University Health Network executive makes case for building "Un-Hospitals" in Ontario

Abhi Mukherjee, Director of Finance at the University Health Network, writes that the healthcare system's funding mechanism is fueled by volume and the flow of sick patients, and imagines a scenario where the population didn't need so many hospital beds and the associated infrastructure. He wonders what would happen if the concept of "proactively keeping people healthy" was promoted, and whether there would be a need for an "Un-hospital," what he describes as a network of trained (healthcare and allied) professionals working with the community and actively engaged in keeping the population healthy. Mukherjee shares some ideas on how the concept may work:

• An Un-hospital isn't a physical structure, but a network that collaborates o provide proactive healthcare to residents for early detection of symptoms and prevention of diseases;
• The concept could be piloted in a densely populated suburban region with a relatively stable resident base that would be identified and divided along geographical lines into Care Units;
• A "virtual" central command centre would see a group of analysts and health informatics professionals collecting data, looking at trends, analyzing reports and feeding valuable information for decision-making throughout the Un-hospital system;
• Each Care Unit would have a dedicated Wellness Network Team made up of family physicians, nurses, PSWs, dentists/ hygienists, eye care teams, physio therapists, psychiatrists, mental health professionals, geriatric professionals, nutritionists, yoga instructors, lab technicians, etc.;
• Mobile lab units would collect samples at residents' homes and also feed back vital data to the central command's database. High-risk residents would be given wearables and mobile apps to feed data to the database;
• Residents identified for specific diseases as "medium to high risk" would be coached and monitored;
• There would be an emphasis on home care;
• Each Wellness Network Team would share data and be accountable for the mental and physical well-being of each family under their care;
• The Wellness Network Team would interact with schools, community centres, local gyms etc. to provide holistic care to the residents;
• The central command would measure the performances of each Care Unit and be transparent in publishing key performance metrics; and
• The measure of success would be lower acute episodic cases to hospitals from preventable diseases ailments.