HOLIDAY HOURS
The AFHTO office will be open Dec. 20- 23, but with significantly reduced staff. The office will close Dec. 24 at noon, and reopen on Jan. 4, 2022. We will be monitoring the info@afhto.ca inbox for urgent items only during this time.
Our very best wishes of the season. Please stay warm and safe.
Dear Members,
It’s been hard and everyone is exhausted. We know what a toll the last 21 months have taken and this week in particular – with the rapid increase of cases due to the Omicron variant – has not been easy. The modeling presented by the Ontario Science Advisory Table yesterday shows that without prompt intervention, ICU occupancy could reach unsustainable levels in early January. Although vaccines are less effective against the Omicron variant, boosters (third shots) can substantially increase protection.
Teams pivoted and answered the call by the Chief Medical Officer to prioritize vaccination in the ‘all hands-on deck’ request that was made earlier this week. Thank you to everyone who took a moment to fill in our survey over the last few days about this. We remain in awe of the amazing work you do every day, especially when faced with such uncertainty, short timelines, and limited resources.
For teams who are struggling with getting vaccines or wanting to participate in your public health vaccine clinics but do not know where to get assistance, the Ministry has provided a list of the PHU operational contacts who you can connect with.
We’d like to provide some information that you may find helpful as you continue to fight this pandemic, during this especially challenging time.
Ministry of Health guidance documents
With the Omicron surge, the Ministry has issued COVID-19 Case, Contact and Outbreak Management Interim Guidance which they continue to update as more about the variant is learned. Just a reminder that any updates to the Ministry Guidance Documents can be found here.
Updated IPAC recommendations and access to Rapid Antigen Tests
On December 15, Public Health Ontario issued an Interim IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID 19 which provides a summary of PPE recommendations.
Given the high transmissibility of the Omicron variant, there is a recommendation to move to fit-tested, seal-checked N95 masks or, if not available, well-fitted medical mask or non-fit test N95. Other recommendations around PPE in ambulatory settings can also be found in the document. As usual, work with your current supplier to see if you can access the relevant PPE but if you cannot, you can order Critical Personal Protective Equipment through the Ontario Health website.
This same website also allows you to order rapid point-of-care kits for you and your staff. On December 16, the Ministry posted an updated COVID-19 Guidance: Considerations for Antigen Point-of-Care Testing which now includes:
OCFP Community of Practice – The latest on Omicron and what it means for your practice
On December 17, the OCFP, with the DFCM at the University of Toronto, held its Community of Practice. Dr. Peter Juni provided a sobering update on the impact that the Omicron variant will have on our healthcare system if additional public health measures are not taken. The session was timely and below are some informative resources from it:
Medical and clinical trial exemptions
Effective December 15, Ontarians with exemptions for medical reasons or who are participants in COVID related clinical trials will be eligible to download an enhanced vaccine certificate (with a QR code) from the Ontario Portal. This QR code, when scanned by the Verify Ontario app and supported by ID, will allow patrons access to settings requiring proof of vaccination. Medical notes issued by out-of-province physicians will not be considered eligible for Ontario residents to receive a QR code.
The Ministry has developed a guidance document Medical and Clinical Trial Exemptions: Guidance for Issuing and Entering Records into COVaxON and a Sample Statement of Medical Exemption for COVID-19 Immunization that you can use.
Mobile Vaccine Clinics
The Chamber of Commerce and Ontario’s Vaccine Support Council have been working to stand up a number of mobile vaccine clinics in the short term – many of you may have seen this in earlier waves with the contributions of Fleets Coffee. Here are some possible supports that they can provide to you and your community:
If you would like to learn more or if you have questions, please contact Kirk Tobias at kirk.tobias@fleetscoffee.com.
Release of OHT-PHU COVID-19 Vaccine Resource Document
Today the OHT Branch at the Ministry released the OHT-PHU COVID-19 Vaccine Planning and Implementation Casebook: Notes from the Field covering memo that went to all OHTs and a casebook deck that was shared on some of the learnings from the OHTs.
