3. Digital health care

As a result of population growth and the aging of Ontario’s population, the demand for health services will increase everywhere in the coming years, including for Francophones. Given that health care costs are increasing more quickly than those in all other sectors combined, the government must establish cost-effective services. In this scenario, digital health services could have a dramatic effect by improving access through online health services while reducing the dependence on expensive in-person services and visits to the hospital. But this raises a dilemma when Francophones’ fundamental need to be served in person is more vital than ever. Considering the aging population, it is obvious that elderly Francophones prefer to have in-person versus virtual consultations.

The Ontario Telemedicine Service (OTS) offers virtual health services by establishing remote connections between providers and patients. This initiative is particularly important to reach the province’s remote and rural communities, especially in emergency situations.¹²⁶ The province also offers the “Telehealth Ontario” line, which provides free health advice from registered nurses.¹²⁷ This system is already in place in both languages and appears to serve Francophone patients and clients very well. As digital services continue to evolve, it will be essential to develop innovation mechanisms to improve and make these services more personalized in accordance with Francophones’ needs so that they are sustainable health care solutions.

An example of personalisation like this on the regional scale is the telepsychiatry service provided to Francophones by the South West LHIN, in the framework of the Ontario Telemedicine Service.¹²⁸ These services are particularly important because patients with mental health and addiction problems must often wait a long time to be able to get in-person appointments with specialists; the telepsychiatry service improves timely access to care without requiring individuals to travel.¹²⁹

In the same vein, in 2011, Trellis Mental Health and Developmental Services, the Waterloo Wellington LHIN, and other health services partners collaborated in the launch of a mental health telemedicine service offered in region in French, within the framework of the Ontario Telemedicine Service.¹³⁰ In Ottawa, Montfort Hospital has also started to provide remote medical expert services to Francophone communities in Northern and Eastern Ontario.

The data from the use of these services should also be used to analyze individual communities, particularly those in remote areas or various language groups, in order to identify their unique issues and to develop targeted solutions, as well as to oversee and evaluate the well-being and vitality of minority communities. For example, the tool used by the Ministry of Health and Long-Term Care to assess impact on health equity can be digitalized to compare the Francophone-community results and better plan the policies and programs intended for Franco-Ontarians.¹³¹

The development of a complete human resource strategy for Francophone health in the province is another crucial question that can be addressed from a digital point of view. Inter alia, this strategy would include better matching and pairing of Francophone professionals and citizens. The Réseau Santé Nouvelle-Écosse created a directory to improve Nova Scotian Francophones’ access to primary health services. This French-speaking healthcare professional directory was created in collaboration with Nova Scotia’s Department of Health and Wellness. The public can use this directory to find information on services in French, while Francophone health care professionals can ask that their names be added to the directory.¹³² A similar initiative in Ontario would be paramount to improve access to services in French.

The Ministry of Health and Long-Term Care established the Health Professions Database (HPDB). The HPDB annually collects demographic, geographic, education and employment data about each regulated health professional (excluding physicians) in Ontario. The database also collects data on the health professional’s ability to provide care in French. This database offers the opportunity to help healthcare agencies conduct evidence-informed health workforce planning to support planning services in French everywhere in the province.

At the time of writing, the most recent data in the HPDB was from 2016; however data goes back to 2008. The ministry is currently collecting 2017 data. HPDB data can be requested from the ministry at any time for health human resources planning.Also, the recent implementation of OZI (the database developed by Réseau des services de santé en français de l’Est de Ontario) in the entire province will play a pivotal role in mapping available French health services, as well as in the regional planning and coordination of access to these services and to professionals. With the assistance of Entities, LHINs, and the Ministry of Health and Long-Term Care, this is one of the most promising initiatives for improving access to health services in French.

It is also essential to use digital technology to take full advantage of the expertise available, by creating a network of agencies that are active in the province and working towards similar goals in order to establish an exhaustive human resource strategy for health services in French. Agencies have already worked on such initiatives. For example, the Société Santé en français and the Réseau franco-santé du Sud de l’Ontario established the Health Human Resources Strategy. This is an online resource that helps health organizations improve access to services in French by developing expertise at the level of bilingual human resources and by providing advice on issues such as recruiting and retaining bilingual personnel.¹³³ The Société Santé en français also created a network to facilitate the sharing of best practices in French health care.¹³⁴

Generally, the Francophone lens, established by the Minister Responsible For Francophone Affairs, also applies in this context of digital health and government services. It can offer precious advice to other ministries to help them efficiently integrate services in French at all levels of policy and program planning.¹³⁵

RECOMMENDATION 11

The Commissioner recommends that the Minister Responsible for francophone Affairs, with the help of Cabinet colleagues, provide a complete strategy that takes into account the cultural and linguistic differences of francophone communities with regard to the deployment of digital systems, and opportunities for better services adapted and tailored to francophone community needs everywhere in the province. The strategy must focus on key sectors of health and long-term care, as well as direct services to the population, including through the use of a linguistic identifier on health insurance cards and drivers’ licence.