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As a nurse for twenty years, Jana Bartley has seen patients fall through the cracks in the health system, first hand. Unfortunately, she’s not alone.

Four-fifths of Canadians find the health care system too complicated, and more than three-quarters say that navigating the system is a challenge, stressful, and confusing.

“People don’t know what they don’t know,” says Bartley.

Having been a legal nurse consultant for many years, working with several medical malpractice lawyers across Canada, “I’ve seen my fair share of tragic outcomes. I decided I’d rather help to try and prevent a tragic outcome than read about it after the fact.”

“I had many lawyers disclosing to me that many calls that they received weren’t from people looking for a lawyer: they were asking for help. This really hurt my heart and opened my eyes in terms of how healthcare consumers were feeling confused, frustrated and scared, trying to navigate the system themselves,” she notes.

To address this critical issue, she created Integrity Healthcare Consultants (IHC) to ensure patients have full access to knowledgeable experts who know the healthcare system and can ensure they have the right information, have the best care, and feel empowered and engaged to make informed decisions that are right for them.

Bartley recalls, “My very first client was from New Jersey! She called me and said ‘I am my friend’s power of attorney and she is in the hospital and needs

my help, but I can’t take time off work. I can’t travel to Toronto. Can you help me?’ ....this was our first success story. I will always remember the sense of

relief in her voice when I said ‘yes, we will help every step of the way.’”

A much sought after expert on health issues, she has spoken at medical annual general meetings for healthcare professionals and disease support groups, appeared on Rogers television three times, co-authored a book and is cited in various research articles.

While working inside the hospital system, she became acutely aware of how many health issues could be prevented, particularly by medical professionals

otherwise hampered by corporate politics and bullying. When she voiced her concerns to improve corporate cultural, morale and ultimately patient care, however, she was summarily dismissed from her job.

Complexity, and advocacy needs do not end in the Toronto area. It became apparent that these services were also essential in the Eastern area and other parts of Ontario. With the same goals, concepts and collaborative approach as Bartley has, Anita Comfort has joined Jana’s team in expanding the areas in which their services are provided. Anita is a Registered Nurse, and Legal Nurse Consultant based out of Ottawa. Together, they will ensure that the knowledge needed to educate and empower clients is shared from city to city. Their base of connections and consultants continues to be hand-picked, and services expanding.

“So that is what inspired me to build a hand picked team of healthcare professionals from different specialties who share my passion to be able to provide navigation and education services,” she says of launching IHC.

“We take the worry out of trying to navigate and learn the health care system, and treatments. We shoulder all of that for you, while providing you with

a thorough description and plan for the actual care and education.”

With doctors already stretched for time, it is a challenge for them to discuss all options of care or treatment with their patients. Or, patients may not

completely understand what their doctor says, nor completely retain the medical advice they’re told.

In many circumstances patients and their families will take it upon themselves to do their own research, typically on the internet. “Although we encourage our clients to be knowledgeable we do caution them on Dr. Google. We advise them on how to get good quality, information that they can rely on.”

Seniors are especially vulnerable, a demographic tending to have multiple chronic conditions or cognitive impairments, adding to communication challenges.

Those are many of the reasons an advocate like Bartley can help: to translate medical terminology, sit in on appointments or family meetings, take notes and ask the right questions – whether for the patient themselves or on behalf of a family member. The “sandwich” generation in particular is struggling with full-time jobs, kids and aging parents.

She wants physicians to see her and her team as allies and part of the health team. “We all want the best for our patient and we speak the same language’ so teamwork is the best approach.”

She has met many doctors who feel that the services of Integrity Healthcare

not only benefit the patient, but also the healthcare team.

In doing so, she has been able to decrease hospital admission and

readmission rates for her clients, decrease hospital stays by speeding up the complex discharge process, thereby preventing patients from contracting potential hospital infections.

In addition, she has been able to expedite medical tests and services, and

reduce medication errors.

One of many examples, Bartley’s client, Walter, needed life saving brain

surgery. She was able to expedite surgery from a five-month wait to a five week wait, just by speaking directly to the neurosurgeon.

Bartley was called out of desperation from the family, who needed imminent help for their father. After being diagnosed with hydrocephalus, and having an assessment from a neurosurgeon, options for surgery were discussed.

Bartley spoke to the neurosurgeon at Sunnybrook who hadn’t seen Walter

for many months, and informed him of Walter‘s progressively failing condition


The response was very impressive.

“Surgeons have very little time allocated to them by the hospital, so that

is one factor that contributes to long wait times for operative procedures,” she notes.

She was also there to make sure the family’s questions were answered to

their satisfaction, and to help coordinate home care services to ensure a safe home environment for Walter when he was discharged after surgery.

“People assume they’re in safe hands, and safe care, but there’s nobody

coordinating the multiple doctors that they’re going to see, and the doctors don’t routinely speak to each other. So there’s many pieces to the puzzle, but no one putting the pieces together.

“We encourage our clients to always follow up to get results after any type of

diagnostic procedure and test. We coach them to be part of the team and to be accountable for their pieces of the puzzle.”

