Doctors Nova Scotia has recently released a position paper outlining recommendations to strengthen so-called health homes where numerous health-care professionals work in a collaborative setting. President Dr. Amanda MacDonald Green says the association wanted to highlight in the paper that it’s currently a “hodgepodge” of how they operate in the province. “We’re wanting to bring everyone together so we can arrive at a shared definition of what a health home means – you can’t refine what you can’t define – and bring all the partners together so we can really optimize what’s going on, learn from each other what’s going well,” she told CTV Atlantic’s Todd Battis during an interview. MacDonald Green believes every health home should have a unique assessment because different communities have different needs. “There may be some communities that would benefit more from having stronger family practice nurse supports to manage a higher population of people with diabetes or COPD, versus different communities may benefit from social work supports for dealing with other things related to substance use or whatever the local context calls for,” she said. MacDonald Green, who is also a family physician, says while Nova Scotia has had “unprecedented investments” in health care, it is somewhat siloed in how it’s delivered. She uses a primary care pharmacy clinic in Windsor that many of her patients use, as an example. “For us to collaborate, it doesn’t work well, we’re on the same computer system, but it doesn’t actually communicate with each other, so we’re spending time writing notes and faxing back and forth instead of having easy access for direct collaboration,” she said. “It’s more about insuring we’re optimizing on the investments that were already made and really bringing them to their full potential.” MacDonald Green says many patients have benefited from health homes and collaborative care despite struggles with optimization. “Even if my patient isn’t seeing me for (a) specific visit, I’m still involved in their care, I’m still looped in. Their chart is still part of their health home. And so, it really gives a lot of continuity of care for the patient,” she said. “And with better continuity of care we see less over prescribing for things like antibiotics, we see less unnecessary investigations, we see the ability to find patterns if there’s a change in the patient, where if you’re only seeing that patient for a moment of time and not necessarily again, you’re not going to have that benefit of that extra level of care.” There are currently more than 120 health homes in the province, according to Nova Scotia Health. Doctors Nova Scotia shared 10 recommendations for enhancing them in its position paper, which can be found online. For more Nova Scotia news, visit our dedicated provincial page