New restrictions announced today
Today, December 17, the Premier announced that Ontario will further strengthen the response to Omicron. Here are some of the measures that will be taken:
This comes into effect at 12:01 AM this Sunday, December 19. The news release can be read here.
In addition to the provincial measures, the federal government has strongly advised against international travel, which, while safe, does impact holiday and family plans.
This is not an easy time. We know how hard you are all working, and we know how difficult these restrictions will be on many who were looking forward to larger gatherings for the holidays, or who had travel planned and are now needing to reconsider it for personal and public safety.
We have all been through a difficult 21 months and after weeks like this past one, it can feel especially hard. But we can remain optimistic that the work everyone is doing to prevent the spread of this virus and to administer and receive vaccinations is one way to help us get through this.
Our sincere thank you to all of you for what you do every single day. We hope you can enjoy some rest and time with your close family in the coming weeks.
If you have any questions or need additional support that we can provide, please email us at info@afhto.ca. Our office will be closed the week of December 27, but we will be checking and responding to time-sensitive emails.
Yours in good health,
The AFHTO Team
Within the AFHTO member portal, members can find the Quality and Knowledge Translation section.
Under the Quality Improvement Tools and Resources section, members can find COVID-19 tools to help support EMR workflows for COVID-19 vaccination patient population identification and documentation.
Additionally, QI resources ranging from standardized D2D queries to member initiatives can be found for teams to adapt and implement within their teams.
Throughout the year, AFHTO has been a part of multiple research initiatives which wouldn’t be possible without you! Check out the recent research publications and presentations on this page.
2021 has been a year with many challenges, which teams have responded to with their flexibility and resilience. To share the great work of teams, updates and supports, AFHTO collaborated with many partner organizations to organize webinars for teams. These webinars have been archived in this library within this section for your reference.
As we plan the webinar schedule for 2022, if you have any suggestions for webinar topics, please email improve@afhto.ca.
Updated Omicron Guidance
The COVID-19 Omicron Case, Contact and Outbreak Management Interim Guidance has been updated. This will be available on the Ministry’s website in French and English shortly.
Ontario Health e-Reports
As we move into the push of COVID-19 third doses, it will be critical to reconcile the patients with a 3rd booster shot to create a list of those without one. As of November 15th OH eReports have included patients that have received their third dose. There is also a new additional OH eReport which includes the full vaccination history of all rostered patients whose vaccination status is on record. All toolkits on the OntarioMD website have also been updated to work with this new report.
Supporting EMR Documentation of COVID-19 Vaccinations
The eCE Automates team at the eHealth Centre of Excellence has launched a new process for the Bernie bot that will help primary care clinicians to document their patients’ COVID-19 vaccinations seamlessly and efficiently within their electronic medical records (EMRs). eCE are offering this virtual assistant at no cost to you or your team. Contact them to learn more.
TELUS PSS Toolbar – Assisting in Reconciling Vaccinations
The HRM COVID Immunization Maker toolbar allows you to reconcile your patient’s COVID-19 immunization history in the TELUS PS Suite EMR with vaccination reports received via the Ontario Health Report Manager with one click of the mouse.
The content can be installed into your PS Suite instance as a custom form and will integrate into your records window using a downloadable reminder.
By ensuring that patient records contain the correct number of COVID-19 vaccines, you can find those patients who are still not fully vaccinated, as well as those who are eligible and best suited for third shots
To find out more visit this link.
Thank you for all your hard work this year, and our very best wishes for this season. We want to continue to capture your team’s hard work. With Omicron set to become the dominant strain this week, we want to capture how many teams have pivoted their operations for the next two weeks to support the province’s request that health system partners prioritize vaccination efforts, either within their own teams or working in the public health or hospital clinics. To share your team’s story, please fill out this survey before midnight today, December 16th.
Upcoming Webinars:
The latest on Omicron and what it means for you and your practice
Friday, December 17th at 8:00-9:30 am
Dr. Peter Juni, head of Ontario’s Science Advisory Table, will be providing an important update on Omicron and what it means for you, your practice, and our communities. You will also hear from Dr. Sacha Bhatia, Vice President at Ontario Health, about the health system response and what primary care is being asked to prioritize. Finally, Dr. Shane Tepper will discuss organizing to support vaccination and other services in the Peel community.
