Health Links

Upper Canada Health Link

About Health Links

Health Links are designed to improve the delivery and co-ordination of care for our most vulnerable patients. They bring together existing health care providers such as primary care, hospitals, home care, mental health and addictions and community support agencies. Together, they develop new and better ways of coordinating services for patients with the highest complexity of needs while making better use of health care resources.

 

Learn more about Health Links in Ontario


About the Upper Canada Health Link

 

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The Upper Canada Health Link (UCHL) helps coordinate local healthcare and community service providers to work together to find new ways to do things for complex patients. The UCHL works with the patient to coordinate their care, reduce duplication of services and ensure the patient is receiving the right care, in the right place, at the right time.

 

The Upper Canada Health Link (UCHL) includes North and South Dundas County and South Ottawa including Osgoode, Metcalfe, Russell and Embrun).

UCHL_Catchment 


Our Patients

The UCHL supports complex patients who have multiple co-morbidities. These patients are often treated by multiple health care providers and have frequent visits to the Emergency Department or a long length of stay when admitted to the hospital. The UCHL works with patients who:

  • Have at least 4 chronic conditions
  • Are vulnerable (for example: low income, low health literacy, transportation concerns, no known caregiver, social isolation).

Referrals to the UCHL can come from:
  • Patients themselves
  • Families/Caregivers
  • Health care providers (for example: family physician, community nurses, specialists)
  • Hospitals
  • Anyone who is concerned about an individual in the community with complex needs

Coordinated Care Plans

Each health link patient will receive a personalized care plan called the Coordinated Care Plan (CCP). The CCP is a comprehensive document that contains the patient’s full history which saves the patient from having to retell their story at all their appointments and hospital visits. The CCP includes:

  • Patients goals
  • Care Team
  • Medical History
  • Current medication list
  • Plan to achieve goals of care

Our Partners

The UCHL works with many partners in the community, including:

For more information, contact Laurie Hogan, Program Administrator, at 613-774-2422 ext. 6146.
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