Putting Patients with Complex Needs at the Centre of their Care

Coordinating all the services and supports that a person with multiple health conditions requires. That’s the idea behind the Health Links approach.

Health LinkThe patient's primary care provider, home and community care organizations, specialists and other community partners – as well as the patient and caregivers – work with a Health Links care coordinator. Together, they develop one coordinated care plan that focuses on the patient’s goals and what is important to them.

The goal is to improve the quality of care and the health care experience for those who use the health system the most - and the Health Links approach reduces unnecessary hospital admissions and emergency department visits.

Integrating the Health Links approach to care is a strategic priority of the Champlain LHIN’s Integrated Health Service Plan 2016-19. We want the Health Link approach to be the standard of practice – the "new normal" - for patients with the most complex needs.

In 2017-18, more than 2,900 people in the Champlain region received better coordinated care due to the Health Links approach. The number of primary care providers (family doctors and nurse practitioners) involved in this new way of working to support patients is growing: 83 per cent of care teams include at least one primary care provider, compared to 72 per cent in 2016-17.

Meet Jack

Jack and Debi Beriault

Jack and Debi Beriault

"Health Links is a great model. It is very personal. They really understand what you are going through.” Jack Beriault, client. 

What does this model of care mean for Health Links clients? Read Jack’s story.

How to Access Health Links

Anyone – a family doctor, care provider, friend, family, caregiver or even a patient - can identify someone who fits the Health Link criteria. Visit Champlain Healthline for more information.

More Information

  • For general information on the Champlain LHIN's regional approach to Health Links, please contact Marcia Gibson (marcia.gibson@lhins.on.ca).