Building The Data Foundations For Integrated Care- Lessons from East Toronto’s Chronic Disease Pathways

Delivering truly integrated care for patients with chronic disease requires hospitals, primary care, home care and community organizations to work as one connected system — yet the data supporting that journey often remains fragmented across organizations, platforms and workflows. Drawing on East Toronto’s experience building integrated chronic disease pathways, discover how stronger data foundations can connect care today while creating the trusted foundation for tomorrow’s AI-enabled services. Walk away with a roadmap to: 

• Connect fragmented data across hospitals, primary care, home care and community partners to support a more coordinated patient journey. 

• Standardize referrals, data capture and reporting so information can move more consistently between organizations and care settings. 

• Integrate tools such as REDCap, dashboards and reporting capabilities into operational workflows rather than creating additional layers of complexity. 

• Govern data across organizational boundaries to improve quality, consistency, accountability and trust. 

Turn fragmented data and disconnected workflows into the shared information foundation required for integrated chronic disease management — and ensure future AI is built on data that healthcare teams can trust.