Nova Scotia Members’ Final Report in English

NovaScotia Priorities Panelon PrimaryCare:

Newperspectivesand possibilitiesforprimarycare inCanada

Areportwrittenby membersofthepublic

Chair’sNote

Morethan250peoplevolunteeredto jointheNovaScotiaPrioritiesPanelon PrimaryCare.Ultimately,34were selectedtoparticipate.Theyjoinedthe processinMayandconcludedthe processinJulyasfriends.Overthe courseofthesethreemonths,they spentcloseto30hourstogether learningaboutthechallengescurrently facingtheprimarycaresystemand whatmightbedone.Theydeliberated intentlyaboutitsfuture.

Thisreportreflectstheirhardwork,andit isapublicdocumentinallsensesofthe word.Itreflectstheconsidered judgementofarandomlyselected, broadlyrepresentativegroupofNova Scotians,whotooktheirmandateto developasetofconsensus recommendationsonbehalfofthe broaderpublicveryseriously.Wehope thisreportwillinfluencethetrajectoryof theprovince’shealthcaresystem;it speaksdirectlytopubliclyelected officialsandpublicservantsatalllevels ofgovernment,aswellasother decision-makersintheprimarycare system.Finally,thisreportispublic:freely availableontheproject’swebsite

anddisseminatedwidelythrough partners,members,andthemedia.

Deliberativeprocessessuchasthis prioritiespanelareattheirstrongest whentheybringtogetherpeoplewith diverseexperiencesandperspectivesto findcommongroundandasharedsense ofpurposeandresponsibility.Thepanel membersappreciatedlearningfrom presentationsandmoderated discussionswitharangeofhealth systemleadersandacademics;Iam alsogratefultheylenttheirtimeand expertisetothisprocess.

TheNovaScotiaPrioritiesPanelidentified sevenvaluesand26recommendations thatitbelievesshouldguideprimarycare renewalinthisprovince.Ihopeyouwill joinmeasIextendcongratulationsto eachandeverypanelmemberforthis thoughtfulreport,anddeepappreciation foralltheirwork.Ihopeyouwilljointhem inpushingforchangeandexpecting betteroftheprimarycaresysteminNova Scotia.

JasminKay OurCareNovaScotiaPanelChair

JasminKay OurCareNovaScotiaPanelChair

WhatPolicyMakers ShouldKnow

Dr.RuthLavergne

OurCareNovaScotiaCo-Lead

AssociateProfessor, DepartmentofFamily Medicine,DalhousieUniversity TierIICanadaResearchChair inPrimaryCare

Dr.KathStringer, OurCareNovaScotiaCo-Lead

FamilyPhysician,SpryfieldClinic, DalhousieFamilyMedicine; DepartmentHead,Departmentof FamilyMedicine,Dalhousie University

Dr.TaraKiran, OurCarePrincipalInvestigator

FamilyPhysician,St.Michael’s HospitalAcademicFamilyHealth Team;Scientist,MAPCentrefor UrbanHealthSolutions,St. Michael’sHospital,;UnityHealth Toronto;FidaniChairin ImprovementandInnovation, UniversityofToronto

TheOurCaresurveyhighlightedthat oneinfivepeopleinCanadadon’thave afamilydoctorornursepractitioner, andmanypeoplewhodoarestill strugglingtoaccesstimelyprimary carewhereandwhentheyneedit. Residentsofruralandsmalltown communitiesfaceevenmoreprofound accesschallenges.

Primarycareimpactsusall,butin confrontingongoingchallengeswehave yettomaximizethebenefitofbroader publicinvolvement.Tomakesure primarycareworksforeveryone,we needpeoplewithvariedexperiencesand needsatthetable.OurCarewas designedtodojustthis.

TheNovaScotiaOurCarePrioritiesPanel

broughttogetherpeoplefromcities, towns,andruralareaslivingallacross theprovince.Somehadpositive experiencesofrelationship-based primarycare,thoughmanydescribed challengesfindingaprimarycare practitionerthattheyorclosefriends andfamilyexperienced.Somedescribed themselvesashealthy,whilesomehave dealtwithseriousandongoinghealth concerns.Somehadcometoboth CanadaandNovaScotiarecently,and somehadlivedheretheirwholelives. Someneverhadtoworryaboutmoney, whileothersworriedaboutmakingends meet.Whattheysharedwasawillingness tovolunteertheirtime,tolearn,tolisten, andtoconsiderwhatprimarycarethat meetstheneedsofallNovaScotians couldlooklike.

Despitedifferentexperiences,OurCare publicvolunteersor“panellists”have identifiedcommonchallenges.Theyfeel thesystemlacksempathyandisnot centredaroundpatientexperiences. Theydescribeasystemofillnesscare thatdoesnotaddresstheunderlying socialdeterminantsofhealth,andwhere servicesanddataaredisconnected.

Whatwecanallagreeon

Whatwasbothmovingandremarkable abouttheOurCareprocesswasthat, despitedifferences,panellistscame togetherquickly,easilyagreeingon numerouscommonconcernsandideas, andarticulatingsharedvaluestoguide primarycaredelivery.

Theyagreethatthesystemneedstobe centredaroundpeopleandbe empathetic,accessible,andaffordable. Theyagreeonthevalueofconsidering wellnessbroadly,andthatthesystem needstosupportpatientsaswhole people.Theyagreeonthevalueof knowledgethatempowersselfcareand alsomakesitpossibleforeverypersonto playanactiveroleaspatientsand citizensinholdinghealthsystems accountable.

Whatwasevenmoreremarkablewas agreementonrecommendedsolutions.

PanelliststoldusthateveryNovaScotian shouldhaveaccesstomultidisciplinary care,withinterprofessionaltrainingand clinicalenvironmentssupportinga

cultureofintegratedcare.Panellists emphasizedthatprimarycareneedsto considerwellnessholisticallywith attentiontosocialdeterminantsof health.Panellistsdescribedthepotential forimprovedaccessibilitythroughvirtual care,andalsobysupporting transportationtobringpeopletocare andhomevisitstobringcaretopeople.

Panellistsrecognizedtheneedforsecure andconnecteddataandclearand accessiblenavigationtodeliver seamlesscare.Panellistsmadeclear thatpatientsandcommunitieswantto berepresentedinplanning,strategy,and decision-makingaboutprimarycare andexpectmeasurementandreporting onprogress.Theyalsoidentified opportunitiesforcommunitiesto contributedirectlytograssrootsefforts tosupporthealthcareprofessionalsto becomeconnectedtocommunities.

Itisn’tjustpanellistswhoagreeonthe recommendationsandvaluesthat underpinthem.Inaconcludingsession inJuly,panellistssharedchallenges, values,andrecommendationswith clinicians,researchers,healthsystem planners,andpolicymakers.The challengespanellistsidentified,the valuestheyarticulated,andthe recommendationstheyproposed resonatedcloselywithattendeeswho havebeenapproachingthistopicfrom theirownperspectives.Thoughthoughts onexactlanguage,priorities,anddetails ofimplementationmaydiffer,everyone 6

couldagreeonthespiritanddirectionof therecommendationsproposed.

Manyrecommendationsechoandalign withpolicydirectionsthathavebeen longdiscussedbutnotfullyand equitablyimplemented.TheOurCare panelhasdemonstratedthevalueof publicinvolvementandthepotentialfor thepublictoplayanactiveroleinthe ongoingreviewandimprovementof policychanges.

Weallagreethereisaproblem.OurCare hasdemonstratedthatwecanalso agreeoninformed,evidence-based solutions.Whatislefttodoisact.

Dr.RuthLavergne,OurCareNovaScotiaCo-Lead

Dr.KathStringer,OurCareNovaScotiaCo-Lead

Dr.TaraKiran,OurCarePrincipalInvestigator

NovaScotiaPrioritiesPanel

At-a-Glance

TheOurCareNovaScotiaPrioritiesPanelbroughttogether34peoplelivinginNovaScotia,randomly selectedtoroughlymatchtheprovince’sdemographics.Theyspentapproximately30hourslearning fromexpertsanddeliberatingtogetherbeforemakingrecommendationsonwhatabetterprimary caresystemshouldlooklike.OurCarewillbealsobeconductingPrioritiesPanelsinOntario,Quebec, BritishColumbiaandManitobain2023.Formoreinformation,visitOurCare.ca/PrioritiesPanels.

RecommendationHighlights:

34members

16speakers

30programhours

25recommendations

Members’Values

People-centred• Accessible• Empathetic• Knowledgeempowering

•Accountable• Affordable• Wellnesspromoting•

Toensureweareworkingtowardsacommongoalofhealthcarefor allNovaScotians,wecallontheprovincialgovernmenttoarticulate andpubliclyshareaclearlydefinedandexpressedvisionstatement foraccessible,timely,andequitableprimarycare.

PatientHealthData

• ExtendOnePersonOneRecordfromprovincialhospitalsto primarycare

• Protectpersonalhealthinformationbyappropriatelylimiting accessanduse

SustainableDeliveryModels

• Increasethenumberofcommunity-basedcollaborative careteamssothateveryNovaScotianhasaccessto multidisciplinarycare

• Incentivizehealthcareprofessionalstomovetowards team-basedcaree.g.bysubsidizingoverheadcosts

• Provideaccesstovirtualandtelemedicinethattriagesand facilitatespathwaystoappropriatein-personcarefor strategicallylocatedcommunities

• Improveruralaccesstomedicalspecialists

Education,RecruitmentandRetentionofHealthCare Professionals

• Advanceinterprofessionalhealtheducationinmedical schoolandfamilymedicineresidency

• Increaseopportunitiesforhealthprofessionalstosettlein NovaScotia,e.g.bybolsteringgrassrootsprogramsthataim tocreatecommunitiesfornewprofessionalsandtheir families

Theproblemswe wantsolved

Lackof interoperability• Siloedandinefficient useofhuman resources•Barriersto care•Lackofpublic educationand awareness•Too muchshortterm thinking•Narrowand unresponsiveprimary care•Systemlacks empathy•

RecommendationHighlights(cont’d):

ExpansivePrimaryCare

• Expandmobilehealthunits,accesstovirtualcare,affordable high-speedinternet,affordabletransportationtohealth services,andhomevisits

• Increasefinancialsupportforindividualsexperiencing barriersaccessingfee-basedservicesandproductsrelated toprimarycare

• Supportcareprofessionalstoincludesocialprescribing alongsidemoremainstreamformsofhealthcare

• Embedsocialdeterminantsofhealthingovernment strategicplanningandoperations

PublicGovernanceandSystemOversight

● Strengthenexistingpatientadvocacyandcommunity representationintheplanning,strategyanddecision-makingof primarycare

● Collectmetricsonhealthandwellnessbestpracticestiedto expectedoutcomesandimplementadashboard,similartoOne NovaScotia

● RespondtoeachrecommendationintheOurCarePriorities PanelReportandcommittoactionablesteps

InformedPublic

● Promotecitizenparticipationinhealthcareadvocacy,for example,asPatientandFamilyAdvisorsinCommunity HealthBoards

● Developanaccessible,user-friendly,andculturallyinclusive primaryhealthcarenavigationservice

Understanding thePanelProcess

APrioritiesPanelisalong-form deliberativeprocessthattypically involves30to48randomlyselected residents.Theseresidentsarechosen usingaprocesscalledaciviclottery, arandomselectionmethodthat prioritizesfairnessandwide representation.Theindividuals selectedforaprioritiespanelcome togethertolearnabout,andthen advisepublicauthoritiesondivisive andcomplexissuesthattypically involvetrade-offsorcompromises. Thepanelmembers’objectiveisto reachaconsensusonaseriesof recommendationsthatcanbe directedtogovernment,professional associations,andsocietyatlarge.

WhatisaCivicLottery?

Aciviclotteryisabalancedwayof selectingthemembersofapriorities panel.Itisbasedonaformof sortitionthatusesarandomized selectionprocesstorecruitpanelists fromapoolofvolunteersthathave indicatedtheirinterestinservingon thepanel.Theresultisagroupof volunteersthatbroadlymatchesthe demographicsofthejurisdictionit represents.

Morethan250peoplevolunteeredfor theNovaScotiaPrioritiesPanel.Many ofthesevolunteershadcompleted theOurCareNationalSurvey,while othersreceivedaninvitationto volunteerthroughlocalpartnerssuch asEngageNovaScotiaorthrough membersoftheNovaScotiaAdvisory Group.Eachvolunteerindicatedtheir interestinthepanelbyansweringa fewdemographicquestionsina questionnaire.Thestratifiedcivic lotteryprocessensuredthat membersofthepanelwerefairly selectedandbroadlyrepresentative ofNovaScotia’sdemographics.

OurCaredeliberatelysoughtto overrepresentresidentsweknoware underservedbytheprimaryhealth caresystem:racialized,lowerincome, newcomer,gendernon-conforming residents,andthosewholiveinrural, remote,ornorthernregionsofthe province.Inshort,thepanelwas composedinsuchawayastodeliver demographicdiversityandtoensure weheardfromresidentswhoare mostdisadvantagedbythecurrent system.

Thispanelprocessandreportdo notrepresenttheexperiencesor viewsofMi’kmawPeople

Harmfulactsofcolonizationcontinue toimpactFirstNation,Métis,andInuit Peoplesacrossthecountry.

InNovaScotia,13FirstNation Mi’kmawcommunitieshavebeen leadingaprocessofhealth transformationfortheirpeople.They werenotengagedinthedesignof theOurCareproject,andnoneofthe membersofthispanelself-identified asamemberofaMi’kmawFirst Nation.