Diabetes Care: Tools And Resources To Support Mental Health Needs
Thursday January 13, 2022, 12:30–1:30 pm
Ontario Health is hosting a webinar for endocrinologists, primary care providers, and diabetes educators on screening for mental health needs among people with diabetes, and resources available to support them. This is the first of an ongoing series that will highlight Ontario Health’s three diabetes quality standards.
Quality Rounds: The Reality of Virtual Care: Lessons from The Pandemic
January 28th, 2022, 12:00 – 1:00 pm
Over the last two years of the pandemic, the popularity and usage of virtual care has increased dramatically. Join us as we hear from patients and providers on the enablers and barriers to delivering and using virtual care during the pandemic, as well as exploring the future opportunities of virtual care in Ontario.
If you are interested in learning more, please contact Courtney Paxton at Courtney.Paxton@ontariohealth.ca.
Webinar Series: MyPractice Primary Care Report: Using Data For Improvement
Please join Ontario Health in this quality improvement webinar series as we learn about the MyPractice: Primary Care Report, a confidential report that includes personalized practice level data, along with suggestions to support you in improving care for your patients. This 1-credit-per-hour Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 1.0 Mainpro+Ⓡ credits. The program is part of a series that has been certified for up to 4 Mainpro+ credits.
In Case You Missed It: Check out eBulletin #113 or other back issues here!
Questions? Comments? Contact us at improve@afhto.ca.
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Focused vaccination efforts in response to Omicron variant
With the Omicron variant becoming the dominant strain of COVID-19 and cases sharply increasing, the health system has been asked to implement an ‘all hands-on deck’ and immunize as many individuals over 50+ as possible before December 24th.
To highlight the urgency and the request from the Ministry, several memos have been released to the field:
As a follow up, we sent this email to the triad yesterday morning. We’ll provide more updates as soon as we can, so please check your email and let us know if you have any questions.
From OntarioMD regarding finding those who would be eligible for third shots:
#AFHTO2021 videos + 2022 planning committee sign up
All our 2021 conference videos and slides are now available to members, including the closing plenary MOVING FORWARD TOGETHER: The Power of Resilience with Dr. Mamta Gautam.
Become an influencer (sort of)!
Maybe you’re not getting free swag as an Instagram influencer, but you can get free registration and that’s just as good! Become a part of our 2022 conference planning committee and shape our first hybrid conference. As members, you’re our main audience so you should have a major say in how 2022 looks.
Review our ToR and sign up by Jan. 4, 2022.
2021 University of Toronto Family Medicine Report
The 2021 University of Toronto Family Medicine Report is authored by nearly 100 family doctors and health care providers from across Ontario, Canada and beyond. On the theme ‘caring through crisis’, it features personal stories, reflections and anecdotes that represent just a small fraction of the incredible work happening in family medicine and primary care, as well as data from the University of Toronto Practice Based Research Network (UTOPIAN). It includes stories from a number of our teams including St. Michael’s Hospital Academic and Toronto Western FHTs.
Post COVID-19 guidance and more
Recent updates include:
We continue to update several pages on our site with resources and news:
Primary care data reports for OHTs video
Primary Care Data Reports for OHTs were presented at a webinar on December 8, 2021. Hosted by INSPIRE-PHC, this session was intended to orient attendees to the reports and was followed with a Q and A session. The recording is available here.
Year-end communications and thank you
Although we will have further emails, this is the last newsletter for 2021, and we’d like to say thank you to all our members who allow us to provide support. May you squeeze every bit of joy you can out of these busy times. Thank you for all your hard work this year, and our very best wishes for this season.
2022 Legal Issues for Primary Care Team Webinars, Jan. 6- Dec. 1, 2022
Led by Kate Dewhirst. Learn more here.
ECHO Care of the Elderly (COE): Dementia series, Jan. 12- Mar. 23, 2022
You can find information here and register here.
