Operational Direction: Local Delivery Group Expansion to Support Spread and Scale of Digital Priorities
In June 2023, Ontario Health established Local Delivery Groups (LDGs) to serve as regional digital implementation leads for provincial and regional priorities that benefit from a collective delivery approach. There are currently ten LDGs across the province, each with one Lead Organization that is accountable to Ontario Health for coordinated implementation of priorities within a region. Initially focused on advancing shared services for cybersecurity, LDGs have helped participating health service providers – primarily hospitals to date – meet regulatory and legislative requirements, address varying levels of cyber maturity, and reduce the overall risk of cyberattacks across the sector.
The success of LDG partnerships has laid the foundation for more coordinated digital planning which was communicated through Operational Direction in the Spring. This direction established a process for hospitals to plan collaboratively with Ontario Health and LDGs to rationalize Hospital Information Systems (HIS) and improve connected care for patients and caregivers. This direction remains in effect and supports the advancement of provincial and regional coordination of digital solutions.
Ontario Health is now expanding the role of LDG Lead Organizations to include accountability for the implementation of core elements of Patients before Paperwork, the provincial initiative established to reduce administrative burden and improve access to care. Under the umbrella of Patients before Paperwork, a number of provincial solutions will require regional planning, implementation and adoption, beginning with eReferral and central intake for diagnostic imaging (CT and MRI), orthopaedics, and cataracts.
This fiscal year, LDG Lead Organizations will:
- Continue working with Ontario Health to expand the Provincial Cybersecurity Operating Model.
- Continue to review and propose local and regional digital rationalization opportunities.
- Work with health service providers to implement Patients before Paperwork through fit-for-purpose regional governance models that drive execution of provincial priorities:
- Implement eReferral within their facilities this fiscal and lead the planning for system-wide implementation in 2026/27.
- Advise on Central Intake structures and support the successful implementation of regional hubs, as per direction from the provincial clinically-led governance structure.
Expansion of central intake will also include coordinated access to mental health and addiction services. Ontario Health at Home is also recognized as an LDG Lead Organization for advancing planning within home and community care.
All health service providers are directed to work collaboratively with their respective LDG Lead Organizations to implement these priorities.
To advance immediate eReferral goals, all providers, beginning with hospitals, are directed to work with their LDG Lead Organization on broad-scale implementation of eReferral across all facilities and communities in their catchment area for 2026/27.
LDG Lead Organizations will hold an accountability agreement with Ontario Health to implement these priorities and will provide local governance, oversight and administration for the members within a region and in alignment with provincial guidelines.
The following organizations have been designated as LDG Lead Organizations, with six assuming additional accountability as Central Intake Lead Organizations within their respective Ontario Health region:
# | Region | LDG | Lead Organization | Central Intake Lead Organization |
---|---|---|---|---|
1 | North West | North West LDG | Thunder Bay Regional Health Sciences Centre | Thunder Bay Regional Health Sciences Centre |
2 | North East | North East LDG | Health Sciences North | Health Sciences North |
3 | East | East of the East LDG | The Ottawa Hospital | The Ottawa Hospital |
4 | East | Central East LDG | Scarborough Health Network | The Ottawa Hospital |
5 | Central | Central North LDG | Royal Victoria Regional Health Centre | Trillium Health Partners |
6 | Central | Central South LDG | Trillium Health Partners | Trillium Health Partners |
7 | Toronto | Toronto LDG | University Health Network | University Health Network |
8 | West | South West LDG | London Health Sciences Centre | Hamilton Health Sciences |
9 | West | Hamilton Niagara Region LDG | Hamilton Health Sciences | Hamilton Health Sciences |
10 | Provincial | Home and Community Care LDG | Ontario Health at Home |
These LDG Lead Organizations will work closely with one another and with Ontario Health to implement provincial strategic direction with the goal of connecting and coordinating the health system through a standardized digital architecture.
As always, please reach out to your Ontario Health region for questions and support.
ISSUED TO: | Health Service Provider Executive Officers and Executive Directors including Ontario Health Team Leadership |
ISSUED FROM: | Matthew Anderson, Chief Executive Officer, Ontario Health |
CC: | Nicole Robinson, Interim Chief Regional Officer, West Region Christine Nuernberger, Interim Chief Regional Officer, Central Region Scott Ovenden, Chief Regional Officer, Toronto and East Regions Brian Ktytor, Chief Regional Officer, North West and North East Regions Stephanie Lockert, Interim Executive Vice-President & Chief Operating Officer Angela Tibando, Senior Vice-President, Digital Excellence in Health Dr. Sacha Bhatia, Executive Vice-President, Primary and Community-Based Care Anna Greenberg, Chief Executive Officer (Interim), Ontario Health atHome |
RELEASE DATE: | October 9, 2025 |
Last Updated: October 10, 2025