PanelSnapshot

34members

Gender:*

17-Women

17-Men

Age:

5 -18-29yearsold

7 -30-44yearsold

12-45-64yearsold

10 -65+yearsold

Memberswhoidentifyas Indigenous:1

Health:

26-Good,VeryGood,orExcellent

8-FairorPoor

Memberswhohavebeenin Canadalessthan10years:6

Geography:

15-Central

9-West

5-North

5-East

Memberswhoidentifyas partofaracializedgroup:9

*-“Women”referstocisgenderandtransgenderwomen.“Men”referstocisgenderandtransgendermen. ourcare.ca

TheMembers’ Reportofthe OurCareNova ScotiaPriorities PanelonPrimary Care

WhoWeAreandWhyWe Volunteered

TheOurCarePrioritiesPanelfeatures

34NovaScotianresidentsfrommany walksoflife.Ourgroupisamosaicof folkswholiveinthisprovinceandis representativeoftheruralandurban populationsacrossallregions.Our groupincludeseveryonefrom studentstoretirees,lifelongresidents tonewcomers,aswellaspeoplewith variedbackgroundsinandlived experiencesofhealthcare,arangeof culturalandracialdiversity,andfolks allacrossthewellnessspectrum.We representarangeofsocioeconomic andeducationallevelsandabroad arrayofprofessionalandvolunteer experiences.Forsome,thisisa continuationofmanyyearsof volunteerismandcommunity involvement,and,forothers,thisisa newexperienceandopportunityto havetheirvoicesheard.

Therichdiversityofourgroup allowedustoidentifyandanalyzethe problemsrelatedtoprimarycare fromvariousperspectives,consider manydifferentpointsofview,and debateawiderangeofpossible solutions.Wewereencouragedto haveanopenmind,beempathicto oneanother,andsharechallenges wemaybeexperiencingwithhealth care.

Wealsoallhavethreethingsin common:weseemanyissueswith theprimarycaresysteminNova Scotia,areconcernedaboutits future,andaremotivatedtodowhat wecantotakeactionandcontribute tosolutions.Wecametothese conversationswithrespectforone another,andashareddesiretowork togetherforcommongoodandthe bettermentoftheprimarycare systemthataffectsusall.Our discussionincludedconstructive debateandexplorationofdifferent ideas.

Ourgroupof34volunteersinvested itstimeandenergyduringahotand sunnyweekendinJuly(nosmall sacrifice!).Weallbelievethatthe publicneedstobeincludedin conversationsaboutprimarycare renewalandweallfullyparticipated inthecreationofthisreport.

Weallhavepersonalexperiencewith theissuesandlimitationsofthe primaryhealthcaresystem,andwe havewitnessedthecrisisasithas developedandworsenedovertime. WehaveseenthepopulationofNova Scotiachangealotinrecentyears–forthebetter!–whiletheprimary caresystemhasremainedstagnant.

Peoplefeelpowerlesswhentheyare inneedofprimarycarethatthey

cannotaccess,butthisopportunity hasbeenanempoweringoneforall ofus.Wewantourrecommendations tobeacatalystforprimarycare transformationthatmeetsthe changingneedsofourpopulation andprevailsoverpoliticalideology. Wehavevolunteeredwiththe expectationthatour recommendationswillbetaken seriouslyandwillbeconvertedinto tangibleandtimelyaction.

WhatWeLearned

Welearnedagreatdealaboutour healthcaresystemsandthe democraticprocessthroughthis panel.Thehealthcaresystemis complex,withmanycompeting actorsandinterests,butthisprocess supportedusinsiftingthroughalot ofinformation,allowingustocreatea visionforbetterprimarycareforall. Thecollaborativeprocessthatwe undertookherereflectspossibilities thatcanbeunlockedwhenwework togethertoaddressimportantissues. Infact,manyofthe recommendationspointtowards morecollaborativemodelsofcare.

Weweresurprisedandencouraged tolearnaboutallofthecurrent effortsbeingmadetoimproveour healthcaresystem,and,although nothingisperfect,wearehopeful

thatthisreportisyetanotherstepin therightdirection.Everyonedeserves andhasavestedinterestina primarycaresystemthatworks better,andwefeelthatitisour responsibilitytobringtheinterestsof NovaScotiaresidentsforwardin bringingaboutchange.Theprocess waschallenging—itoftenfeltlike marchinguphill—andyetgivesus hopethatabetterfutureispossible.

TheChallengesWeWant Solved

OurcurrentPrimaryCareSystem, whilenotbroken,isinefficientand doesnotrespondtotheneedsofa healthysociety,bothinurbanand ruralsettings.Toomanyofusdonot haveaccesstoaprimarycare professionalthatwecanseeona regularbasis.

Thelastseveralyearshaveseen tremendousadvancementin technologyandprocessesbutthey havebeenprimarilyappliedtoacute careinthehospitalsetting.Another keyissuewiththecurrentprimary caresystemisthatitprovides emergencyhealthcare(sickcare) ratherthanpreventativehealthcare. Thegrowthofeffectiveprimarycare isfurtherhamperedbyalackof resourcesincluding moneyand people,leadingtoinequitiesinthe

provisionofhealthcareservicesfor thosewithdiversecultural,racial,and socioeconomicneeds.

Therecommendationscontained herearedevelopedwiththefollowing underlyingassumptions:

1. Theprimarycaresystemis fractured.

2. Anew/modifiedmodelof primarycareisrequiredtoget usbeyondwhereweareto whereweneedtobe:amore effectivesystem.

3. Healthcaremustrecognize andrespondpositivelytosocial determinantsofhealth.

4. Itisnecessarytoprovidea responsible,feasible,and affordableresponsetothese recommendationswithinthe nextsixmonths.

5. Itisapparentthatthereisa disconnectbetweenacademic andoperationalsettings,andit isimportanttoinitiatemore productiveandresponsive dialoguebetweenthetwo.

Weidentifiedsevenchallengesthat webelieveneedtobeaddressedin ordertoensureahighquality, equitableprimarycaresystemforall NovaScotians. Theyare:alackof interoperability,siloedandinefficient useofhumanresources,barriersto care,lackofpubliceducationand

ourcare.ca

awareness,toomuchshort-term thinking,narrowandunresponsive primarycare,andasystemthatlacks empathy.

Lackofinteroperability

Theabsenceofreal-timedata exchangebetweendifferentdigital informationsystemsisakey challenge.Werecognizethatthislack ofinteroperabilityisalong-standing andcomplicatedchallengethat affectsmanydifferentactorsinthe healthcaresystem.

Itaffectspatientexperience,reducing qualityandcontinuityofcare becauseeachhealthcare professionaldoesnothaveeasy accesstoasinglepatientrecord.

Primarycareclinicianscarrythe burdenofadditionaladministrative workchasingpatientrecords.This potentiallydelaysdiagnosisor accesstocare,oritleadstothe developmentofinappropriatecare plansbecausethehealthcare cliniciandidnothavea comprehensivepictureofthe patient’shealth.

Government—asstewardofthe public’shealthandwellbeing— also strugglestogetaclearlineofsight onhealthoutcomes,andis

contendingwithexpensive,inefficient administrativeprocessesthatdonot maximizetaxdollars.

Thoughcompaniesdevelopingand providingthesehealthrecord systemsoftenbearthebruntofthe criticism,theyarenotgivenguidance orastandardtowhichtheycan conform.

Overall,thesiloingofelectronic resourcesandinformationsystems slowsdiagnosis,leadstomoreerrors, andincreasescosts,allwhile reducingaccesstohealthcare.

Siloedandinefficientuseofhuman resources

Currently,variousstakeholdersand supportingsystemsoftenoperatein isolationfromoneanotherwith limitedcapacitytomeetpatient demand.Thereisfrequentlylittle abilitytoshareknowledge, experience,orsolutionstocommon problems.Thesesiloescreateissues forallparticipantsinprovidingor accessingtimelyandcomprehensive accesstorequiredservices. Resourcesmaybeavailabletosome andrestrictedtoothersbasedon theirpointofcontact;asaresult, someresourcesmaybe underutilized.Thesesystemsactas unintentionalgate-keeperslimiting accesstocare,creatingduplication

ourcare.ca

ofeffort,increasingcosts,and restrictingaccesstoimportant knowledgeanddata.

Barrierstocare

Currently,NovaScotiansfacemany barrierstoaccessing21stcentury primarycare,including,among others,limitedtechnology,internet access,anddigitalliteracy.Inequality andinequityacrossgender,culture, socio-economicstatus,andethnicity arecontributingtounequalhealth accessandoutcomes.Ruralaccess tocareisalsoaprominentissue. Therearenotenoughemergency roomdoctorstokeeprural EmergencyDepartmentsopen, forcingpeopletotravellong distancestourbancentrestoreceive primarycare.Finally,manyNova Scotianshavetroubleaffording healthcareservicesandproducts suchasprescriptions,preventative solutions,andtransportationtoand fromhealthcareservices.

Lackofpubliceducationand awareness

Thereisalackofpubliceducation andawarenessaboutourprimary caresystem.Outofthegroupof34 concernedcitizens,onlyoneortwoof usknewaboutcurrentresources,like theHealthNovaScotiawebsite, that NovaScotiaHealthhasinplace.It

becameevidentthatwe,a representativesampleofthegeneral public,wereunawareofthese resourcesandarethereforenotusing them.Currentinefficienciesinour communicationsystemsresultina lackoftransparencyandlimited understandingofdifferentservice optionsandhowtoaccessthem.

Toomuchshort-termthinking

Ourprimarycaresystemreliestoo muchonshort-term,politically motivated,andexpedientband-aid solutions.Thereisaresistanceto changefromentrenched bureaucraciesandcompeting interests.

Welackalong-termvisionthat addressesthefactorscreatingan evermoreexpensivesickness-care system.

Narrowandunresponsiveprimary care

Currentprimarycareisnotas responsiveasitshouldbewith regardstomanyaspectsofthe existingsystemthatrequireattention, including:

1. Insufficient/inappropriate compensationformedical personnel;

ourcare.ca

2. Lackoforganisationaland administrativesupportfor smallprivatepractices;

3. Lackofincentivestoworkin ruralareas;

4. Insufficientuseofresources andtechnology;

5. Narrowscopeofpracticefor differentprofessionals.

Otherfactorsthatnarrowthescope ofprimarycareare:

1. Inadequateandaffordable accesstonon-medical resourcesandprogramsthat supportahealthylifestyle: nutritiousfood,exercise, sufficientincome,housing,and otherservices;

2. Narrowviewsofhealthcare needsbypractising professionals;

3. Healthcaremodelsthatdonot accountfortheinfluenceof socialdeterminantsofhealth;

4. Inadequateaccesstomental healthsupport.

Systemlacksempathy

Thereisalackofcultural competencyandempathybuiltinto thestructureofthecurrenthealth caresystem.Thatmedicalguidance andpatientresourcesaremodelled

almostexclusivelywiththeexample of70kgmale;thesemodelsarebuilt forasingularpatientarchetypeand notfortherealitiesofadiverse population.Thishasledtoalackof inclusivityinprimarycareservices, andalackofvalueattachedto patients'voices,livedexperiences, andideas.Thisresultsinbothalack ofautonomyforpatientsandalack ofcommunityparticipationinthe decisionsthataffectourhealth.

OurValues

Valuesaretheguidingprinciplesthat shapebehaviouranddecision making.Theyindicatewhatis importanttousandwhatarethe basicandfundamentalbeliefsthat guideormotivateourattitudesand actions.

Thefollowingarethevaluesthatwe, themembersoftheNovaScotia PrioritiesPanelonPrimaryCare, deemmostimportantfor governmentsandhealthcare professionalstoconsiderwhen developingfutureactionstoensure thatequitable,high-qualityprimary careisavailableforallNovaScotia residents.

Webelievethatprimarycareshould be:people-centred,accessible, empathetic,knowledgeempowering, accountable,affordable,and wellnesspromoting.

People-centred

Apeople-centredapproachto primarycaremeansthatthecare systemworksforthepeople accessingitandthepeopleworking withinit.Therelationshipbetween careprofessionalsandpatients shouldbeanactivepartnership basedontrustandfocusedona patient’soverallhealth.

People-centredsupports collaborativeteamsandbuilds healthiercommunitiesinbothurban andruralareasofNovaScotia.

Accessible

Accessibilitymeanspeoplecanget carewhenandwheretheyneedit regardlessofwhotheyare. Accessibilityisfoundationaland timely.Accessibilitymeanstheright carefromtherightpersonattheright time.

Empathetic

Empathyentailshumanizingthe healthcaresystem.Foraclinician, empathyisensuringapatientfeels heard,understood,andsafe,andthat theclinicianisinvestedintheircare andwellbeing.Forapatient,itmeans actingasapartnerwithyourclinician andacknowledgingthepressures cliniciansfaceworkinginastressed healthcaresystem.

Knowledgeempowering Seamlessandsecureaccessto healthinformationisessentialfor everyoneinapatient’scircleofcare. Thismustincludeuser-friendly, robust,secureelectronicmedical recordsystemsthatcantalktoeach other.

Thisisimportantsothatanyone involvedinthepatient’scircleofcare hasup-to-dateinformationtomake informeddecisionsthatcontributeto improvedpatientoutcomes.

