Ontario LHINs using the Internet to inform and engage

I have noted several Ontario LHINs are actively using the Internet to inform and engage their communities.  The SouthEast LHIN, for example, provides a tool for registering your interest in various topics so that they can send an email notification when there is a new announcement regarding these topics. Check out:


One of the topic areas for which you can register to get news is board meetings.  A complete agenda, supporting documentation, and board minutes are provided.  There is some very interesting reading in the board meeting minutes.  I applaud their efforts to be open and transparent.

Another initiative comes from the SouthWest LHIN (hmmmmm …. LHINs with the South in their name seem to be reaching out).  Julie White (Twitter handle – GET_ENGAGED), Director of Communications & Customer Service,  is actively using Twitter to post announcement regarding events and other items of interest.

If you are aware of any other similar LHIN initiatives please let me know and I’ll post information about them on this blog.


15 responses to “Ontario LHINs using the Internet to inform and engage

  1. Sounds interesting, but as usual I’m a skeptic. Who is their audience and what do they expect to get out of this? Maybe I need more coffee, but the whole thing seems like it came out of a bunch of half-baked committee meetings.


  2. I don’t get the sense that these initiatives are designed by committee. Rather, I sense that they are sincere attempts to explore how to use the Internet to inform and engage the local communities. As with many Internet initiatives through the years, the best ones often involve considerable experimentation, so I applaud both groups for taking risks and trying different approaches.

    I’m quite impressed with both initiatives, though each is taking a different approach. The wealth of information available from the SouthEast LHIN is breathtaking … I am reading board minutes and board agendas and material submitted to the board for review! Unprecedented transparency IMHO.


  3. We’re another LHIN (Hamilton Niagara Haldimand Brant LHIN) who is reaching out through the web (twitter handle chandrarice), trying to be where people already are engaged in discussions about their health and healthcare. I think it is reasonable to be skeptical about what it will offer – given how quickly the internet shifts, and how differently people use the various tools, it is impossible to be certain that for example the tweets that I post daily are of any value to others. But Mike has got it right – it is a genuine attempt to be accessible, to engage, to be part of the conversation where the conversation is happening. I’m always open to learning from others how I could engage with them in ways that work for them. Any suggestions Mark?

  4. Sorry Mike, I should also note that all LHINs have the mypage feature for their website. Some are also using facebook such as Erie St. Clair…

  5. To what end? Community input is not making any difference. Government appointees must follow the wishes of their political task masters at the Ministry of Health and Long-term Care.

  6. Peter, thanks for you comment. I think that the community input can have a big impact, particularly if the community is aware of what is happening and how it impacts them. In addition, much of the information that I have seen posted by the LHINs as to do with informing the public about programs that they might not otherwise hear about. I still contend that the more open and transparent the LHINs can be, the better.


  7. Chandra,

    I like the idea of community engagement, but call me a luddite but I’m just unclear if the LHINs are looking for feedback from the general public or the much much smaller healthcare-focused/obsessed public. I would think a one-to-one effort with those who have recently used healthcare services would derive better feedback, than a bunch of bloggers like me.


  8. Peter,
    Like all things complex, we both have to follow the ministry’s guidance to ensure that no matter where in Ontario you go, you can get appropriate care, as well as attend to the specific needs of our community. Community input does shape our work, although sometimes the direct path between input and outcome is not clear. For example, when we asked people what they would change about the health system to make it better, (see http://www.hnhblhin.on.ca/Page.aspx?id=4850) one of the most frequent comments people made was about hiring more doctors. Unfortunately there is a shortage of doctors. We can recommend to universities that they train more. We can encourage the re-certification of foreign doctors. We can put in place more incentives to bring doctors to our area. And we do all these things. Most importantly, however, we can really consider what the unmet needs are for those who feel there aren’t enough doctors. When we do this, when we delve deeper and ask people, it may turn out that they need to refill their prescriptions more easily, to get routine tests done quickly, to have more post visit follow-up, etc. In learning this, we work to encourage inter-professional teams that include nurse practitioners who could do all these things. Some people argue that the community input was hire more doctors, and therefore we must not have listened if we hired more nurses instead. But our take on it is that we have to balance what we hear (hire more doctors), and the underlying need that needs to be met (prescriptions, tests, followup) with the health care context (that there aren’t doctors to be hired), and the resources that are available (interprofessional teams and nurse practicioners).
    Does this help?