Opening ourselves: An introduction to anti-oppression practices and frameworks (part 1), Jan. 13, 2021
Hosted by Healthcare Excellence Canada. Register here.
ECHO Programs at UHN, starting Jan. 13, 2021
Liver -starting Jan. 17
Concussion- starting Jan. 19
Chronic Pain/Opioids- starting Jan.13
Rheumatology- starting Jan. 14
Register here.
Winter/Spring 2022 Continuing Professional Development, Jan. 18- June 2022
Queen’s Faculty of Health Sciences’ Continuing Professional Development program. View options here.
Quality Rounds: The Reality of Virtual Care: Lessons from the Pandemic, Jan. 28, 2022
Hosted by Ontario Health. Find out more here.
Message for EDs/Admin Leads, Board Chairs and Lead Clinicians
Dear Members,
Last night, the Primary Care Collaborative members were invited to a meeting with Dr. Kieran Moore, Chief Medical Officer of Health, Dr. Catherine Zahn, Deputy Minister of Health, Ministry of Health representatives and Ontario Health representatives. Dr. Moore provided an update on Omicron and issued a call to action to primary care to play a significant role in vaccinating people 50+ over the next two weeks.
Omicron update:
Response:
Call to Primary Care:
There will be more information coming from the Ministry of Health and Ontario Health, hopefully later today or tomorrow. However, we wanted to share this information with you this morning in case you begin to get contacted by your health system partners or PHU to start planning. Dr. Moore shared last night that this is absolutely the most important thing primary care can do in response to the pandemic.
We will continue to share information with you as we receive it.
Please reach out if you have any questions or concerns,
Yours in good health,
The AFHTO Team
NOW AVAILABLE
All our 2021 conference videos and slides are now available to members, including the closing plenary MOVING FORWARD TOGETHER: The Power of Resilience with Dr. Mamta Gautam.
Also available to members:
Maybe you’re not getting free swag as an Instagram influencer, but you can get free registration and that’s just as good! Become a part of our 2022 conference planning committee and shape our first hybrid conference. As members, you’re our main audience so you should have a major say in how 2022 looks.
Review our ToR and sign up by Jan. 4, 2022.
NB- for those who would like to only participate in a concurrent session and poster working group and/or Bright Lights review committee, the call for these will go out separately in 2022.
ICYMI- most conference attendees got a $5 Starbucks digital gift card courtesy of sponsor QHR. If you didn’t see this, please check your junk mail.
We look forward to seeing you next year on Oct 12, 2022!
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Inequity in online renewal for OHIP
Inequities in Ontario’s online health card renewal system must be addressed so marginalized people are not left behind.
The Alliance for Healthier Communities (Alliance), the Association of Family Health Teams of Ontario (AFHTO), the Indigenous Primary Health Care Council (IPHCC), and the Nurse Practitioner-led Clinic Association (NPLCA) call on the government to address the inequities in the online health card renewal system.
“The ability to renew the Ontario health card online is only available to people who hold a driver’s licence. This needs to change to include those with an Ontario photo card,” says Kavita Mehta, CEO of AFHTO. “There are a number of people who do not or cannot drive, including those with medical conditions. Like those with a licence, they need the same ability to renew online.” Read the full statement here.
Please share via Twitter or Facebook– the more people aware of this issue, the better.
Practical approaches to polypharmacy: the gentle art of deprescribing slides and video available
On Dec. 1 we explored approaches to the issues and problems around polypharmacy and deprescribing in primary care patients. We also demonstrated the TAPER tool. The video and slide deck are now available.
Member stories
City of Lakes FHT– stepping up to help with routine vaccination during health unit’s pause
Dryden and Red Lake FHTs– Dryden Rotary supporting community groups
Guelph FHT– Guelph administers first COVID-19 vaccines to children under 12
Primacare Community FHT– health hub now open
Rapids FHT – 2,000 local children already booked for first COVID-19 shot
Interim Omicron guidance, booster letter and more
Recent updates include:
We continue to update several pages on our site with resources and news:
Seeking input on psychological safety factors
In collaboration with the Mental Health Commission of Canada, researchers at the Centre for Studies in Primary Care at Queen’s University and HEC Montreal are inviting health-care workers and leaders to participate in research to identify barriers and facilitators to accessing support for psychological self-care and protection from moral distress.