Accountable

Aprimarycaresystemwith accountabilityatitscore acknowledgesthatallNovaScotians havearoletoplay—andeveryoneis expectedtotakeresponsibilityforthe corecompetenciesandactions requiredtodotheirpart.

Itmeansthatoutcomesaredefined, measured,andpubliclyavailable. Majordecisionsarejustifiedand explained.Anaccountableprimary caresystemisatrustworthyone.

Affordable

Anaffordableprimarycaresystemis inclusiveforeveryone;itstrivesto meetthehealthcareneedsof everyonelivinginNovaScotia, regardlessoftheirincomelevel.

Affordabilitymeansthatthesystem supportsourprimarycare professionalssothattheycansustain along-termcareerinthisprovince. Anaffordableprimarycaresystemis sustainableforpatientsand professionals.

Wellnesspromotionallowsforcare thatfocusesonthewholeperson, ideallyinapreventativemanner.It includesopportunitiestoaccess integratedanddiversecare professionalsandresourcesto supportone’sabilitytoliveahealthy life.

OurRecommendations

Together,wehavedeveloped25recommendationsorganizedintosixdifferent themes,aswellasoneoverarchingrecommendation.Thesethemesare:

A. PatientHealthData

B. SustainableDeliveryModels

C. Education,Recruitment,andRetentionofHealthCareProfessionals

D. ExpansivePrimaryCare

E. PublicGovernanceandSystemOversight

F. InformedPublic

OverarchingRecommendation

Toensureweareworkingtowardsacommongoalofhealthcareforall NovaScotians,wecallontheprovincialgovernmenttoarticulateand publiclyshareaclearlydefinedandexpressedvisionstatementfor accessible,timely,andequitableprimarycare.

A. PatientHealthData

OurrecommendationsforPatientHealthDataare:

1. CommittoextendingOnePersonOneRecord(OPOR),NovaScotia’sfully digitalelectronicrecordsystemrollingoutinprovincialhospitals,to includeprimarycareandalliedhealthprofessionals(e.g.,pharmacy, physiotherapy,psychology,socialwork,anddentistry)tofacilitate seamlesscommunication,enablecontinuityofcare,andimproveoverall patientoutcomes

a. Supportandincentivizeprimarycareandalliedhealthprofessionals touseOPOR.

b. Explorehowrequisitionsandreferralpathwaymodulescanbe embeddedinOPORtoreducetheburdenofcarecoordination currentlyplacedonpatients.

2. CommittomakingOPORfreelyaccessibletopatientsinanonline user-friendlyformatsothattheyhaveasay indecisionsrelatedtotheir ownhealthcare.

a. Enablepatientstoinput/uploadtheirowninformationandtoeasily downloadtheirownrecordsforportability.

b. Ensurepatientswithlimiteddigitalliteracycangethelp,atnocost, accessingtheirownrecords.

c. Encouragetheuseofplainlanguageinmedicalrecords.

3. RequireinteroperabilitybetweenexistingElectronicMedicalRecords(EMR) systemsandOPORtofacilitatetheimplementationofRecommendation1.1

a. Legislatethatwithinadeterminedperiodoftimeanyregulated healthcareprofessional(includingalliedhealthprofessionals)must usesoftwarethatcanupdateintoOPOR.

b. CommittoensuringfutureOPORinteroperabilitywithother Canadianjurisdictionstoallowhealthrecordstofollowpatients withinCanada.

4. Protectpersonalhealthinformationbyappropriatelylimitingaccessto ensurepatientprivacy.

a. Legislatethatpersonalhealthinformationcanonlybeusedfor purposesrelatedtopatienthealthcareprovision,andnotusedfor commercialpurposes(i.e.,sellingtothirdparties,accessto insurancecompanies).

b. Ensurepublicinputintoanyprivacylegislation.

B. SustainableDeliveryModels

OurrecommendationsforSustainableDeliveryModelsare:

5. Requiretheprovincialgovernmenttoprovide,forstrategicallylocated communities,virtualandtelemedicinethattriagesandfacilitates pathwaystoappropriatein-personcare.

6. RequireNovaScotiaHealthtodevelopandimplementastrategyto improveruralandcommunity-basedaccesstomedicalspecialitiesby:

a. Incentivizingprospectiveandexistingfamilydoctorstoexpandtheir skillsetstoincludemorefocusareasandenhancedskillswithintheir scopeofpractice;

ourcare.ca

1-Detailsandnuances

a. Recruitingandretaininggeneralinterniststobestrategicallylocated atcollaborativecareclinics;and,

b. Exploringnewwaysforprimarycareprofessionalstoconsultvirtually withotherhealthcarepractitionersonbehalfoftheirpatients.

7. Increasethenumberofcommunity-basedcollaborativecareteamsand clinicsthatincludefamilydoctors,physicianassistants,nurse practitioners,dieticians,socialworkers,andotherprimarycare professionalssothateveryNovaScotianhasaccesstomultidisciplinary careandmedicalprofessionalscanspendmoretimewithpatientsand lesstimeonadministration.

8. Incentivizehealthcareprofessionalstomovetowardateam-basedcare model,bysubsidizingoverhead(e.g.,spaceand/orcost-shared administration)andensuringthatcommunity-basedcollaborative primarycareisincorporatedintotheprovincialhealthcarebudget.

9. Incentivizespecialistsacrosstheprovincetoallocateaportionoftheir timetosupportingcommunity-basedcareteams.

C. Education,RecruitmentandRetentionofHealthCare Professionals

OurrecommendationsfortheEducation,RecruitmentandRetentionofHealth CareProfessionalsare:

10. Advanceinterprofessionalhealtheducationinmedicalschooltoinstilla cultureofintegratedcareinemergingNovaScotiahealthprofessionals.

a. MandateincreasedintegrationofPrimaryCareandPublicHealth curriculumsinmedicaleducation.

11. Strengthenthecommitmenttoincreasingopportunitiesandincentivesfor healthprofessionals,bothgraduatingandpractising,tosettleinNova Scotiathrough:

a. Incentivesforstudentsinhealthprogramssuchassupportsfor tuitionandhousing,aswellasongoingprofessionalopportunities.

b. Bolsteringexistinggrassrootsorganisationsorinitiatives(e.g., HealthyPictouCountyandthecommunitydrivenHealthyYarmouth Program)thataimtocreatecommunitiesfornewhealth professionalsaswellasopportunitiesfortheirfamilies.

12. Engageawidergroupofpeopletobringabroaderperspectiveto post-secondarymedicalcurriculumdevelopment,includingcommunity organisationsandyouth,inordertoremaincurrentandrelevantto patients’needsandconcerns.

D. ExpansivePrimaryCare

OurrecommendationsforExpansivePrimaryCareare:

13. EnsurethatallNovaScotians—especiallythoselivinginruralareas— haveaccesstohighqualityandbarrier-freehealthcarethroughthe expansionofmobilehealthunits,accesstovirtualcare(incommunity centresandinhomes),accesstoaffordabletransportationtohealth services,andhomevisits.

14. Supportcareprofessionalstoincludesocialprescribing(e.g., evidence-based,non-allopathicmethods)alongsidemoremainstream formsofhealthcaretoenhancehealthoutcomesforthewholeperson andcommunity.

a. Thissupportincludesdevelopingsystemssuchasanactive databaseorcommunitynavigatorforcareprofessionalsto navigate,prescribe,andpartnerwithcurrentsocialservicesand non-allopathicinterventionopportunities.

15. Increasefinancialsupportforindividualsexperiencingbarriersto accessingfee-basedservices/productsrelatedtoprimarycare,including socialprescribing,sothatimportantcarecostsarereducedandhealth outcomesareimprovedequitablyforalldemographics.

16. EnsureallNovaScotianshaveaffordablehigh-speedinternetforaccessto virtualcare,aswellastrainingandtechnologyneededforbarrier-free care.

17. Requirethatkeygovernmentdepartments(suchasNovaScotiaHealth, SocialServices,HealthandWellness,Justice,Education,etc.)embed socialdeterminantsofhealthintheirstrategicplanningandoperationsso thatkeyhealthissuesareaddressedinaholisticandpreventativeway, promotingequitablehealthoutcomes.

E. PublicGovernanceandSystemOversight

OurrecommendationsforPublicGovernanceandSystemOversight

18. WecallontheDepartmentofHealthandWellnesstostrengthenexisting patientadvocacyandcommunityrepresentationintheplanning, strategizing,anddecision-makingofprimarycareinorderto:

a. Ensurethatpatientslivedexperiencesareincludedinallelementsof theprocess,

b. Improvetransparency,

c. Advocateforpatients,and

d. Guidefuturedecision-making.

19. Tofurtherstrengthenthevoiceofpatients,theDepartmentofHealthand WellnessandNovaScotiaHealthmustreviewandoptimizethedesign, methods,andregionalrepresentationofexistingPatientFamilyAdvisory CouncilsandCommunityHealthBoards.

20. Tofurtherpromoteaccountabilityandtransparency,theDepartmentof HealthandWellnessmustcollectmetricsonhealthandwellnessbest practicestiedtoexpectedoutcomesandimplementadashboard,similar toOneNovaScotia(OneNS).TheDashboardshouldbepubliclyaccessible andcommunicateinaclearandeasytounderstandwaysothatthe publiccantrackprogressonhealthoutcomesovertime.

a. Thisdashboardshouldincludemetricsthatdemonstrateprogress ontherecommendationsfromtheOurCareNovaScotiapanel.

b. Anonymized,non-identifiablerawdataonhealthoutcomesshould bemadeaccessibleforpublicaccountabilityandresearch purposes.

21. AsafirststeptowardschangingtheprimarycaresysteminNovaScotia, wecallonallbodiesrelatedtoprimarycaretoreviewthereportofthe OurCarepanel,andforthePremier’soffice,theLeaderoftheOpposition, andtheDepartmentofHealthandWellnesstoprovideapublicresponse withinsixmonthsofpublicationtoeachrecommendationintheOurCare reportwithacommitmenttoactionablesteps,whereverpossible.

22. Toensureaccountabilitytothevisionputforwardbythispan-provincial panel,werecommendextendingthemandateoftheNovaScotiaOurCare Panelasanongoingcitizens’panelonprimarycarepriorities.Thiswillbuild onthemomentum,foundationalknowledge,andestablishedrelationships developedthroughthisinitiative.

F. InformedPublic

OurrecommendationsforanInformedPublicare:

23. Theprovincialgovernment,withmeaningfulcommunityinputandexternal expertsinfieldslikegraphicdesignanduserexperience,shoulddevelopa primaryhealthcarenavigationservicethatisaccessible,user-friendly, andculturallyinclusive.Thisserviceisdesignedto:

a. Enablepeopletotakecontroloftheirhealthandwellness,

b. Accesstherightcarefromtherightprofessionalattherighttime, and

c. Promotepreventativecare.

Acomprehensivepublicdisseminationplanwillpromotethesenew resourcesinschools,post-secondaryinstitutions,hospitals,socialand traditionalmedia,libraries,andcommunitycentres.

24. TheNovaScotiaHealthAuthorityshouldsupportcitizeninclusioninhealth carebypromotingcitizenparticipationinCommunityHealthBoards,as PatientFamilyAdvisors,andinotherhealthcareadvocacyopportunities.

25. Theprovincialgovernmentshoulddesignaphasedchangemanagement plan,includingoutreachandengagement,tochangepublicmentality awayfromfamilydoctorsastheonlyfirstpointofcontactforprimary care.Thisplanshould:

a. Launchapublicrelationscampaign(e.g.,“Didyouknow…?”).

b. Identifyearlyadoptersandpromotehealthcareaccesspointsto childrenandyouth.

c. Measurepublicperceptionofprimarycareovertime.

d. Buildtrustinalliedhealthprofessionals.

e. Promotebenefitsofadistributedcaredeliverymodel

OurCarePrioritiesPanel Program

TheNovaScotiaPrioritiesPanel, consistingof34membersfromacross theprovince,metonlinetwice,inMay andJune2023,andthenoverthree daysinHalifaxinJuly.Duringtheir nearly30hourstogether,panel memberslearnedaboutprimarycare inNovaScotiaandotherjurisdictions; theyheardfromandengagedwith16 subjectmatterexpertpresentationsor moderateddiscussions.Themembers alsospentasignificantamountof timeinconversationwitheachother astheyparticipatedinaseriesof facilitateddiscussionsand deliberationsthatculminatedinthe consensusrecommendationsput forwardinthisreport.

Session1:

Saturday,May13,2023

Virtual

ThefirstmeetingoftheNovaScotia PrioritiesPanelonPrimaryCarewas heldonline,anditservedasan orientationtotheprocessandtothe primarycaresysteminNovaScotia.

JasminKay,theChairofthePanel, andDr.TaraKiran,OurCare’sPrincipal Investigator,welcomedthemembers andintroducedtheNovaScotiaPanel Team.Jasminspokeaboutthe panel’smandateandtheworkthey woulddotogether,highlightingthe specialcharacteristicsofdeliberative processesthataskparticipantsto considerthebroaderpublicinterestin theformulationoftheir recommendationsandreport. Membershadtheopportunitytomeet eachotherinsmallbreakoutgroups.

*Owing

Dr.RuthLavergne,anassociate professorintheDepartmentofFamily MedicineatDalhousieUniversityand oneofOurCare’sPrimaryCareLeads inNovaScotia,andDr.LeahJones,a familydoctorandtheAcademic DirectorofBlackHealthwithin Dalhousie’sFacultyofMedicine,joined thepaneltopresentanoverviewof theprimarycaresystem

inNovaScotia.Memberslearned whatahighfunctioningprimarycare systemshouldprovidetopatients,as wellashowitiscurrentlydelivered andstructured.Theylearnedhow changingdemographics,outmoded policyandlegislation,andchanges tothesystemareimpactingthework ofprimarycarepractitionersand contributingtothehumanresource crisisfacingthehealthcaresystem today.

