s also a distinctly New Brunswick approach that accounts for our province’s unique challenges and opportunities.
The framework is the continuance of a conversation to create access to team-based primary health care throughout New Brunswick. This plan will evolve over time as we receive additional feedback from health-care and community partners. Over the coming months, the Department of Health and the New Brunswick Medical Society will engage in further conversations with key stakeholders, including community leaders, regional service commissions and hospital foundations, among others. “This Summit is the culmination of all our collective efforts over the past several months to improve and transform primary care. Our patients and our colleagues deserve it”, said Dr. Paula Keating, president, NBMS.
Nora Lacey, Chief of Physician & Patient Engagement
