Over the past year, we have attended several events focused on integrated care—from webinars and roundtables, to major gatherings like the Canadian Social Prescribing Conference, the North American Conference on Integrated Care, the International Conference on Integrated Care (ICIC), and the Ontario Integrated Care Action Summit.
These experiences highlighted the deeper shifts taking place across systems, communities, and relationships. The conversation about integrated care is no longer about why—it’s about how. We all know health is shaped by more than what happens in hospitals and clinics. The social determinants of health—mental health, housing, income, and social connection—all determine how people access and experience care.
While the sector has bought into the imperative of integration, translating it into coordinated action remains complex. Integrated care cannot be just designed on the front-line. There must be proper enablers in place, including policy, governance, technology, and funding. Here are the themes, trends, and opportunities we’re leveraging to tackle this complexity in the health and wellbeing space.
1. Governance in the Grey Zones
The Insight
Governance is one of the biggest challenges when trying to integrate care. Critical levers for funding, decision-making, and accountability are so siloed that they cannot translate to streamlined care on the front lines. While there is rationale for departmental focus, its trickle-down effect is the fragmentation in patient care.
We’re not suggesting this is an exercise of centralizing authority and accountability. Instead, we’re focused on how we can create the structures and relationships to enable effective collaboration across departments, teams, and communities.
What’s Next
Tackling the problem starts with rethinking governance. It isn’t a top-down flow or a power grab, but a bridge built across silos. That means setting up shared accountability, common goals, and collaborative mechanisms that connect housing, health, social supports, and community services under a unified purpose.
We’re watching promising efforts in places like the UK and Australia, where Integrated Care Boards or loosely networked, cross-sector partnerships are shifting toward more holistic care. And closer to home—in Nova Scotia, for example—there’s momentum toward integration across the Department of Health and Wellness, long-term care, mental health supports, and housing/homelessness services. Cross-portfolio partnerships like these are the seeds of structural change. But to grow, they need formal supports.
Governance won’t look the same everywhere. There’s no single blueprint. Rather, the role of skilled convenors and designers—people who know how to bridge departments, align incentives, and build trust—becomes critical.
This is where the Davis Pier approach can move the needle. We leverage our expertise in public-sector transformation, human-centred design, and collaborative policy work to help design and implement governance models that reflect real-world complexity. Whether through advisory bodies, cross-department working groups, or new “backbone” organizations—we help build the kind of flexible, trust-based infrastructure that supports integrated care beyond pilot projects.
2. Data that Serves
The Insight
Data is most valuable when it is used to learn and adapt, not just to report.
Most impactful systems rely on data that supports continuous improvement and meaningful insight, rather than compliance.
A standout example of this comes from the Burlington Ontario Health Team (OHT). They have developed a set of standard evaluation measures to assess the success of their Community Wellness Hub model. These metrics were built into the design of the very first Hub, and continued data collection is a requirement for any new OHT adopting the model. This approach supports both local insight and a broader understanding of the model’s impact as it scales across the province.
What’s Next
If we want data that serves people, we need to start with better questions. Instead of “how much data can we collect?”, we should ask: “what do we need to learn, and who benefits from that learning?”
We need the right data collection tools and the right structures to govern that data, share it appropriately, and act on what it tells us. We need data integration—not just across programs, but across sectors. And we need clear pathways for information to ensure that insights flow from care providers to decision-making tables and back again.
At Davis Pier, our strength in data modelling, evaluation, and human-centred design positions us to support this work. We help our clients build logic models, evaluation frameworks, and feedback loops that reflect the complexity of people’s lives. In doing so, we translate raw data into stories, signals, and actionable insights—and we help ensure that data becomes a tool for learning, not just measurement.
3. People over Diagnosis
The Insight
We need community-led and community-informed approaches that integrate mental health, housing, and income assistance. The social determinants of health are not “extras.” They are foundational.
A clear theme across multiple events is that relevant sectors are bought in on the importance of this holistic view of care but is grappling with how to translate that into practice.
Roles like community health centres and Community Health Boards—especially in places like Nova Scotia—hold significant potential. These local bodies already collect on-the-ground insight about what people need, but we’ve seen that their input is often treated as advisory only. There’s no guarantee that feedback becomes action.
Models like Burlington OHT’s Community Wellness Hub remind us of what’s possible—a system designed around people, not programs. And one that offers access to services, community connection, and stable supports in tandem.
What’s Next
Organizations that claim to serve communities must work to embed lived experience into governance, design, evaluation, and accountability. That means leveraging community-led design, participatory engagement, and ongoing feedback loops. It means supporting roles that gather lived-experience insight and recognizing them as leaders, not token voices.
We also believe in learning from existing wisdom—including care models rooted in Indigenous and land-based traditions. For integrated care to be truly inclusive and responsive, it must open to diverse experiences and expectations for care and allow them to inform new systems.
At Davis Pier, we’ve built our practice on this kind of collaboration. Our work in human-centred design, community engagement, and co-design helps communities shape solutions not just react to them. We bring together clients, service providers, and community members to co-create models that reflect lived realities and community needs.
Shawna Larade is a Partner at Davis Pier. She co-leads the firm’s Health & Wellbeing Practice and is passionate about driving positive change in the public sector. Shawna specializes in transformational management consulting and her expertise in both project management and change management supports organizations in streamlining operations, enhancing efficiencies, and elevating service delivery.
Lauren MacEachern is a Senior Associate with a background in implementation science, health services, and qualitative research. At Davis Pier Lauren has applied her knowledge and skills to support implementation initiatives in home care services. With research experience in continuing care and integrated care systems, Lauren is passionate about applying evidence-based solutions to complex health problems and planning for sustainability and scale-up of successful initiatives.