Afteralivelyquestionandanswer period,membersreconvenedintheir smallbreakoutgroupsforaninitial discussionaboutthevaluesthat shouldguideprimarycarerenewalin theprovince.

Dr.TaraKirandeliveredthesecond andfinalpresentationofthesession; shepresentedfindingsfromthe OurCareNationalSurvey.Dr.Kiran’s presentationalsosurfacedafew datapointswheretheresponses fromNovaScotiansdifferedfromthe nationalaverage.Thesurvey gatheredinsightsfrommorethan 9,000Canadiansabouttheir experienceswithprimarycare,and theirpreferencesandprioritiesforthe future.ItwasonlinefromSeptember 20toOctober25,2022.Thelinkwas disseminatedthroughmultiple channels:byVoxPopLabsandtheir

proprietarypanel,throughanopen linkcirculatedtoOurCare collaboratorsandpartners,and amplifiedthroughasocialmedia campaignandearnedmedia.Thefull resultsofthesurveyareavailableto thepublicatdata.ourcare.ca.

Session2: Saturday,June10,2023 Virtual

ThesecondsessionoftheNova ScotiaPrioritiesPanelwasalsoheld online,anditfocusedonprimary caresystemsinotherjurisdictions,as wellasspecificconsiderationsto improveaccesstoprimarycarefor equity-deservingcommunitiesin NovaScotia.

Thesessionbeganwithawelcome andrecapofthefirstsessionfrom Jasmin,whichwasfollowedbya presentationfromDr.TaraKiranon modelsandfeaturesofprimarycare systemsinafewOECDcomparator countries(includingFinland,the UnitedKingdom,andthe Netherlands).Herpresentation highlightedhowthesesystemsdiffer fromcurrentdeliverymodelsandthe structureofprimarycareinNova Scotia.Shediscussedfeaturesof primarycaresystemssuchas practiceandrosteringmodels,

fundingandpaymentmodels,useof informationsystemsanddata sharing,afterhoursandurgentcare, andaccountabilitymeasures.

Membersalsoengagedwiththree guestspeakersduringadiscussion aboutaccesstoprimarycarefor equity-deservingcommunities. Jasminmoderatedthediscussion withDr.Asra’aAbidali,afamily physicianwhosepracticesettings haveincludedtheHalifaxNewcomer Clinic;PaulinaMeader,aMi’kmaw womanandlicensedpracticalnurse; andDr.GaynorWatson-Creed,a publichealthspecialistphysicianand theAssociateDeanofServingand EngagingSocietyforDalhousie’s FacultyofMedicine. Eachspeaker spokeaboutsomeofthedeficitsof thecurrentprimarycaresystemin providingaccesstohighqualitycare forresidentswhofacemultiple compoundingbarriersto understanding,navigating,and accessingthecaretheyneed. Speakersalsosharedideasfor changeandencouragedthe memberstoplaceequityatthe forefrontoftheirrecommendations forprimarycarerenewalinNova Scotia.

FollowingtheQ&Abetweenmembers andtheguestspeakers,members

brokeintosmallgroupstodiscuss theprosandconsofthedifferent featuresandtoidentifywhich featurestheymightwanttosee adaptedtotheNovaScotiacontext.

Jasminadjournedthesession followingthereportbackofthis discussion.

Session3:

Friday,July7,2023

Halifax

Amonthlater,themembersofthe NovaScotiaPrioritiesPanelgathered inHalifaxtocontinuetheirwork.The firstin-personsessionwasheldatthe CambridgeSuitesHotel,wheremany memberswerestaying.

Jasminwelcomedmemberstothis finalstepofthepanelprocessand sharedwhatwastocomeoverthe nexttwoandhalfdays.Members theneachtookaminutetointroduce themselvestothebroadergroup. Followingthis,membersself-selected intosmallworkinggroupstodevelop definitionsforthevaluesidentified duringtheirfirstonlinesession.

Afterbreakingfordinner,members heardabouttheroleoftechnology andvirtualmodalitiesofcareinan evolvingprimarycaresystem.

JasminKaymoderateda conversationwithDr.AshleyMiller,a generalinternistandtheChief MedicalInformationOfficerforNova ScotiaHealth;AbbeySanfordfrom Maple’sHealthSystemPartnerships team;andDr.SherylSpithoff,a researchscientistwithWomen’s CollegeResearchInstituteinToronto. Eachsharedtheirperspectivesonthe opportunitiesandchallengesthat virtualcareplatformsanddigital informationsystems—suchasthe recentlyannouncedOnePersonOne Recordsystem—posetothedelivery ofhighquality,equitableprimary care.Thiswasfollowedbytimefor questionsfromthemembers.

Jasminadjournedthedayat8:00pm.

Session4:

Saturday,July8,2023

Halifax

Thepanelreconvenedoverbreakfast attheCanadianMuseumof ImmigrationatPier21.Followinga recapofFriday’sprogramand previewofthedayahead,thepanel welcomedfourguestspeakersfora conversationaboutchallengesfaced byprimarycarepractitionersand systemleaders.Dr.MariaAlexiadis,a familydoctorandInitiativeLeadfor

PrimaryCareTransformationwith NovaScotiaHealthAuthority;Dr. RoopConyers,aphysicianand MedicalSiteLeadwiththeAnnapolis CommunityHealthCentre;Erin Sarrazin,aprimarycarenurse practitionerandCommunications DirectorfortheNursePractitioner AssociationofCanada;andLisa Woodill,DirectorofPharmacy PracticeforthePharmacy AssociationofNovaScotiaeach offeredasnapshotoftheir day-to-daywork.Theyspokeof challengestheyencounterinthe system,newpracticesthatarebeing piloted,andideasforwhatabetter primarycaresystemcouldlooklike. TheQ&Awiththememberscould havegoneonmuchlongerthantime allowed.

Followingthis,thepanelworkedin smallgroupstoidentifykeyissues thathavecontributedtothecurrent crisisinNovaScotia’sprimarycare system.

Thesecondpresentationofthe morningfeaturedDr.Katherine Fierlbeck,ChairoftheDepartmentof PoliticalScienceatDalhousie University.Dr.Fierlbeckspokeabout thepoliticalcontextthatinfluences theprimarycaresystemandmakes healthcarereformdifficult.Shealso

sharedideasforthemembersto considerintheirrecommendations, andfieldedmanyquestionsfrom themduringtheQ&A.

TheremainderofthedayatPier21 wasspentinsmallgroupandplenary discussion.Membersidentified prioritiesandbegantodraft recommendationstheyfeltwould addressthesepriorities.

Theday’sactivitieswrappedand membersmadetheirwaybacktothe hotelfordinnerandafree-flowing “AskMeAnything”sessionwithDr. KatherineStringer,DepartmentHead attheDalhousieUniversity’s DepartmentofFamilyMedicineand theotherPrimaryCareLeadfor OurCareinNovaScotia.Duringthis finalQ&Awithaprimarycareexpert, memberswereabletoraiseany lingeringquestions,seekinputon issuesdiscussedoverthecourseof theafternoon,andtestsomeoftheir ideasforchange.

Session5:

Sunday,July9,2023

Halifax

Membersreconvenedatthe CanadianMuseumofImmigrationat Pier21onSundaymorning.After breakfast,PanelChairJasminKay

recappedtheworkthepanelhad producedinitsfirstoneandahalf days.Innewsmallgroups,members continuedworkingonthe recommendationsdraftedon Saturdayandsharedbackrevised andnewrecommendationsfor discussionwiththebroadergroup duringaplenaryreportback.

Followingabreakforlunch,members againmovedtonewtablestodraft thereportsectionsthatwouldbe presentedtotheinvitedguests.

TheNovaScotiaPrioritiesPanelwas joinedbyinvitedguestsin-person andonlineforareadingoftheirdraft report.Jasminwelcomedguestsand providedabriefoverviewofthe projectandcontextbeforeinviting memberstothepodiumforaread outofthereport.Followingthis, JasminintroducedColinStevenson, Chief,SystemIntegrationattheNova ScotiaDepartmentofHealthand Wellness,andthenDr.MariaAlexiadis tothepodiumtodeliverreflections andremarks.Followingthese remarks,Dr.Stringer,Dr.Lavergne, andDr.Kiraneachsharedtheir thoughtsandappreciationforthe members’work,andsomeinformal dialoguebetweenthemembersand theinvitedguestsensued.

Finally,eachmemberwasinvitedto thefronttoreceiveaCertificateof PublicServicethatrecognizedtheir contributionstotheconversation aboutthefutureofprimarycarein NovaScotia.Thein-personsession wasadjournedfollowingthe presentationofthesecertificates.

MeettheMembers

JESSICABAY

ABDULANIFOWOSE

I'macitizenofNigeriabybirth,andI'm23 yearsoldandastudentofCapeBreton Universitystudyingforanundergraduate degree(BachelorofEngineering Technology).AsIamstudyingforaBachelor ofEngineeringTechnology,Iamvery concernedaboutandalsohavehada passiontofocusontheprimaryhealthcare systemeversincemymigrationtothe provinceofNovaScotia,Canada.I'mgladI foundapathtoparticipateinthisprogram, andI'mworkingtowardsbringingmoreideas tosolvetheissueswe,NovaScotiaresidents, arefacingintheprimaryhealthcaresystem.

SELENAATWELL

MynameisSelenaAtwell.Iamamature studentattendingNSCCBurridgeCampusin Yarmouth,NovaScotia.Istartedmylifein HallsHarbour,NovaScotiaandhavelivedin quiteafewplacessincethen.Ihavehung myhatinDayton,N.S.forthepastfouryears.I havenothadafamilydoctorforabout12 yearsandhavebeenluckynottohaveany seriousailmentsinthattime.Myhobbies includereadingbooks,hiking,camping,and meditation.Iamgratefultohavethe opportunitytohavemyvoiceheardonthis panel,andIlookforwardtomeetingyouall soon.IcurrentlyserveontheYarmouth CountyLearningNetworkboardofdirectors andtheFirstVoiceAdvisoryCommitteefor FeedNovaScotia.

Iworkremotelyforabusycivilinfrastructure companyinTorontofrommyhomeinthe woodsinruralNovaScotia.IgrewupinNova Scotia,butIhavebeenluckyenoughtohave livedalloverthelandthatwenowcall Canada,andIreallyappreciatethebeauty anddiversityofthemanylandscapesand thepeoplewholivehere.Iamalsofinishing mydissertationformyPhDin CommunicationandCultureatYorkand TorontoMetropolitanUniversities,andIlike makingvariouscraftswhenIhaveanyspare time.IvolunteeredforthisPanelbecauseI believethatchangeneedstop-down authoritythatisempoweredbybottom-up knowledgeandawareness.

CYNTHIABAZINET

IliveinUpperPortLaTour,wheremyfamily ownsandoperatesafarmthatgrows organicsaffron,tea,herbs,andvegetables. WemovedherethreeyearsagofromtheU.S. afterIretiredfromacareerinteaching.I haveaBAandanMAinEnglishaswellasa PhDinEducation.Muchofmyprofessional lifecentredonthesocial,emotional,and academicwell-beingofadolescents.In additiontoteaching,Ialsoworkedinhealth careforover15years,soIhaveanactive interestinmattersofpublichealth.I volunteeredforthepanelbecauseIbelieve stronglyinarobustuniversalhealthcare deliverysystemthatmeetstheneedsof everyone.

DOMINICBOYD

I'ma69yearoldsocialworkerlivingin Caribou,N.S.withmywife,Jane,workingtwo daysperweekasatherapist,andI’m involvedwithseveralvolunteergroups includingourCommunityHealthBoardand theAlzheimerSociety.Myadultchildrenand twogranddaughtersliveinthearea,andI enjoyseeingthem.IlivedfortenyearsinN.B. and19inOnt.;fromAustraliaoriginally,Igrew upinHalifax.I'macommunityorganizerat heartandhaveanMSWincommunity practice.Ilovetoplaytennis,hike,jog,and workoutdoors.Iloveridingmymotorcycle. I'vehadvariousexperienceswiththeprimary healthandtertiarycaresystemsandwould lovetocontributetoimprovingthings.I'm dedicatedtodoingupstreamworkand improvinghealthholistically.IhopeIcan contributealottothePanelexperience!

MANICHAKRABARTY

IgrewupinYellowknife,N.W.T.andmovedto NovaScotiaafewyearsago;Iemigrated fromIndiawhenIwas11withmyfamily.Iam aneconomistandsocial entrepreneur/businessownerwholovesto workonruralhealthandeconomic developmenttopics.Oneofthereasonswhy IlovedsettlingdowninYarmouthisthe senseofcommunityandtheopenheartto solvecommunityissuesasacommunity wherenovoicesareleftbehind.Myfavourite activitywhennotworkingisdiscoveringour beautifulprovincethroughhikesandlong drives. Ijoinedthispaneltoshedsomelight ontheprimarycarepanelthrougharural lens,andIhopemyvoicehelpsaddress someofthepertinentruralandurbangaps currentlyinhealth.