A disconcerting statistic is that three in five Canadians over the age of 20, have at least one chronic condition.

IHC does not exist on its own. A multitude of consultants allows Bartley and Comfort to ensure each client’s individual goals are supported, met, and followed up with. One important branch to IHC is having a Pharmacist as part of their multidisciplinary team.

Having a pharmacist as part of the multidisciplinary team at IHC allows

for timely medication reviews. When clients have multiple doctors prescribing

medications it can be a pharmaceutical nightmare. She can also relate to being a patient, diagnosed with her first of four chronic diseases when she was eighteen years old – “I remember when my Mom and I heard the doctor say ‘you have Crohn’s disease’. I remember thinking disease’? You must be mistaken because I am only 18.” Tests, procedures and multiple medications seemed to be the answer and her future, but when she decided to think outside of the medicinal box she discovered non-medicinal options

that have had her symptom free for years.

These are critical needs, especially when some eight million Canadians are

providing care or assistance to a loved one. For some, that means coordinating appointments with family members who live in another city.

Indeed, the latest statistics show that more than a half-million Canadians had

to reduce their working hours due to care giving, while nearly four hundred thousand left their jobs to provide care for someone.

“Many family members don’t feel they are the best person to be providing the care to a loved one; they don’t get trained for the role, they seem to be ’assigned’.”

Navigating the system will become increasingly top of mind for more and

more Canadians in the very near future,with a major concern being how to obtain the best health care possible.

“There are medical errors and misdiagnoses being made consistently,”

Bartley explains, “there is just no process for follow up and coordination for multiple services. If a healthcare consumer is being investigated for an illness, they need to be their own healthcare champion.”

There are seven million medication errors a year in Canada, she notes. “That’s why IHC has a pharmacist to do medication reviews for individual and corporate clients.”

“Doctors don’t intentionally make mistakes or misdiagnose, but it’s happening

because the way our system is so complex. We see a different doctor for every part of our body, but unfortunately they don’t have the opportunity to talk to each other. Our hope is to prevent, educate and just help people realize all their options, and be informed.”

That means IHC will facilitate coordination between different doctors and hospitals; help with medication management and pharmacy engagement, and coordination of priority homecare if required.

“We navigate, educate, and advocate,”she says.

“Our big goal is to be able to empower the client, and have our clients engaged in their health care decision making.”

On the corporate end, IHC educates employees on health promotion and

disease prevention.

That means the potential to save employers thousands of dollars from

benefit claims, and decrease employee absenteeism due to sick time.

Corporate packages can include onsite health screening for early illness detection, health coaching for chronic disease management, medication reviews and health promotion and disease prevention education sessions.

“The sandwich generation are particularly affected - those who are in

the thick of full time jobs, kids, and aging parents. They’re not focusing on their health and that can really take its toll. That stress is huge. That contributes to corporate absenteeism, and mental health issues,” she adds. That’s why IHC offers to come to the workplace so employees don’t

have to neglect their health. “So for example, an employee with diabetes, we want them to know the importance of managing their diabetes, to prevent potential cardiovascular complications that they are at high risk for.”

The Sanofi survey published in June 2016 revealed that 64 per cent of plan

members with chronic conditions would meet with a health coach to manage their condition, if their plan covered it.

Picture a tree. This tree has branches that are able to support many needs, but each having its own reason for existing. The three main branches are Advocacy, Navigation and Education. From these branches there is the individual aspect – for families and their loved ones, and the corporate aspect. Needs for each individual are specific. Those branches are the small new ones that are growing from the base. New ones, but in no means less important. Living, continuing to live, and not being alone in “figuring it out” are individualized needs each person has.

For example: Mrs. Brown and her husband have travelled to Florida for the last 35 years. It became part of their life. Three years ago, Mr. Brown was diagnosed with dementia.Over the years, travelling has become something Mrs. Brown didn’t want to think about anymore. It was going to have to be a thing of the past - or was it? IHC engages consultants and connections that will allow Mrs. Brown to continue to travel to Florida every year, with Mr. Brown by her side. IHC will also allow weddings, family reunions, or suppers out with family to be a thing of the present, and not a memory of the past. Simple, perhaps, but necessary to maintain an optimal level of functioning, both for Mrs. Brown and her husband.

Keeping in mind the tree, there are roots that allow a tree to grow. Our goal is to plant roots in all parts of Ontario, and let them extend in to the other provinces, becoming national. Advocacy and navigation is a wise spread need. The knowledge to empower should not be kept in one area. IHC’s mission is to share the knowledge that will empower.

Whether you are a care-giver, or a person with a chronic illness, there is no need to feel alone, or be alone with the decisions that lay ahead. And so, until the time comes when the healthcare system is more family centered, education focused and navigation friendly Bartley’s team is there to empower, educate and support you to live longer, better lives.

Dave Gordon has penned more than a thousand articles, and more than five hundred editorials, on every topic imaginable. He writes regularly on domestic and international politics, current events, culture, relationship issues, and much more.

He has spent time in the newsrooms of the Toronto Sun, Pittsburgh Post-Gazette, Baltimore Sun, National Post and eye Weekly.

Integrity Healthcare Consultants

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