A framework for community-oriented primary healthcare

To build on the very valuable contribution of Kates et al., this commentary takes a population health perspective and provides a complementary framework and means of accelerating transformative change in community-oriented primary healthcare (COPHC). The six basic requirements that make up this framework are (1) a geographical population focus, (2) patient and community engagement - a governance mechanism, (3) comprehensive COPHC services, (4) collaborative inter-professional teams and partnerships, (5) performance measurement and quality improvement and (6) innovation in financing. Transformative change in COPHC can be accelerated by the following: an increase funding for the primary prevention of chronic disease; the facilitation of inter-professional collaboration with resources and data; the development of indicators and databases for the above six basic requirements; and annual public reports by the Health Council of Canada based on these indicators to track progress in the transformation of COPHC, with the co-operation of the Canadian Institute for Health Information. The 6% annual uplift in the Canada Health Transfer is a potential source to fund these initiatives.