Learn more about the study and participate in a Canada-wide survey.
Together We Care 2022 Virtual Conference: call for content
The Ontario Long Term Care Association (OLTCA) in partnership with the Ontario Retirement Communities Association (ORCA) will host an online experience for Together We Care (TWC), Monday, April 4 – Wednesday, April 6, 2022. The call for content is open until Dec. 20.
Call for abstracts – Choosing Wisely Canada
Choosing Wisely Canada is now accepting abstract submissions to be featured virtually at their National Meeting, on May 25 and May 26, 2022. Deadline is Jan. 28, 2022.
Bounceback refresher webinars, Dec. 7-15, 2021
Do you or your staff need a refresher on the BounceBack program and eligibility criteria? Attend an upcoming webinar in English or French. Links to resources also available. Register here.
Primary Care Data Reports for OHTs, Dec. 8, 2021
Hosted by Drs. Michael Green and Rick Glazier, INSPIRE-PHC. Find out more here.
Echo Ontario Bariatric Network Series, starting Jan. 2022
New series of sessions beginning January focusing on post bariatric surgical care. Register here.
Diabetes Care: Tools and Resources to Support Mental Health Needs, Jan. 13, 2022
First of an ongoing series that will highlight Ontario Health’s three diabetes quality standards. Register here.
Family Medicine Summit 2022, Jan. 18, 28-29, 2022
Kick-off event, January 18, 2022, with live stream days Jan. 28 & 29. Find out more here.
Webinar Series: MyPractice Primary Care Report: Using Data for Improvement, Jan. 24 & Feb. 28, 2022
Next in Ontario Health QI webinar series, focused on using the antibiotic prescribing and cancer screening indicators respectively. Register here.
MEDIA STATEMENT
December 7, 2021
The Alliance for Healthier Communities (Alliance), the Association of Family Health Teams of Ontario (AFHTO), the Indigenous Primary Health Care Council (IPHCC), and the Nurse Practitioner-led Clinic Association (NPLCA) call on the government to address the inequities in the online health card renewal system.
“The ability to renew the Ontario health card online is only available to people who hold a driver’s licence. This needs to change to include those with an Ontario photo card,” says Kavita Mehta, CEO of AFHTO. “There are a number of people who do not or cannot drive, including those with medical conditions. Like those with a licence, they need the same ability to renew online.”
The Ontario driver’s licence and the Ontario photo card are government-issued cards that show proof of identity and proof of residency, and they are both accepted for in-person renewal. The government does not accept the Ontario photo card for online renewal.
“This is concerning at any time, and it is particularly concerning during a pandemic,” says Sarah Hobbs, CEO of the Alliance. “One group that could be disproportionately affected by this practice are people with disabilities. People made more vulnerable by the pandemic, and at higher risk, are also faced with inequitable access to this system. These populations should not be treated differently or be limited to only being able to access in-person ServiceOntario renewals. We call on the government to step up and make the online OHIP renewal system equitable and accessible for all people living in Ontario.”
Katie Hogue, nurse practitioner and chair of the NPLCA, echoes this concern. “There are many medical circumstances that can prevent people from driving, such as mobility challenges, vision impairment, dementia, and epilepsy. There are also conditions like rheumatoid arthritis, which can keep a person from driving while also making them immunocompromised. The system is not considering these people or their needs.”
The CEO of the IPHCC, Caroline Lidstone-Jones notes this concern across the healthcare system. “The pandemic has highlighted inequities in our healthcare system. We must prioritize those who are vulnerable and at-risk. This discrimination is one example of an inequitable system but this one has a quick solution: allow people with a photo card to renew their health card online, the same way those with a driver’s licence can.”
The associations represent family health teams, community health centres, nurse practitioner-led clinics, Indigenous primary healthcare teams, and other interprofessional models of primary care in Ontario.
For further information: Beth MacKinnon; 647-234-8605 x1201; beth.mackinnon@afhto.ca