    I love the idea of talking one on one with people who have recently used health care services. Hospitals do this as part of their quality improvement, and do most of our health service providers. And I will look for opportunities to ask specifically for recent patient examples.
    Also, bloggers like you are future health care users. The LHIN both is interested in what the general ‘healthy’ population thinks is important to the health system, as well as the actual experiences of people using the system.
    Being here, having this conversation, is one input among many to learn.
    Even your confusion as to who we are looking to engage helps me think through how I need to have conversations so that this is clearer.
    It is all part of the learning process.

  9. Mike

    I would be the first to contend more open and transparent health care policy development is required, but let us be honest. There was no public outcry for the regionalization of Ontario’s health care system. Most Ontario citizens do not even understand what a LHIN is.

    This was a government construct driven by the imperative of cutting costs and any community opposition to this agenda has met fierce resistance from the government appointed staff of the LHINs.

  10. Chandra:

    The delivery of health care may appear complex, but desires of Canadians are pretty simple…. universal, publicly administered, accessible heath care. I attach some pertinent comments.

    *Thoughts on the Closure of a Local Hospital: Burk’s Falls *

    *Kathleen A. Tod*

    *December 2009 saw the closure of the Burk’s Falls and District Health
    Centre. Burk’s Falls Health Coalition member and retired hospital
    administrator, Kay Tod, had this to say of the hospital’s demise. *

    The silence is heart-rending. Rooms that once offered sanctuary to the sick
    and halls that once resounded to the echo of busy feet are now filled with
    overflowing boxes and sundry equipment.

    The venerable Burk’s Falls and District Health Centre is dead! Sixty-one
    years of history, care and healing is now “headed south”. Literally.

    Without much in the way of public consultation, close to 7,000 residents of
    the surrounding communities were informed by the Muskoka Algonquin
    Healthcare Services (Huntsville and Bracebridge Hospitals) that all lost
    local services could be “easily obtained” at three area hospitals — one
    situated 45 minutes south, another an hour to the north and yet another an
    hour or more to the east on Georgian Bay.

    Tell the 23% of our population over the age of 65 — many without access to
    transportation – and young mothers with sick babies that it “will be easy”.
    Convince our summer residents and the thousands of tourists who find
    themselves requiring medical intervention that they only have to travel an
    hour or so for care and medical intervention.

    We, in this area, are devastated and rightfully feel that the Premier, the
    Minister of Health, the NELHIN, the NSMLHIN and the Muskoka Algonquin
    Healthcare Services have ignored and abandoned us. All this, in spite of
    the principle in the Canada Health Act stipulating that it will “*protect,
    promote and restore the physical and mental well-being of Canadians and
    facilitate access to health services without financial or other barriers.”*

    We fought the good fight with dignity and passion. For a brief moment this
    past summer, we thought our voices had been heard when a task force was
    struck to develop Guidelines for Rural and Northern Healthcare. We soon
    learned this that it was little more than a sham.

    Optimistically, we continued to demonstrate our concerns in various ways,
    assisted by the Ontario Health Coalition (OHC). Twice we traveled to Queen’s
    Park with our message. It would seem no one heard.

    Heartfelt thanks go to the Ontario Health Coalition for assisting us in our
    efforts to save access to health care in our area. Your support was much
    appreciated and we wish you much success in all your good works.

    *(Editorial Note: Burk’s Fall’s hospital has been in existence since 1949)*

    *Tragedy in Fort Erie Leads to Investigation*

    Fort Erie teen, Reilly Anzovino was involved in a terrible car accident in
    Fort Erie on December 27th, 2009. She was taken by ambulance to Welland
    because the closest emergency department in Fort Erie was recently closed
    due to budget cuts. She passed away prior to arriving at the hospital. This
    is the second death since the emergency department closures in Fort Erie and
    Port Colborne that has raised questions about whether the closures have
    contributed to avoidable fatality.

    After writing to the Chief Coroner for Ontario in support of the family and
    the community’s requests for an inquest into Ms. Anzovino’s death, the
    Ontario Health Coalition received confirmation from the coroner’s office
    that they are investigating and will make a decision about an inquest.

