How Ontario’s COVID@Home Pathway Transformed Pandemic Care

When the COVID-19 pandemic hit Ontario, early responses — even as hospitals were being overwhelmed — largely left primary care at the sidelines. In Hamilton, clinicians saw the need to do things differently, creating the COVID@Home Clinical Care Pathway. This grassroots, evidence-based initiative empowered family doctors to monitor and support COVID-19 patients remotely. It started as a local idea, first tested at the McMaster Family Health Team and then in practices across Hamilton, before quickly growing into a province-wide program, helping tens of thousands of Ontarians.

A Simple Idea with Big Impact

The COVID@Home concept was straightforward: give primary care providers an evidence-based clinical pathway to support their care of patients isolating at home with the use of loaned pulse oximeters — small devices that measure blood oxygen levels.

It worked (as shown in a new publication). Patients on the pathway were less likely to die from COVID-19. They felt reassured, informed and connected, even while isolating at home. Providers, too, reported high satisfaction, saying the pathway made care easier and more effective.

“Primary care was built for this type of response,” says Dee Mangin, a family physician and the lead behind COVID@Home. “We know our patients, we manage complex conditions and we’re trained to respond to acute illness. Clinicians just needed the support to do it safely and effectively.”

Mangin based the pathway on systems used elsewhere in the world, including in Christchurch New Zealand where she was practicing during the devastating 2011 earthquake that hit the city. Mangin knew from that experience that the strength of COVID@Home wouldn’t be just in the technology, but the people who come together to make it succeed.

“Everyone just said yes,” Mangin recalled. “It was a massive team effort.”

Volunteers delivered pulse oximeters to homes and translated patient materials into 13 languages. Primary care clinicians across Ontario joined regular webinars to learn about the program and share their approaches and successes with each other. Mangin, a member of the McMaster University Department of Family Medicine, and fellow primary care experts spent countless hours maintaining clinical guidelines with the most up-to-date evidence and policy.

From that solid footing, the program emphasized flexibility. Clinics could adapt the tools to fit their local context, whether urban or rural. It wasn’t about enforcing a rigid model — it was about empowering people to respond to their patients and help build the system at all levels. Weekly webinars created a space for providers to share ideas and learn from each other.

A Legacy Beyond the Pandemic

While the Pathway was designed for COVID-19, its impact may be much broader. It introduced many clinicians to the power of structured, evidence-based care pathways and showed how quickly primary care can innovate in a crisis.

It also sent a powerful message to policymakers: trust primary care. “When you give family doctors the right tools and support, they can do extraordinary things,” Mangin said. “We’re not just here for coughs and colds. We’re the foundation of the health system.”

The COVID@Home model was adapted in New Zealand and Australia, and its lessons are still being further studied. But for the thousands of patients who felt safer, calmer and better cared for during a frightening time, its value is already clear.

An early draft of this story was prepared with the assistance of Microsoft Copilot AI. All facts and details have been confirmed by humans.