MARGARET-ELLENDISNEY

Iamaretiredteacher,smallbusinessowner, andofficemanager.Ihavebeenanactive volunteerinthecommunitiesinwhichIhave lived,holdingleadershiprolesduringperiods oftransitionorchange.Ihavehada long-standinginterestinhealthcarerelated issuesandhavebeenapalliativecare volunteerfor30years.Iamastrong advocateforvolunteeringbothasameans ofstrengtheningcommunityandasan avenuetoself-knowledge.Iremainactiveas avolunteerinthePictouCountyPalliative CareSociety,theNovaScotiaHospice PalliativeCareAssociation’sAdvancedCare PlanningCouncil,Gyro,andMentoringPlus Strategies.Hobbiesincludesingingina senior’scommunitychoir,bookclub,travel, andwalkingtostayashealthyasIcan!

DARRELLGAUDET

DarrellGaudetwasborninNovaScotiaand currentlylivesintheAnnapolisValleywithhis partner.DarrelIwasapoliceofficerfor33 years,servinginbothfederalandmunicipal policeagencies.Hecurrentlyworksforthe PublicHealthAgencyofCanadaasaSenior Advisorandisalsoengagedwiththe CanadianFootballLeagueasacompliance representativeforAtlanticCanada.Darrell enjoysstayingactiveandtakesadvantage ofthemanyoutdooractivitiesNovaScotia hastooffer.Hehasmanyfamilyandfriends thatrelyonNovaScotiahealthcareandhas seentheprosandconsofthesystem.After workinginahelpingprofessionforhisentire career,Darrellseeshiscontributionstothe OurCarePriorityPanelasanotheravenueto givebacktothecommunity.

CAROLEHILL-BOJARSKI

IgrewupinYarmouth,N.S.and,aftera20 yearcareerintheU.S.,returnedhometocare formyageingfather.Alongwithmecame myhusbandBobandtwodaughters.Iwas educatedinbothCanadaandtheU.S.and becameaProjectManagerandDirectorof ServicesintheU.S.Uponreturninghome,I becametheCommunityHealthBoard CoordinatorfortheCountiesofYarmouth andShelburnefor15years.Mypassionis cookingandlearningaboutdifferentfoods, art,andculture.Currently,Iamsemi-retired, workingasasubstituteteacherwiththe Tri-CountySchoolBoard,ChairoftheFriends oftheArtGalleryofN.S.-WesternBranch,and amemberoftheBoardofDirectorsof YarmouthLifeSkillsforDisabledPersons.

CHIKAIWUJI

Sevenmonthsago,IrelocatedtoCanada fromNigeria,myhomecountry,whereI practisedlaw.Now,I'mpursuingBusiness ManagementatShannonSchoolofBusiness, CapeBretonUniversitytogainmanagement expertise.Additionally,Iserveasthe InternationalStudentRepresentativeatCBU StudentUnion,jugglingmystudiesand studentaffairs.Motivatedbymyfirsthand encounterwithprolongeddoctorwaittimes, whichwasnewtome,Ieagerlyvolunteered fortheOurCarePriorityPanel.Myaimisto contributetothegrowthoftheNovaScotia HealthSystem.

VIPANKAMBOJ

IwasborninPunjab,thenorthernregionof India.Ilivedtherefor18yearsbefore immigratingtoSydney,NovaScotia2years agoforhighereducation.Currently,Iam pursuingmyBachelorofSciencedegree fromCapeBretonUniversityandworkingas ResearchAssistantatIntagBio.SinceI movedtoCanada,I’veheardaboutthe challengespeopleface,especiallyinthe healthcaresystem.Sincethen,Istarted volunteeringfortheCapeBretonRegional HospitalFoundation,CanadianRedCross, andothernon-profitorganisations.I volunteeredforthePanelbecauseIwantto knowmoreabouttheprimaryhealthcare systeminNovaScotiaaswellasinCanada overall,andhowIcangivebacktothe communitywhereIwillbelivinginthefuture.

DEEPTILIMAYE

IwasbornintheMiddleEast,immigratedto Halifaxintheninetiesasachild,andmoved toSydneyin2021afternineyearslivingin California,Ontario,andQuebec.Iama professionalFrench-Englishand Spanish-Englishtranslatorworkingremotely foraQuebeccompany.Ilivewithmy husband,andwearelookingtoadopta child.Whennotnappingduetomychronic fatigue,Ienjoywalkingmy8-year-old beaglemix,playingboardgamesandtrivia, andseeingandparticipatinginproductions atthelocaltheatre.Iamhappytovolunteer fortheOurCarePrioritiesPanelbecauseIam extremelyconcernedbythestateofhealth careinNovaScotia,CapeBretonin particular.

FOSTERMACKENZIE

OCTAVIORAFAELLÓPEZ VILLATORO

MynameisOctavioLópez.I’mfromGuatemala, andI’m35yearsold.ImovedtoCanadawith mywifeandourtwodaughtersinDecember 2022.IhaveaMedicalDegreefrommycountry, andIhavepractisedmedicinefor8yearsso far.Duringmypractice,Iobtainedexperiencein manyaspectsofthefield:workingin emergencycare,intensivecareunits,surgery, andservingasaMedicalOfficerinthe PeacekeepingMissionoftheUnitedNationsin theDemocraticRepublicofCongo.Ialso workedinanNGObackinGuatemala, overseeingthedevelopmentofhealth programsinthecountry.

Iconsidermyselfafamilyperson,reliable, honest,organized,andpassionateabout medicineinallitsaspectswithastrong humanitariansense.Iencourageothersto pursueahealthierversionofthemselves throughpromotinghealthylifestyles.

LearningaboutthehealthsysteminCanada andtheobstaclesthatitiscurrentlyfacingis verymotivating.Andif,throughtheknowledge andexperiencethatIhavegainedoverthe years,Icancontributealittlebitinorderto pursueabetterhealthsystemforallofus,itwill behighlyrewardingforme.

Ihavelivedwithmywife,Dorcas,bothN.S. natives,inthePortersLakeareafor42years.I amaretiredarchitect,havingfoundedand partneredapracticefor25yearscoveringthe AtlanticProvinces;agraduateofDalhousie Universityin’79;andpastPresidentofthe provincialarchitectsassociationandafederal lobbygrouppromotingarchitecture.Iamalso apastmemberofRAIC;satonHopeCottage Board;andsitonBoardofSoulsHarbour RescueMissiontoprovidefood,clothing,and sheltertounhousedpeopleatrisk.Ihavethree children(ages48,50,and52)and6 grandchildren(ages2-25),andamexpecting anothergrandchildinAugust.Myinterests includetravel,family,health,andsupporting mychurch.IvolunteeredforOurCareto advocateforchangeandimprovementinour HealthCareSystem.

REGMANZER

MynameisRegManzer,andIamabornand raisedmaritimer,community-inspired researcher,gardener,motorcycleenthusiast, musician,and,mostimportantly,afatherand husband.

Withaloveforcommunityandcontagious curiosity,Ihavebeenpulledtowardsthe intersectionofhealthandwell-being, economicprosperity,andenvironmental sustainability.Thishasledmethroughyearsof healthcareexperience,professionalconsulting, communitysectorresearchandevaluation, andformaleducationinbusinessanda master'sdegreeinenvironmental sustainability.Myambitioninlifeistofoster connectionsbetweencommunitiesand governmenttocreatecollaborative,viable solutionswithandforallNovaScotians,inthe serviceofasocietythatprioritizesbelonging andwell-beingforall.

BILLMCINTYRE

OriginallyfromCapeBreton,Ihavelivedin HalifaxandDartmouthforabout35years.Now retired,mycareerspannedover30yearsof serviceworkingwiththeGovernmentof CanadainNovaScotia,Quebec,andOntario, withmuchofitatthemanagerialand executivelevels.Mostofmyexperience comprisesworkintheareasofbusinessand communitydevelopment,policy,andproject management.Mymostrecentvolunteer experienceincludesservingontheboardsof theShubenacadieCanalCommissionaschair, whereIcontinuetovolunteer,andthe MuseumsNovaScotiaBoardofGovernors.I haveMBAandMPAdegrees,alongwitha ProjectManagementProfessionalcertification. Ienjoygolf,travel,hiking,biking,history,and justaboutanythingbyandontheocean.I wantedtovolunteerfortheOurCarePriorities Paneloutofconcernforthestateofprimary careinNovaScotiaandtheurgentneedto ensurethatprimarycareisaccessibletoallon anequitableandcontinuedbasis.

BENMCVICKER

IwasborninBridgewater,grewupinHalifax, andlivedprimarilyinTorontofrom2007-2020 withaboutayearandahalfabroadbefore returningtoNovaScotia.DuringthistimeI completedaPhDinHistory,butmyinterests graduallyshiftedtohealthcare.Epilepsywasa day-to-dayfactorinmylife,andIchoseto undergobrainsurgeryfouryearsintomy doctoraldegree.Recoveryandrelearningin theshorttermwerefollowedbypatient advocacyasalong-terminterest.Since August2020,Ihavebeenamemberofthe PatientAdvisoryCommitteetotheCentrefor AddictionandMentalHealth(Toronto),andI currentlyworkasaResearchCoordinatorat DalhousieUniversity'sDepartmentofMedical Neuroscience.

KIRKMUNROE

IwasborninHalifaxandgrewupinSydney.I livedinOntariofor20yearsbeforemoving backtoNovaScotiainmid-2020.Currently,I amacofounderofPaintwithDataInc,avisual analyticsconsultingcompany.IhaveaBScin PharmacyfromDalhousie,andIampast presidentofthePharmacyAssociationofNova Scotia,althoughIhavenotworkedina pharmacysince1999.I’vebeenworkinginthe dataandsoftwarespaceforthelast23years.I currentlyliveinHammondsPlainswithmywife anddog.Ilookforwardtocontributingtothe conversationandchangeforprimaryhealth careinNovaScotia.

JODYMYERS

IwasborninHalifax,a7thgenerationNova Scotianonbothsidesofmyfamily,and currentlyliveinHalifax.However,inbetweenI havelivedinvariousplacesincludingNewYork City.IgraduatedfromDalhousieUniversityin 1972asaPhysEdteacherandtaughtinthe highschoolsystemfortwoyears.In1974,I movedonandtravelledonalonginner journeythatledmetobecomeavegetarian, yogateacher,andartist.IntheserespectsI wasapioneer;Itaughtthousandsofyoga classesovertheyearsandfoundedoneofthe firstyogateachertrainingprogramsinAtlantic Canada.Ihaveawonderfulhusbandand togetherweenjoyhiking,biking,andtravelling. In2022Iexperiencedahealthscarewhichled metobecomevegan.AfterdoingresearchI havediscoveredthescienceisin,intheform ofthousandsofpeer-reviewedstudies (accordingtodoctors)showingthegrand healthbenefitsofaplant-baseddiet,notjust forpeople,butfortheplanet.

ERNESTNG

IwasbornandraisedinMalaysiabefore movingtoHalifaxin2019foruniversity.During mytimeinuniversity,Iwasheavilyinvolved inharmreductionamongsttheuniversity populationsurroundingsubstancesand high-riskbehaviour.Sincegraduating,Inow workinsupportingstudentstransitioninginto universitylifeandaddressingsomeofthe barriersthatpreventcertaingroupsfrom adaptingtothechangesassociatedwith thattransition.Iamlookingforwardto participatinginthisconversationasIhave livedexperienceasanimmigrantnavigating thehealthcaresysteminNovaScotia,as wellastounderstandinghowdifferentage groupsinteractwiththehealthcaresystem differently.

VELOAKES

Ihavelivedinnorth-endDartmouthforthe pasttenyears.ItellpeopleI’mretired becauseIhaven’tworkedinthepastseven yearsandhavenoplanstoreturntomypast careerasasecretary.Ispendalotoftime outside,walkingalmosteverywhereIgo.I alsospendtimeatTheNorthGrove,a communityfoodcentrejustafewminutes away,bothasaparticipantandasa volunteer.I’mnotthebestcook,butI definitelylovetoeat.Myotherhobbies includereading,knitting,andspendingtime withfriends.Iamhonouredtobepartofthis panelandknowthatourworkwillimpact healthcareforeveryoneinNovaScotia.

TROYPALLO

Hi,mynameisTroy,I'manoutgoingperson andlovetheoutdoors.Iconsidermyselftobe apeopleperson.IvolunteeratTheNorth GrovewhenIcan,andhavebeendoingso foralmost5yearsnow.Itendtomygarden thattheyprovideforme.Ialsovolunteered fortheUnitedWay.Ialsovolunteeredforthe Tattoo.Ilovemusic,exceptrapandheavy metal.I'malsoamovieaddict;Ihavealarge collectionofmoviestowatch.Iconsider myselfafamilyperson,andIvisitmyparents wheneverIcan.

JUDYPORTER

I’velivedmostofmylifeinColeHarbour, enjoyingphotographyasahobby.Growing up,Ispentasmuchtimeinthehospitalas out.Aformerexecutiveassistant,nowon disability,Ibecameacommunityvolunteer, runningafreesoccercampfor24years, hostinginternationalstudents,andserving asachurchyouthleader.Livingwithmultiple chronicillnesseswhileactingasmyparents’ caregiverhasbeenachallenge,butitwas madeeasieraftermarryingmyownpersonal paramedic,Phil.InthepastdecadeI’ve focusedmyattentionwithinN.S.Healthasa volunteerPatientFamilyAdvisor,bringinga patient’sperspectivetohealthcare discussions.I’mexcitedforthisopportunityto helpdrivepositivechangeforpatientsand familiesofNovaScotia.

