1. Integrated Health Services Coordination & Delivery
Associations Meeting
March 31, 2016

2. meaningful contribution to the healthcare transformation in Canada2
is in the care business
Medavie is a diversified health services company dedicated to making a
meaningful contribution to the healthcare transformation in Canada
through integrating benefits management, health management,
and health care delivery
© Medavie Inc.

3. 3
Medavie EMS
Medavie EMS oversees operations for a number of subsidiaries in the fields of emergency medical services (EMS) and public safety, EMS and clinical training, and mobile and community health solutions.
Operations are located in the Maritimes, Ontario, Alberta, Saskatchewan, and Massachusetts
The largest private ambulance company in Canada
A workforce of 3,900 including clinicians, management and administration staff
A fleet of 550+ vehicles including ambulances and support units
Over 500,000 annual requests for service
Partnered with Dr. JP Arseneau at the Clinique Médicale Nepisiguit in Bathurst, NB
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4. 4
Current State There are a number of ongoing issues that are challenging the sustainability and efficacy of the health system.
Fiscal Reality:
Goal of finding efficiencies and capacity in healthcare system
Looming changes to federal health accord
Choices outlines initiatives being considered within Strategic Program Review
The Alternate Level of Care Summit highlighted systemic issues including:
Highest % of ALC bed days in country
High rates of chronic disease
Regional variations in service level
Need for increased health system integration
In 2011, the New Brunswick Health Council recommended that:
“The Government of New Brunswick, through the Department of Health, review the organization and delivery of primary health care in the province with a view to maximizing the utilization of existing human and financial resources.”
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5. A new Part III entity was formed “Ambulance New Brunswick”5
Our Experience
In 2007, a similar arrangement was created:
The collective agreements in place in 2007 (CUPE & NBNU) are still in force today and include ANB employees as members. NB EMS has a very collaborative working relationship with both unions.
We look forward to continuing this relationship with these two unions and NB Union as well if the proposal goes forward.
A new Part III entity was formed “Ambulance New Brunswick”
ANB consists of Paramedics, Emergency Medical Dispatchers and Flight Nurses
ANB is managed on behalf of the government of New Brunswick by New Brunswick EMS, a subsidiary of Medavie EMS
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6. This exploratory phase will take 4-6 months.
Medavie EMS Mandate
The Government of New Brunswick has entered into a Memorandum of Understanding with Medavie EMS.
Key facts:
The MOU will explore the possibility of enhanced primary health care provision in the community.
This exploratory phase will take 4-6 months.
The deliverable at the end of this timeline is a proposal for a strategy and implementation plan.
© Medavie Inc.

7. Integrating Ambulance New Brunswick (ANB), the7
Medavie EMS Proposal
Integrated health services coordination and delivery
The proposed model would improve the patient experience and create more capacity in the health care system by:
Integrating Ambulance New Brunswick (ANB), the
Extra-Mural Program (EMP) and Tele-Care 811 into a new Part III company
Developing a Health Services Coordination Centre (HSCC) by leveraging the Medical Communications Management Centre operated by ANB and Tele-Care
Developing care pathways for patients with complex needs in collaboration with the patient, Primary Care Provider, Extra-Mural Program and Ambulance New Brunswick resources
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8. Medavie EMS Proposal Governance Model8
Medavie EMS Proposal
Governance Model
The new management company would be contracted to operate and manage EMP/ANB while providing oversight to the current 811 contract
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9. Medavie EMS Proposal Capacity improvement and synergies9
Medavie EMS Proposal
Capacity improvement and synergies
Administrative efficiencies
All resources working to top of scope
Optimal match between patients and providers
Establishment of community paramedicine (resources are already available, but not used currently)
Optimal management of patients in the community leading to a decrease in Emergency Room and hospital use
© Medavie Inc.

10. 10
Roadmap to the Future State Medavie EMS developed a roadmap for New Brunswick in collaboration with the Department of Health.
This roadmap outlines a multi-phased approach to realizing the inherent opportunities to improve the patient experience and create more capacity in both the primary and acute care system.
Integrating ANB, EMP and 811 1
Developing a Health Services Coordination Centre 2 3
Leveraging HSCC and integrated workforce to focus on the management of complex patients over time
© Medavie Inc.

11. Future State Integrated health services coordination and delivery11
Future State
Integrated health services coordination and delivery
The Medavie EMS proposal is aligned with the recommendations in the primary health care framework, government commitments and recommendations from the New Brunswick Health Council.
Expected improvements:
Patient and provider experience
Access to primary health care
Increased capacity in community and acute care
Reduction in Emergency Room and hospital usage
Management of patients with complex needs in the community
Accountability
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12. Stakeholder Engagement12
Stakeholder Engagement
Our journey so far
We have met with:
RHA CEOs
EMP Managers
NBNU
NBU
CUPE
Associations
Social Development
Healthcare Leaders
Designated Medavie EMS representatives have now had sessions on policies and procedures prior to going on site visits.
© Medavie Inc.

13. 13
Associations
We know that you have many questions. We would like to take some time to answer your questions, knowing that we do not have all the answers at the moment. Your input and involvement as we move forward will be essential.
© Medavie Inc.