When patients finally get a diagnosis after months of uncertainty, they are often left with the indelible memory of all that it took to get there: the months or years of explaining their condition to someone, advocating for themselves, and navigating a complex healthcare system. These are experiences that Nurse Practitioners (NPs) strive to correct by coordinating compassionate care, managing complexity, and advancing seamless integration.
Yet the data we use to shape healthcare policy often fails to capture most of that work.
What the Numbers Miss
Ontario’s Ministry of Health has set out its vision in Your Health: A Plan for Connected and Convenient Care, describing goals in terms of patient experience — better information, connected care teams, faster and easier access to services. The plan tracks progress through six indicators: ending hallway healthcare, reducing alternative levels of care, repeat ER visits for mental health and substance use conditions, surgical wait times, timely access to home care, and systemic vacancy rates.
These indicators capture outcomes that matter to Ontarians. But they tell us very little about what is driving those outcomes or what is preventing them from improving further. They do not tell us which providers are delivering care, in what context, or through what combination of interventions. They do not tell us what happens upstream, before a patient ends up in the ER or on a surgical waitlist. And critically, they do not tell us what NPs specifically contribute to any of these results.
Alongside RNs, RPNs, physicians, pharmacists, physiotherapists, midwives, personal support workers, administrators, and patients’ loved ones, NPs are on the frontlines of ensuring that Ontarians receive high-quality, personalized care. NPs function as Most Responsible Providers (MRPs), lead teams, manage complex patients, and support communities. This work includes patient education, care coordination, prevention, chronic disease management, and system navigation. All of these are essential contributions to patient outcomes that are largely invisible in the current metrics shaping policy.
One of the most significant of these contributions is continuity of care: the experience of healthcare as a coherent system rather than a series of disconnected encounters with different providers. Continuity of care improves the efficiency and efficacy of our healthcare system and significantly reduces the mental and emotional burden that falls on patients when they have to restart, re-explain themselves, or navigate different systems. It is one of the most meaningful markers of a well-functioning, patient-centred system.
Don’t just take it from me. Here’s what patients are saying:
“I have been receiving primary care from my Nurse Practitioner for the past five years, and my experience has been exceptional. She has consistently provided compassionate, thorough, and patient-centred care. In my experience, Nurse Practitioners develop strong, long-term relationships with their patients and often have a deep understanding of their medical history, concerns, and healthcare needs. This continuity of care has made a significant difference in my healthcare journey.”
“My NP listened to me. After trying so many different providers that made me feel like the problem was in my head and I should try harder or take pills, my NP heard all the changes that I was going through, how stressful and challenging it was to move to Canada and adapt here. She heard me and my concerns, made me feel valued.”
These kinds of testimonials are incredibly powerful and reinforce the importance of collecting data that more accurately captures the full extent of NPs’ contributions to our healthcare system.
An Incomplete Picture Has Real Consequences
Without data that reflects the full scope of NP practice contributions, both service delivery care models across all sectors and funding models default to what is currently measurable: patient throughput, defined procedures, and hierarchical models of care. These frameworks conflict with the way NPs actually work, and they constrain NPs from practising to their full extent. The result is a healthcare workforce that is systematically underutilized at precisely the moment Ontario faces a deepening access-to-care crisis.
When NPs are not funded or deployed to their full capacity, patients lose access to the kind of continuous, prevention-focused, relationship-based care that keeps them out of emergency rooms and surgical waitlists. These are the very outcomes Ontario’s plan is trying to improve. The data gap and the care gap are the same problem.
What Good Measurement Looks Like
Other jurisdictions are already doing this. The British Columbia Patient-Centred Measurement Steering Committee has developed a provincially coordinated, scientifically rigorous strategy for collecting and reporting data that reflects the full reality of care. Their approach incorporates self-reported data and focuses on patients’ experience, satisfaction, and quality of life, capturing the spectrum of care that people receive and including the work that conventional metrics miss. The result is a dataset that enables more effective, evidence-based policy decisions.
Ontario can look to this model for inspiration. Fulsome data on the NP workforce, continuity of care, preventative care outcomes, and long-term system impacts are not currently part of the policymaking picture — but they need to be. Collecting this information is admittedly more complex than comparing wait times or repeat hospitalizations. But its importance cannot be overstated.
Measuring What Matters
Effective, patient-centred healthcare policy must be built on data that reflects the full reality of care. Ontario should begin tracking NP-specific workforce data, including patient panel composition and complexity; measuring continuity of care as a system indicator; incorporating patient-reported experience and outcome measures into provincial reporting; and developing flexible service delivery and funding models that recognize and compensate the full scope of NP practice.
Patients may not remember how many forms were completed or how quickly a metric was processed. They will remember when they felt heard, when someone took the time to understand them, and whether they could access the care they needed. These are the true markers of a healthcare system that is working.
Sources
https://www.ontario.ca/page/your-health-plan-connected-and-convenient-care
https://www.ontario.ca/page/published-plans-and-annual-reports-2025-2026-ministry-health#section-5
