Business case for QIDSS proposals for 2017-2018 annual operating plan submissions

The MOHLTC has signalled an openness to consider proposals in 2017-18 annual operating plan submissions to expand funding for QIDSS among AFHTO members. To support teams in making a case for their request for QIDSS funding, AFHTO has compiled the following messages you might consider including in your submission. In addition, members may want to review previous guidance for making QIDSS proposals, budget advice (FAQ # 6-11) and a case study of different approaches to deploying QIDSS. See also input from members involved in QIDSS partnerships regarding success factors. Please consider this information when budgeting for your new QIDSS role. Note that AFHTO has never had nor will have ANY role in decisions regarding which teams are approved for QIDSS funding nor how much funding is allocated. All QIDSS funding has gone and will continue to go directly to the host team for the QIDSS (usually on behalf of a partnership of teams who intend to collaborate on the deployment of the QIDSS). AFHTO’s role is to coordinate and support AFHTO members and QIDSS to ensure that collectively, the QIDSS resources (including the central team at AFHTO) achieve the goals of the QIDS program which was to advance measurement and improvement of quality of team-based primary care for ALL AFHTO members. This unique and unorthodox combination of local deployment with central coordination is definitely complex and at times difficult to navigate. It is also vital to ensuring that QIDSS remain closely tied to the immediate needs of front line providers while at the same time contributing to the “big picture” of demonstrating and improving value in team-based care. QIDSS have proven to be the “special sauce” that has made it possible for AFHTO to have a significant impact on the sector and the policy-makers that govern it. We look forward to success with the proposals for additional QIDSS funding to further enable AFHTO members to lead the sector.

Considerations in making business case for QIDSS roles

• General case for QIDSS:
  • D2D has been far more successful in recruiting participants than other reporting initiatives
  • QIDSS were the crucial enabler for teams to participate in Data to Decisions (D2D) which is increasing the capacity of teams to access and use EMR data to improve
  • Capacity to access and use data is fundamental to improving performance in primary care. “Data Driven Improvement Using Computer-Based Technology” is the second building block recognized as crucial to high performance in primary care (Bodenheimer et al, 2014)

• Demonstrate good stewardship of QIDSS resources to date (if available for your partnerships)
  • Number of teams in partnership have contributed to how many iterations of D2D
  • Degree of alignment/consistency in patient experience questions between members of partnerships
  • Extent of collaboration between partners: partnership agreement, joint work-plan, sharing of D2D (and other performance) data

• GAP that additional QIDSS support would fill
  • Increase ability of all teams to participate in D2D and using their data to improve (ie cite how many hours per team QIDSS support is available – do NOT include travel time in this – ie if QIDSS spends 4 hours to travel to a team, they can only spend 3.5 hours supporting them) – suggest not explicitly referring to travel support resources as this is difficult for MOHLTC to support
  • Increase access to consistent, timely, ongoing patient experience capture, dissemination and use between teams: ie same patient experience surveys and same methods across all partners
  • Increase consistency of EMR data between partners
  • Increase use of EMR data: outline some example projects of how you might use EMR data within your team to improve data quality and/or actual performance
  • Enable teams or providers not part of your partnership to participate as your existing partners do – explicit plans for collaborating with non-team providers would likely be well received by MOHLTC