AIMEEREDDING

MynameisAimeeRedding,andIwasborn andraisedinDartmouth,N.S.GrowingupI wasraisedbyasinglemother,andnowIam currentlyraising2childrenasasingle mother,andasasinglemotherIoftensee andexperiencedifficultieswhenitcomesto gettingandkeepingadoctorand/or specialist.

Oneofmybiggestpassionsiswritingand gettingmyvoiceheardassomeonethatis livingwithbothmentalandphysical challenges.CurrentlyIamaclientat LakeCityWorks,andIamnoticingalackof resourcesthatarebothattainableand available,whichiswhyIdecidedtovolunteer fortheOurCarepanel.

Iwanttobeabletostresstothosethatwork inthehealthcarefieldtheimportanceof beingabletofindandkeeptheright professionalsthatwouldhelpuslivethelife wewereintendedtolive.

DARSHANASARAVANAN

IwasborninIndiaandlivedinTokyoand CaliforniabeforemovingtoOttawa.Inowlive inHalifaxforuniversity.Iammajoringin neuroscienceatDalhousieUniversitywitha focusonneurotechnologyandscience communications.Ialsovolunteerata retirementhomeandRedCrossCanada.I volunteeredfortheOurCarePrioritiesPanel becauseitallowsmetogivebacktothe communitythathassupportedmeforthe pastfewyears.Iseethisasagreat opportunitytolearnmoreabouttheprimary caresystemandasanopportunitytoshare myexperiences,ideas,andperspectivesin thehopesthatIcanhelpmakeapositive difference.

SAMSEMARK

IwasbornonaRoyalAirForcebasein Germany,leavingthereattheageof6 monthstoliveinfiveothercountriesand manyplacesinboththeU.K.andCanada, andfinallycomingtorestinCanadain1991. Havingstartedoutasanaeronautical engineerandfinishingasabusinessprocess re-engineeringspecialist,Ithenboughtand operatedaB&BinN.S.Iamnowretiredand stayinginoneplaceinNovaScotia,thank heavens!Ihavethetimetogivebacktothe community,soIvolunteeratthehospital, andthisisalsothereasonwhyIvolunteered forthispanel.Oneofmyfavouritepastimes iswalkingwithmydog.

ERICASMITH

IgrewupinLowerSackville,butLunenburg hasbeenmyhomeforthepast13years.I workedinforestryasagenerallabourerfresh outofhighschoolfor9years,thenmovedon totheCanadianArmedForcesasaNaval RMSclerkfor2.5years.Ialsoplannedtotrain SAR/HRDservicedogsasahobbytogive backtomyprovincewhiledoingsomething I’mpassionateabout.Currently,I’munableto workduetochronicillness.Ivolunteeredfor thispanelbecauseIwitnessedthedeclineof ourhealthcaresystemsince1988andwant thepatientexperienceheard.

MARIANNESMITH

MynameisMarianneSmith,andIwasborn inVermilion,Alberta.ImovedtoConsortasa child.

IgrewupinConsortwithmymother, stepfatherandonesister.ImovedtoCalgary in1980.Myparentspassedawayin1994and 1995,and,lookingforachange,inJanuary, 2001IcametoNovaScotiaforathreemonth projectandthenacceptedapermanent position.

Mybackgroundisininsurance,Group Benefits.Iretiredwhenmyjobmovedfrom HalifaxtoToronto,soldmyhousein2020, andamnowinanapartmentwithmy2cats, MaisieandMillie.Andyes,thereisastory behindtheirnames!

Ispentseveralyearsvolunteering,thendoing paidwork,atathriftstoreintheareabut havehadtogivethatup.Duetosomevision issues,Iliveaveryboringlifethesedays.Iam unabletodothethingsIusedtodo,like reading,sewing,andcrocheting.

Iamlookingforwardtotakingpartinthis panel.Myprimarycaredoctorretiredin November2022,andIamnowwithoutone. Healthcareisveryimportanttome,andI wanttomakeadifference!

KEITHTOWSE

IgrewupintheU.K.andarrivedinNova Scotiathirtyyearsago.IliveinHalifaxwith mywifeandson(andthreecats)andworkin renewableenergydevelopment.Ihave alwaysbeeninterestedinthewaysinwhich governmentandservicessuchashealth careareorganizedandhowbureaucracy canrestrictaccesstothemedicalservices peopleneed.IvolunteeredforthePanel becauseIfeelthatdecision-makingabout howhealthcarecanbeimprovedshouldn’t takeplacebehindcloseddoors–these decisionsshoulddrawontheexperiencesof thoseinourcommunitieswhoneedaccess toitmost.

ANDREATRASK

Andreaisawife,motheroftwoteenagers, anddaughter/daughter-in-lawtofiveN.S. seniors.Withfamilyandfriendsthroughout theprovince,herinterestinthispanel opportunitycamefromadesiretobepartof processestofindsolutionswecollectively haveinprimarycare.

Asherparentsandin-lawsgetolder,various healthconditionshavebeenarisingand haverequiredsupportfromfamilydoctors, specialists,andevenemergencycare.Inone relationshipsheistheprimarysupport personandthushasexperiencenavigating thepublichealthsystem.Oneofherchildren hasType1diabetes,and,astheygrowup, sheworriesaboutwhattheirprimarycare willlooklikeifthingsinNovaScotiaremain unchanged.

Professionally,Andreahasworkedin municipalgovernmentforover20yearsand participatedonnumerouscommitteesand projects.Withthisexperienceshefeltshe couldcontributefairly,honestly,and productivelyonatopicofsuchimportance.

JORDANWATERBURY

IamJordanWaterbury,originallyfromKentville, NovaScotia,butnowresidinginHalifax.My family’sMaritimerootsgoback300years,andI lovetospendtimedrivingaroundand exploringtheprovince.

I'manITspecialistwithexpertiseinsoftware packaging.Academically,IholdaBBAdegree withafocusonlabourmanagementand employmentrelationsfromAcadiaUniversity. Myhobbiesincludereadingvariednonfiction, divingintomysterythrillers,exploringAnglican theology,andspendingtimewithmywonderful familydogs,WillowandPiper.Iinheritedmydry andself-deprecatingsenseofhumourfrommy father'stimeinaMontyPythonsociety.

I’mapassionateadvocateforeconomicjustice andlabourrights,ampoliticallyactivewithin myelectoraldistrictassociation,andserveasa licensedlayminister.Iactivelyparticipatein communitymissionsforsocialjustice,ampart ofanecumenicalanti-povertygroup,and serveontheSocialJusticeandHuman ResourcesteamswiththeDioceseofNova ScotiaandPrinceEdwardIsland.

Ivolunteeredforthispaneltoaddressthe overemphasisonacutecare,the underemphasisonsocialdeterminantsof health,andtohelpNovaScotiagetour prioritiesstraighttoaddresstheprimarycare needsofourcommunity.

MICHAELWESTCOTT

MichaelWestcottmovedfromSouthern OntariotoGranvilleFerryinOctober,2020.

MichaelisagraduateoftheUniversityof Toronto,havingavariedandsuccessful careerinmanagementandsales,workingin bothdomesticandoffshoresettings.His careerexperiencesinclude:insurance, corporateassetacquisitionand management,databasesystems,business analysis,managementconsultingand training,andtechnologyandagricultural start-ups.

Michaeliscurrentlysemi-retiredand exploringseveralbusinessopportunities acrossCanada.

Additionally,Michael’sexperienceinthe not-for-profitsectorincludesChairpersonfor theTerryFoxRuninBurlington,Ont.,and AnnapolisRoyal’sKing’sTheatreBoardof Directors.

NORMANWIEGERS

Iama54year-oldwhowasborninMontreal, Que.andmovedtoLowerSackville,N.S.in1980.I currentlyliveoutsideofWindsorinArdoise,N.S. withmywifeanddaughter.Mysonandhiswife liveinHatchetLakeoutsideofHalifax.Ihave experiencewithhealthcareinNovaScotiaasa consumerandasanemployeeintheHealth DistrictsandourEmergencyHealthServices (ParamedicService).Myworkbackgroundisin materialmanagementandfinance.

Ienjoylivesportingevents,Broadwaymusicals, andreadingawidevarietyofgenres.Iam involvedinmychurchandhaveworkedwith variouschurchgroupsaswellaswithScouting.

IamparticipatingonthispanelasIhopetobe abletomakeapositivechangetohelpNova Scotiaprimarycarebecomemorerobustand sustainableforthefuture.

HEATHERYOUNG

Iamaformerbiochemistandpublichealth officer,andcurrentmilitaryspouseandMSW studentatDalhousieUniversity.Ihavea volunteerhistorywiththecommunityhealth boardsandsearchandrescue,whereImetmy spouse.Myprimaryinterestsrelateto communityhealth,ruralhealthequity,social andstructuraldeterminantsofhealth,and crisisandemergencyresponse.Inmyfreetime Icanbefoundgardening,tinkeringwithplans forasailboatandsustainabletinyhomes,or exploringbeautifulKespukwitkwithmytwo dogs.

GuestSpeakers

SixteenexpertsgenerouslygavetheirtimeandsharedtheirknowledgewiththeNovaScotia PrioritiesPanelonPrimaryCare.ThePanelextendsitssincerestthankstoeachofthem.

Dr.Asra’aAbidaliisafamilyphysicianwhowillbe startingupherownsharedpracticeinHalifaxinJuly.For thelasteightyears,she'sbeenalocumfamilyphysician practicinginanumberofplacesandsettings,including theNewcomerHealthClinicinHalifax.Shehasservedon theAnti-OppressionCommitteeatDalhousieUniversity's FacultyofMedicinesince2020,andwasamemberofan investigationscommitteefocusedondiscrimination basedcomplaintsattheCollegeofPhysiciansand SurgeonsofNovaScotia.Shehasaparticularinterestin obstetrics,andcountsamongherpatientsatthe NewcomerClinicmanyexpectingmothers.Shehasa sonontheAutismspectrumandherhusbandisamore recentimmigranttoCanada,soshebringsbotha providerandapatientperspectivetoequityandaccess toprimarycareaccess.

Dr.MariaAlexiadisisanexperiencedleaderwitha diversebackgroundinhealthcareleadershipandcareer thatspans35years.Shehasbeeninvolvedin establishingpost-COVIDintegratedcareservicesin NovaScotiaandhashelpedleadVirtualCareNS.Since 2018,Dr.AlexiadisisheadoftheDepartmentofFamily PracticeinCentralZoneandInterimClinicalLeadfor ContinuingCareacrossNovaScotia.Atpresent,she holdsadditionalroleswithinNovaScotiaHealth, includingSeniorMedicalDirectorofthePrimaryCare andChronicDiseaseManagementNetworkand,most recently,InitiativeLeadforPrimaryCareTransformation.

Dr.RoopConyers isafamilyphysicianandMedicalSite LeadattheAnnapolisCommunityHealthCenterin AnnapolisRoyal,NovaScotia.Heworksinacollaborative caremodelprovidingcomprehensivepatientcaretoa populationbaseofapproximately10,000,including full-scopefamilymedicine,emergencymedicine, traumacare,procedureclinics,andpalliativecare.Heis alsothePostgraduateSiteDirectorfortheAnnapolis ValleySitewithDalhousieUniversity,wherehesitsonthe SelectionCommitteeandResidencyProgram CommitteefortheDepartmentofFamilyMedicine.At theprovinciallevel,heisaboardmemberfortheNova ScotiaCollegeofFamilyPhysiciansandPeerReviewer fortheCollegeofPhysiciansandSurgeonsofNova Scotia.Atthenationallevel,herecentlycompletedtwo termsasamemberoftheCFPC’sPostgraduate EducationCommitteeandSectionofTeachers.

Dr.KatherineFierlbeckisMcCullochResearchProfessor andChairoftheDepartmentofPoliticalScienceat DalhousieUniversity,withacross-appointmentin CommunityHealthandEpidemiology.Dr.Fierlbeck focusesonthepoliticsofhealthpolicy;shehasa particularinterestinissuesofgovernanceand mechanismsofaccountability.Hercurrentfunded

researchprojectsincludeinvestigationsintoupstream determinantsofeffectiveCOVID-19responsesacross Canadianprovinces,publicpolicychallengesin rethinkingpublichealth(comparativeperspectives),the growthofprivatehealthcareinCanada,andtheimpact ofretirementincomeprogramsonhealthandhealth equityamongCanadianseniors.

Dr.LeahJonesisafamilyphysicianandthenew AcademicDirectorofBlackHealthwithinDalhousie’s FacultyofMedicine.Shewasbornandraisedin Dartmouth,attendingDalhousieforMedicalSchool,and graduatedin2018.AfterattendingMcMasterUniversity forherFamilyMedicineresidency,shepracticedin OttawafortwoyearspriortocomingbacktoNova Scotia.HerroleinDalhousie’sFacultyofMedicineis workingtoengagetheAfricanNovaScotian/Black communitywiththeuniversity,increaserepresentation ofBlackmedicalstudents,adviseoncurriculumasit relatestoBlackhealth,andsupportworkingtowardsa culturallycompetentlearningenvironment.Clinically sheisworkinginprimarycarefortheNovaScotia Sisterhood,aswellasinaddictionmedicine.