  11. Peter,
    The path to more open and transparent healthcare policy development is not an easy one. I hear and share your frustration. That said, I do believe in the power of social media and other online tools to create community and to drive change.

    I applaud the LHIN efforts to experiment with Twitter and facebook and other online tools to engage their communities. I think we should look at small steps first such as informing and educating. I am amazed at the information available regarding board meetings and think that sharing this information is a small but important step towards greater transparency.


  12. Mike

    I do not question the need for further transparency, but let us not confuse transparency with accountability. The experience to date is one sided.

    You speak of “informing and educating” and of “the power of social media and other online tools to create community and to drive change.” It seems to me that the LHINs appointees are charged with presenting a message to the communities while ignoring what communities have to teach them.

  13. As other social media campaigns have demonstrated, the Internet offers a means of aggregating individual voices so that the collective message can be heard by those who need to hear it (e.g politicians).

    Transparency does not mean that any particular idea, even if it has widespread support, get implemented. Rather, it is about making decisions in a way that fairly represents all views and that exposes the reasons that a decision was made.

    Posting board agendas, working papers, and minutes is an important step towards transparency, albeit one of many steps. I prefer to applaud forward progress and encourage the taking of the next step.


    P.S. Thanks for engaging in the debate. Even if we disagree (which I am not sure that we do), the airing of the different viewpoints is very useful.

  14. Thank you Mike for recognizing the importance of the “early days” social media that we are using in the front-line trenches of our health system. I’m not going to repeat the many wonderful statements that Chandra has put forward, but I do want to let Peter know that I understand where he is coming from. For as much as health care is personal, health care is political. It is a topic that sparks passion – whether it happens in boardrooms or around kitchen tables.
    I looked after communications in the South East LHIN prior to joining the South West LHIN in mid-December. While in the South East I had the benefit of spending close to two months on the road, travelling across our region, meeting with anyone who wanted to talk about health care. While there was a usual assortment of health organization representatives, a number of patients and clients, family members, taxpayers and many more sat down with me to share their thoughts on health care. The most common message that I heard was one of thanks — simply for the opportunity. This was truly about listening. About engaging.
    The expectations of our health system far exceed our ability to pay for them — but that doesn’t mean we won’t benefit from having a conversation about how the system really operates – or should operate.
    Yes, the LHIN also needs to do something with the input that we received. I believe that happened in the South East (and similar engagements have resulted in a wonderful plan in the South West). These plans (called Integrated Health Services Plans) may seem like bureaucratic documents — but they are built on a pillar of community input and really do reflect real community needs. They provide communities with the ability to play a huge role in transforming health care. We can’t afford to tinker with the system any longer. And we can’t afford to turn our backs on a serious attempt at making things better because of politics.
    There are some incredibly dedicated people working in health care — both on the front-lines in health provider organizations and in LHINs. LHIN staff are really working to lead innovative change — and are doing so while advancing a new culture based on an old bureaucracy. It can be very frustrating at times, but the successes are well worth it. Many of the ideas being championed today are the excellent ones of yesteryear that had been sidelined not because of their value, but because of their inability to be implemented. Our door is open for making things better, for thinking differently.
    We need to be brave and we need to be bold. I’ve started by commiting my career to helping LHINs (and health care in general) empower health service providers to promote sustainability of quality, accessible care. One way I can do that is by opening up a dialogue with the users and payers of health care.
    My question to you is simple – what are you willing to do to ensure we have an accessible, sustainable health care system?

  15. Julie,
    Thanks for your comments. I particularly appreciate you pointing out (a) that there many people in the system looking to make change (b) that we are operating in a new environment with the LHINs (c) your commitment to opening a dialog.

    On my part I am working to promote the role of IT in transforming the health system. IT is NOT the sole answer but it is a powerful tool that will underpin many transformation initiatives.

    I have also started work on a book exploring use of IT in physician offices. Specifically I am focusing my attention to lessons learned from early adopters that can be shared with the mainstream docs now considering an EMR and other IT. I am looking to interview docs and others involved in physician IT projects to gather these lessons learned and any pointers / introductions that you might have are greatly appreciated.


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