Dr.TaraKiranistheFidaniChairinImprovementand InnovationattheUniversityofTorontoandVice-Chairof QualityandInnovationattheDepartmentofFamilyand CommunityMedicine.Shepracticesfamilymedicineat theSt.Michael'sHospitalAcademicFamilyHealthTeam (SMHAFHT).Dr.Kirancompletedherfamilymedicine residencyatMcMasterUniversityin2004andspenther firstcoupleofyearsinpracticeasalocuminIndigenous communitiesinnorthernOntarioandincommunity healthcentresinurbanToronto.Shepracticedatthe RegentParkCommunityHealthCentrefrom2006to2010 beforejoiningSt.Michael'sin2011.

Dr.RuthLavergneisanAssociateProfessorinthe DepartmentofFamilyMedicineatDalhousieUniversity. HertrainingisasaPhDresearcherandherexpertiseisin quantitativeanalysisofhealthsystemdata.Sheworks withexpertsinqualitativemethods,patients,care providers,andpolicymakersonstudiesthatlookat primarycareacrossprovincesandovertime.Her researchaimstoaddressdisparitiesinaccessto primarycareandbuildevidencetoensureprimary care’sorganization,delivery,andworkforcemeetthe needsofpeopleinCanadanowandinthefuture.

PaulinaMeaderisaproudMi'kmawwomanfromthe traditionallandsofUnama’kiandisamemberof MembertouFirstNationandapassionatehealthcare professional.Shedrawsfromherexperiencesasan Indigenouswoman,anurse,abirth-worker,aknowledge keeper,andapersonwholiveswithachronicdisease.

Shehasgatheredhertraditionalknowledgefromvarious eldersandceremoniesacrossTurtleIsland,butconsiders mostofherteachingstocomefromhermother,Jane. Shefirmlybelievesthatherculturalandspiritual practicesinconjunctionwithhermedicaltreatments havegivenherthelifeandhealthshehasnow.Italso driveshertoinstillasmuchculturalaccess,safety,and humilityintohercareasshecan.Sheisafierceand effectiveadvocateagainstsystemicracisminhealthcare —especiallywhenitcomestoendoflife,pediatrics,and careofbirthingparents.

Dr.AshleyMillerisanacademicgeneralinternist,virtual careadvocate,andpassionatechampionfor digital-enabledhealthcaretransformation.After graduatingfrommedicalschoolatUniversityofOttawa, shecompletedherresidencyinInternalMedicineand GeneralInternalMedicineatMemorialUniversityin2017. ShealsoholdsaMasterofScienceinHealthPolicy, Planning,andFinancingfromtheLondonSchoolof EconomicsandtheLondonSchoolofHygiene&Tropical Medicine.ShejoinedDalhousieUniversityinthe DepartmentofMedicineasAssistantProfessorin2017and nowenjoysaparttimeacademicroleandclinical practiceacrossdiverseacute,ambulatory,and community-basedcareenvironmentsinadditiontoher roleasChiefMedicalInformationOfficerforIWKHealth andNovaScotiaHealth.

AbbeySandfordisapassionatememberoftheHealth SystemPartnershipsteamatMaple.Withabackground asafront-linenurse,shehasadeepunderstandingof thechallengesinthehealthcaresystem.Throughher workatMaple,shehasbecomeanexpertindesigning andimplementinginnovativemodelsofcarethat addresssomeofourstickiestprimarycareissuesbacked byvirtualtelemedicine.Inadditiontoherexperienceasa nurse,shehascompletedaMaster’sofManagement InnovationandEntrepreneurshipthroughQueen’s Universityandworkedwithhealth-techstartupsatMaRS inToronto.

ErinSarrazinisaPrimaryCareNursePractitionerinNova Scotia.Shehasbeenworkinginthehealthcaresystemfor 20years.Shespent12yearsworkingasaRegistered NurseinboththeUSandCanadaprimarilyintheareasof CriticalCareandEmergencyMedicine.Shehasaspecial interestinwomen’shealthandrunsacontraceptiveclinic forherlocalcommunityinadditiontoherfamilypractice. SheisalsotheCommunicationsDirectorfortheNurse PractitionerAssociationofCanada.

Dr.Sheryl Spithoffisafamilydoctor,anAssistant professorattheUniversityofToronto,andaScientistat Women'sCollegeResearchInstitute.Herresearchaims toimprovethehealthandwellbeingofpeoplewhouse substances.Shealsoconductsresearchatthe intersectionofhealthsystems,newtechnologiesand commercialinterests. ourcare.ca

ColinStevensonassumedhisnewrolewiththeNova ScotiaDepartmentofHealthandWellnessasChief, SystemIntegrationinJune2022.Colinbrings25yearsof healthcaremanagementandleadershipexperience, withthepastfifteenyearsprovidingleadershipfor provincialinitiativesororganizationswithinNovaScotia; includingthedesignofprovincialcorporateservicesfor thehealthsystem,theHealthAuthorityConsolidation initiativeandexecutiveleadershipwithNovaScotia Health.

Dr.KatherineStringerisaSouthAfricanbornand trainedfamilyphysician,receivingherMBChBfromthe UniversityofCapeTownin1994.Sheworkedasa communityfamilyphysicianinNewfoundlandfrom 2002,obtainedherCFPCin2004,beforejoiningthe DisciplineofFamilyMedicine,FacultyofMedicineat MemorialUniversityin2009.SheobtainedherFCFPand aMastersinClinicalSciences(FamilyMedicine)through WesternUniversityin2016.Sheisastrongsupporterof medicaleducationandhasheldmanyLeadership positionsincludingtheMemorialFacultyofMedicine ClerkshipDirectorandDepartmentHeadofFamily Medicine.SheiscurrentlytheDepartmentHeadatthe DalhousieDepartmentofFamilyMedicineandtheChair oftheFamilyMedicineSpecialtyCommitteeattheCFPC. Clinicallyshepracticescomprehensivefamilymedicine withaspecialinterestinCareoftheElderlyandadults withDevelopmentalDisabilities.

Dr.GaynorWatson-CreedistheAssociateDeanof ServingandEngagingSocietyforDalhousieUniversity’s FacultyofMedicine,andanAssistantProfessorinthe DepartmentofCommunityHealthandEpidemiology. Sheisapublichealthspecialistphysicianwith18years experience,havingservedastheformerMedicalOfficer ofHealthfortheHalifaxareaandDeputyChiefMedical OfficerofHealthforNovaScotia.Dr.Watson-Creedhas anMDfromDalhousieUniversity,anMScfromthe UniversityofGuelph,aBScfromtheUniversityofPrince EdwardIsland,andhonorarydoctoratesfromAcadia UniversityandtheUniversityofPrinceEdwardIsland.She alsositsaschairormemberofseveralnational populationhealthcouncilsandboards,andisa passionateadvocateforhigh-qualitypublichealth servicesinCanada.

LisaWoodilliscurrentlytheDirectorofPharmacyPractice forthePharmacyAssociationofNovaScotia.Inthisrole, Lisaisresponsibleforeducationandconference programming,projectleadforvariousdemonstration projectssuchastheCommunityPharmacyPrimaryCare ClinicDemonstrationProject.LisareceivedherBSc (Pharm)fromDalhousieUniversityin1999andhas workedinvariouspastpositions,includingDirectorof ProfessionalDevelopment,RegionalPharmacyManager andManagerofPharmacy-Ontario/westernCanadafor SobeysNationalPharmacyGroup.Inthesepositions,she providedprofessionalandoperationalsupportto pharmacyteamsacrossthecountry.

Appendix

MinorityReports

Memberswereencouragedtoconsiderallpointsofviewduringthepanelprocess.Discussions werelivelyandrespectfulthroughouttheproceedings,andwhilesomeminordifferencesin opinionremained,everymemberofthepanelendorsedtherecommendationsinthisfinal report.However,memberswerealsogiventheopportunitytowriteaminorityreportinwhich theycouldhighlightanypointsofagreementordisagreement,orincludetheirowncommentary.

BillMcIntyre

UnderscoringtheSeverityoftheFamily PhysicianChallengeandtheNeedforUrgent RecruitmentandSuccessionPlanning

Astartlingindicatorofthesituationof primarycareinNovaScotiaisthe increasingnumberofNovaScotians registeredontheprovincialNeedaFamily PracticeRegistry.InOctober2019,about5% ofNovaScotianswereregistered or51,014persons.ByJulyof2023thatnumber roseto152,001orover15%of theprovincialpopulation,aperiodofless thanfouryears.Ithasbeenreported thatthetoptworeasonsforindividualsand familiesneedingafamilydoctorare thattheyarenewtotheareaorthattheir doctorretiredfrompractice.

Itshouldbeaconcernthatthesituationwill beexacerbatedasNova Scotiagovernmentstatisticssuggestthat theprovince’spopulationisgrowingat arapidpace–thepopulationreached 1,047,232onApril1,2023,markingan increaseof10%since2017oranannual growthrateof1.6%.However,thelast twoyearsofthattimelinesawannualgrowth between2.5%and3.9% respectively,placingNovaScotiaamongthe highestofrecentCanadian provincialgrowthrates.BecausenewNova Scotiansrepresentasizeable

portionofthenumberofpeopleseekinga familyphysician,itseemsthattheRegistry listcouldgrow.

NovaScotiaCollegeofPhysiciansand Surgeonsdatasuggestthatoverthesame period,thenumberoffullylicensed,resident familyphysiciansacrossNova Scotiahasonlygrownby4.8%(oranetof52 positionsintheperiodfromMay31,2018 [total:1,082]toMarch31,2023[total:1,134]).In Octoberof2022,DoctorsNovaScotia reportedthatroughlyaquarterofthe province’sfamilydoctorswereover60witha verylargenumberofthesenearingor consideringretirement,addingfurther pressureforsolutions.

TheNovaScotiaActionforHealthStrategic Plan(2022-2026)laysoutan aspirationalgoaltoachievearateof135 doctorsper100,000NovaScotians. Steppingupeffortsforrecruitmentand successionplanningwillbenecessaryto balanceresourceswithdemandtoachieve thisgoal,especiallygiventhe realitiesoutlinedabove.

HeatherYoung

FamiliesofFederalemployeessubjectto frequentmovesfacedisproportionate barrierstoprimaryhealthservices.There areabout1000RCMPfamiliesinthe province,and2%ofNovaScotia’s populationcomprisesfamilymembersof CAFregularforcemembers2.Thesefamilies aresubjecttofrequentmoveseverythreeto fiveyears,andoftenfindthemselves movingfromdifferentprovincialwaitlists everyfewyearswithouteverhavinga healthcarepractitioner.Asaresult,many kidsgowithoutafamilyphysicianor specialistuntilasituationbecomescritical. Evennewbornsaregoingwithoutahealth careprofessionalandareplacedonthe newinfantwaitlistforprimarycare.Inmany instances,virtualcareisinsufficientfor medicalneedsorroutinechildhoodexams, andthereisnocontinuityofcareorrecords betweenvirtualcareanddifferentprovincial systems.

GiventhehighproportionofCAFandRCMP familiesintheprovince,NovaScotiaHealth shouldmakeeveryefforttoensurethe continuityofrecords,facilitatethetransfer ofwaitlistpositions,andofferspecialinterim clinicstopreventhealthdisparities compoundedbyothersocialdeterminants ofhealth.

Thisshouldenabletransferbetween physicianswithcompleterecordsto/from otherprovincesforcontinuityofcareto ensurefamilymembersrequiringdirect medicaloversight(beyondwhatvirtualcare canoffer)arelinkedtoanappropriate healthcareprofessionalinatimelymanner. NovaScotiaHealthshouldcollaboratewith GMFRC,CAF,andRCMPoncreating CAF/RCMPfamilyrepresentativesanda transitionclinicthrougharesource-sharing model.

Nochildshouldbewithoutaprimaryhealth carepractitionerfortheirentirechildhood becausetheirparentchoosesacareerin publicservice.

Manser,L.(2020).CanadianMilitaryFamilyDemographics.CanadianForces MoraleandWelfareServices.UniversityofTorontoPressJournal. https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2019-0003

MichaelWestcott

Havingbeeninseveraloftheworkinggroups whereaffordabilitywasdiscussed,thereport doesnotfullyreflectthesediscussions.Not onlydidwediscusstheaffordabilityof user-payproducts(drugs,testingsupplies, etc.)andservices(dentists,physiotherapists, dietitians,etc.),directdiscussionswerealso heldaboutaffordabilityfromthetaxpayer’s perspective.

Publichealthsystemsareamongstthe largestexpendituresbygovernments,and theirgrowthhasoutpacedoverallbudgets bylargeamounts.Recentpollssuggestthat Canadiansareapproachingtheirlimitsasto overalltaxburdens.Thewranglingbetween federalandprovincialgovernmentsasto whoshouldfundincreasedhealthcare expendituresignoresthefactthatintheend, itallcomesfromthesametaxpayer.

Thisrequiressolutionsthatareinnovative, effective,andcanbeaccomplishedwithina totaltaxregimethatwillbeacceptabletoa taxbasethatisfeelingtherearelimitstohow muchthegovernmentcantakefromthem noworshiftdowntheroadbyborrowing.

Itwillnotbeeasy,butisnecessary,to balancewhatsocietywantswithwhatitis willingtopay.

KirkMonroe

ThisistheoriginalIssuedescriptionfor‘Lackof interoperability’(p.19)thatwasdraftedand deliveredduringtheClosingSessiononSunday May15.Theversionthatappearsearlierinthe reportwasadaptedtosuitawrittenreport.

AsapatientofprimarycareinNovaScotia, continuityofcareisverydifficultformeaseach healthcareproviderIinteractwithdoesnot haveeasyaccesstomyoverallhealthrecord.

Tosolvethis,Ineedtorelyonhealthcare providerstoforwardinformationinadvanceof myinteractions,orIneedtogetandbringthe informationmyself.

Thisinefficientprocessleadstoadministrative burden,delayedaccesstocare,and, sometimes,badcareplansthatcouldhave beenavoidedifthehealthcareproviderhad thefullpictureofmyhealth.

Asaprimarycareprovider,Ioftenseepatients forwhomIdon’thavethefullcontinuityofcare. ThismeansthatIamoverburdenedwith administrativeworkto“rundown”this informationfromthepatient’sotherprimary careproviders.

Iendupexposedtomakingbad recommendationsbecauseofanincomplete picture,andIamgenerallyleftfeelinglikeIam doingasub-optimaljob.

Government,asastewardofthepublic’s healthandwellbeing,aswellastryingto maximizeourtaxdollarstooutcomes,thelack ofintegrationbetweentheinformationsystems ofprimaryhealthcareprovidersleadstoan unnecessaryexpensiveadministrativeprocess forpayments,inefficienciesofwheretoallocate resources,andleavesuscompletelyblindto healthoutcomesinNovaScotia.

Asprovidersofhealthcareinformation systems,weareblamedforbeingpartofthe problemandfornotcontributingtoan integratedpatienthealthrecord,butweare notbeinggivenguidanceandastandardto whichwecanconform.

Glossary

Chronic diseases are long-lasting illnesses with generally slow progression. They can have multiple causes, share common risk factors, and often impact quality of life and daily activities, requiring long-term management from individuals, health care professionals, and communities.

Interoperability is the capacity of different systems, devices, applications, or products to connect and communicate without needing input or effort from the end user. This capacity for seamless data exchange is considered a key feature for the growth and smooth functioning of modern information or data systems.

One Nova Scotia was an initiative that emerged from the report of the Commission on Building Our New Economy. One Nova Scotia developed a 10-year plan to reverse trends in population decline and increase economic growth, and progress against its goals are tracked on a public dashboard at www.onens.ca

One Person One Record is a fully digital clinical information system that is intended to replace the close to 100 programs that have been used across major hospitals in the province to date. The Government of Nova Scotia announced a 10-year contract with Oracle Cerner Canada to design and deliver the system in February 2023. The first phase of the system’s rollout targets hospitals and some provincially-run primary care clinics.

Primary Care is first-contact, accessible, continuous, comprehensive, and coordinated person-focused care, usually delivered by a family doctor or nurse practitioner. It involves first contact accessibility, continuity, comprehensiveness, and coordination.

Primary health care is a whole-of-society approach to organizing and strengthening national health systems, bringing services closer to communities. It includes integrated health services; addressing broader social issues affecting health; and empowering individuals, families, and communities.

Social determinants of health are non-medical factors influencing health outcomes, including economic policies, social norms, social policies, and political systems. They significantly affect health inequities within and between different population groups.

AboutOurCare

OurCareisapan-Canadianconversationwitheverydaypeopleaboutthefuture ofprimarycare.Itseekstounderstandwhatresidentswantinahighquality, equitableprimarycaresystemandtocapturetheirrecommendationsfor change.

TheprojectisledbyDr.TaraKiran,afamilydoctorandrenownedprimarycare researcherbasedinToronto.SheandtheprojectteamareworkingwithAdvisory Groupsacrossthecountrytoalignwithdifferentprovincialcontexts.OurCare hasthreestages:

NationalResearchSurvey

ThesurveywasonlinefromSeptember20toOctober25,2022.Morethan9,200 Canadianscompletedthesurvey,sharingtheirperspectivesandexperiences. VoxPopLabsco-designedandexecutedthesurvey.

PrioritiesPanels

PrioritiesPanelswillbeheldinfiveregions:NovaScotia,Quebec,Ontario,British ColumbiaandManitoba.MASSLBPisco-designingandexecutingthepanels withOurCareadvisorsandlocaldeliverypartners.

CommunityRoundtables

Twocommunityroundtableswillbehostedineachofthefiveregions,focusing onequity-deservinggroupsthatwedidnothearenoughfromduringstages1 and2.MASSLBPisco-designingandexecutingthecommunityroundtableswith OurCareadvisorsandlocalcommunityorganizations.

OurCareProjectPartners

OurCareisfundedby:

HealthCanada

HealthCanadaistheFederaldepartmentresponsibleforhelpingCanadiansmaintain andimprovetheirhealth,whilerespectingindividualchoicesandcircumstances. Productionofthisdocumenthasbeenmadepossiblethroughafinancialcontribution fromHealthCanada.Theviewsexpressedhereindonotnecessarilyrepresenttheviews ofHealthCanada.

StaplesCanada-EventheOddsCampaign

StaplesandMAPhavecometogethertocreateEventheOdds:aninitiativetoraise awarenessofinequityinCanadaandtohelpbuildvibrant,healthycommunities.The partnershipisbasedonthesharedbeliefthateveryoneshouldhavetheopportunityto thrive.EventheOddsfundsresearchandsolutionstohelpmakethefuturefairfor everyone.Learnmoreatstaples.ca/eventheodds

MaxBellFoundation

MaxBellFoundationbeganmakinggrantstoCanadiancharitiesin1972.Today,the Foundationsupportsinnovativeprojectsthataredesignedtoinformpublicpolicy changeinfourprogramareas:Education,Environment,Health&Wellness,andCivic Engagement&DemocraticInstitutions.TheFoundationalsodeliversthePublicPolicy TrainingInstitute,aprofessionaldevelopmentprogramdesignedtohelpparticipants moreeffectivelyengageinthepublicpolicyprocess,andPolicyForward,a future-orientedspeakerseriesthatbringsthoughtleaderstogethertodiscussthe intersectionsofpolicy,technology,andinnovation.

OurCareisbasedat:

MAP

CentreforUrbanHealthSolutions

MAPCentreforUrbanSolutionsisaresearchcentrededicatedtocreatingahealthier futureforall.Thecentrehasafocusonscientificexcellence,rapidscale-upandlong termcommunitypartnershipstoimprovehealthandlivesinCanada.MAPisbasedat St.Michael’sHospitalinToronto.

St.Michael’sHospital,UnityHealthToronto

St.Michael’sHospitalisaCatholicresearchandteachinghospitalindowntownToronto. ThehospitalispartoftheUnityHealthTorontonetworkofhospitalsthat includesProvidenceHealthcareandSt.Joseph’sHealthCentre.

OurCareSupporters

OurCareisalsosupportedby:

DepartmentofFamily&CommunityMedicine,UniversityofToronto

TheUniversityofToronto’sDepartmentofFamily&CommunityMedicineisthelargest academicdepartmentintheworldandhometotheWorldHealthOrganization CollaboratingCentreonFamilyMedicineandPrimaryCare.

St.Michael’sFoundation

Establishedin1992,St.Michael'sFoundationmobilizespeople,businessesand foundationstosupportSt.Michael’sHospital’sworld-leadinghealthteamsindesigning thebestcare–when,whereandhowpatientsneedit.Fundssupportstate-of-the-art facilities,equipmentneeds,andresearchandeducationinitiatives.BecauseSt. Michael'sFoundationstopsatnothingtodeliverthecareexperiencepatientsdeserve.

OurCareisworkingwith:

NovaScotiaAdvisoryGroup

RuthLavergne,DepartmentofFamilyMedicine,DalhousieUniversity

KatherineStringer,DepartmentofFamilyMedicine,DalhousieUniversity

SamanthaAiton,DepartmentofHealthandWellness,GovernmentofNovaScotia

MuhammadAzam,DepartmentofHealthandWellness,GovernmentofNovaScotia

MariaAlexiadis,NovaScotiaHealthAuthority

LindsayCormier,NovaScotiaHealthAuthority

LeishaHawker,DoctorsNovaScotia

MaddiMcKay,DoctorsNovaScotia

TimWoodford,NovaScotiaCollegeofFamilyPhysicians

CathieW.Carroll,NovaScotiaCollegeofFamilyPhysicians

EmilyMarshall,DepartmentofFamilyMedicine,DalhousieUniversity

AllisonBodnar,PharmacyAssociationofNovaScotia

SharonRudderham,Tajikeimɨk

MelanieDunlop,NursePractitionerAssociationofNovaScotia

ErikaBaird,NovaScotiaHealthAuthority

ShannonProctor,NovaScotiaHealthAuthority

LeahJones,DalhousieMedicalSchool,DalhousieUniversity

SarahCook,IWKDepartmentofFamilyMedicine-MaternalNewbornCare,Dalhousie University

BrentYoung,DalhousieMedicalSchool,DalhousieUniversity

PamGlode-Desrochers,Mi’kmawNativeFriendshipCentre

GraemeKohler,NovaScotiaHealthAuthority

LindsaySutherland,NovaScotiaHealthAuthority

StephanieLangley,NovaScotiaHealthAuthority

JoanSalah,NovaScotiaHealthAuthority

NationalCollaboratingOrganizations

AkoAnyaduba,BlackPhysiciansofCanada

RickGlazier,CanadianInstituteforHealthResearch

JohnFeeley&MoiraTeed,CanadianMedicalAssociation

ChristieNewton,CollegeofFamilyPhysiciansofCanada

BenjaminDiepeveen,KajanRatneswaran,SusannahTaylor,ElizabethToller&Jocelyne

Voisin,HealthCanada

BillCallery&JenniferMajor,HealthcareExcellenceCanada

MelanieOsmack,IndigenousPhysiciansAssociationofCanada

AdditionalCollaborators

AishaLofters,DepartmentofFamilyandCommunityMedicine,UniversityofToronto

AlanKatz,ManitobaCentreforHealthPolicy

AmandaCondon,UniversityofManitoba

AndrewMacLean,DalhousieUniversity

AndrewPinto,St.Michael’sHospital,UpstreamLab&DepartmentofFamilyand CommunityMedicine,UniversityofToronto

BrynHamilton,AssociationforFamilyHealthTeamsofOntario

DanaCooper,NursePractitioners’AssociationofOntario

DanielleBrown-Shreves,RestoreMedicalClinics

DerelieMangin,DepartmentofFamilyMedicine,McMasterUniversity

DominikNowak,JimWright&RoseZacharias,OntarioMedicalAssociation

EmilyGardMarshall,DalhousieUniversity

IsabelleLeblanc,McGillUniversity

JenniferRayner,AllianceforHealthierCommunities

KamilaPremji,DepartmentofFamilyMedicine,UniversityofOttawa

KimMcGrail,CentreforHealthServicesandPolicyResearch

LeslieGreenberg,MekalaiKumanan&KimberlyMoran,OntarioCollegeofFamily Physicians

MaggieKeresteci,CanadianAssociationforHealthServices&PolicyResearch

MikeGreen,DepartmentofFamilyMedicine,Queen'sUniversity

MonicaAggarwal,DallaLanaSchoolofPublicHealth,UniversityofToronto

MylaineBreton,UniversityofSherbrooke

NebKovacina,McGillUniversity

NicoleBlackman,IndigenousPrimaryHealthCareCouncil

NoahIvers,DepartmentofFamilyandCommunityMedicine,UniversityofToronto

RuthLavergne,DalhousieUniversity

SabrinaWong,UniversityofBritishColumbia

SarahCook,DalhousieUniversity

SarahNewbery,NorthernOntarioSchoolofMedicine

ScottGarrison,UniversityofAlberta

SophiaIkura,HealthCommonsSolutionsLab,SinaiHealthSystem

VanessaWright,Women’sCollegeHospital

VivianRRamsden,UniversityofSaskatchewan

PatientAdvisoryGroups

CanadianMedicalAssociation’sPatientVoiceAdvisoryGroup

MAPCentreforUrbanHealthSolutions’ImprovingPrimaryCarePublicAdvisorsCouncil

OurCareisengagingwithdistinctAdvisoryGroupsineachprovincewhereitisworking. VisitOurCare.caformoreinformationaboutoursupporters.

PanelDevelopmentandFacilitation

TheNovaScotiaPrioritiesPanelonPrimaryCarewasdesignedandfacilitatedbyMASS LBP.

FoundedbyPeterMacLeodin2007,MASSisCanada'srecognizedleaderinthedesignof deliberativeprocessesthatbridgethedistancebetweencitizens,stakeholders,and government.Formorethanadecade,MASShasbeendesigningandexecuting innovativedeliberativeprocessesthathelpgovernmentsdevelopmoreeffective policiesbyworkingtogetherwiththeirpartnersandcommunities.

TolearnmoreaboutMASSLBP’swork,pleasevisitmasslbp.com

EngageNovaScotiawasapaneldeliverypartnerandtheirsupportforthework includedstaffintheCivicConciergerole,recruitingpanelvolunteers,andrecruitmentof thelocalfacilitationteam.

TolearnmoreaboutEngageNovaScotia’swork,pleasevisitengagenovascotia.ca

PrioritiesPanelTeam:

JasminKay,AssemblyChairandProjectDirector

Facilitators:

ChimAlao

ErikaBout

LisaBuchanan

AmandaRaeStorteboom

LauraWhitman

SarahYaffe

CivicConcierge:

ErikaBout

KayteMcKnight

AdditionalsupportfromAbhimanyuSinghChaudhary

Imagecredits:OliviaNeale,DepartmentofFamilyandCommunityMedicine,University ofToronto

Tofollowdevelopmentsonthisproject,pleasevisitourcare.ca