Ultimate Blogging Championship

Category: Uncategorized

  • Queen’s FHT & Belleville NPLC join community partners in prescribing exercise

    Inside Belleville article published October 28, 2016. Article in full pasted below. Erin Stewart, Quinte West News

    Prescription to exercise, doctor’s orders

    A new health care prescription has made its way to the Quinte region; it’s not actual medicine, but a 60-day pass to the YMCA to get people moving.

    The Quinte West and Belleville YMCA have launched “The Prescription to Physical Activity to Better Health” initiative, in partnership with the Department of Family Medicine Queen’s Family Health Team, Belleville Nurse Practitioners and the Belleville and Quinte West Community Health Centre, to promote the importance of regular activity through utilizing prescriptions.

    Health care providers through the three partnerships can now prescribe physical activity through the 60-day YMCA trial period to patients who would like to change their lifestyle or could use some more exercise.

    Bianca Sclippa-Barrett, health promoter at the Belleville and Quinte West Community Health Centre, said the centre is excited to be involved in the new initiative during the project’s launch at the Belleville YMCA on Wednesday Oct. 26.

    “We certainly work at providing a holistic approach to health care and this partnership allows us to provide more than good advice when it comes to physical activity,” she said.

    “It helps people get the access that they need, the tools and support that they need to make positive changes in their lives,” said Sclippa-Barrett. “So the Prescription to Health program will help leverage the different strengths and resources here in our community to benefit the whole community and definitely a big win-win for us all.”

    The Prescription aims to tackle the growing problem of sedentary lifestyles by addressing the common barriers of motivation and access.

    David Allan, President and CEO for the YMCA of Central East Ontario, said people who receive a prescription through the health care providers at the programs partners will be we welcomed to the YMCA with a tour and scheduled an appointment with a trainer who will help explore interests, personal goals, demonstrations and more.

    “When somebody gets something from their doctor, they tend to take advantage of that and will use that and realize there’s a need,” he said. “So it’s up to us then to make sure that they are welcome and given the opportunity to succeed.”

    The key is involvement, said Allan.

    “We are committed to building healthy communities… making sure that people are given the opportunity to do the things they want to do that will change their life.” He said. “If they want to swim they can swim, if they want to use the treadmill we will teach them how to use the treadmill, if they want to attend classes, they can attend classes.”

    The program was initially launched as a pilot project in Peterborough, said Allan, and had a great response.

    “We launched it in Peterborough and it’s been very successful there so we felt we will launch it in this community, knowing that it’ll make a difference.”

    Allan said he’s excited to launch the initiative in Belleville and Quinte West and said it starts immediately.

    More partnerships within the community are definitely welcome, said Allan. The more the merrier, if more family physicians or any health care providers would like to get involved.

    Click here for more information about Queen’s FHT Click here for more information about the Belleville NPLC Click here to access the Inside Belleville article     

  • Data to Decisions eBulletin #45: EMR data quality: even better than we were yesterday

    Are you getting the most out of your EMR? The EMR Progress Assessment (EPA) from OntarioMD will show you where you’re at and help you develop a plan to get where you want to be. NEW: QIDS Specialists can now access this tool. If your EMR could show you which patients had depression, how would you make their care even better? Our standardized, tested EMR query can get you started towards building a registry for patients with depression. When your EMR works for you, you can do even better for your patients. Having difficulty finding out who’s getting vaccinated outside your office? Want help sending vaccination records to Public Health? Read how FHT doctors and pharmacy owners collaborated to create a tool that addresses these and other data-sharing challenges. EVEN BETTER: The tool will also help you review your patients’ medications and ensure they get their colon check kits. EMR data quality saves lives AND wins awards! Powassan and Area FHT was awarded “poster of distinction” at HQT for their story about how EMR data quality saves lives. Other measurement highlights from the AFHTO conference: Watch the Bright Lights videos to see the great work happening in teams across the province to enhance care. Concurrent session, poster, and plenary presentations are also available on the AFHTO website. Submit your evaluation of the conference: AFHTO’s annual conference is the best learning and networking opportunity for people who work in and with primary care teams. Please help us to continue, and to continuously improve – if you didn’t fill in the form at the conference, please take a moment to do so now.

    Help spread the word about D2D – invite others to sign up for the eBulletin. 

  • Getting started on a registry for patients with depression

    This document explains how to use standardized queries in your EMR to start building chronic disease registries. The instructions below focus on Depression. Depression affects about 5 percent of the Canadian population aged 15 years and over during any given year, and affects 12% of Canadians at some point in their lifetime [Statistics Canada’s 2012 CCHS]. The Conference Board of Canada said in a report released in September 2016 that depression costs the Canadian economy at least $32.3 billion annually in lost productivity. Despite the magnitude, burden of illness, and social and economic costs associated with depression, there continues to be societal stigma and self-stigma that discourage individuals and families from seeking treatment and support. While there are real barriers, FHTs can provide access to different treatment options through their interprofessional teams. In order for a FHT program to be efficient and effective, the right patients need to be enrolled. Normally programs require the doctor to remember to enroll the appropriate patient into a program. However, that process for a handful of patients will be slow and least effective. Instead, FHTs can use a Depression Search tool, developed by the AFHTO Algorithm Project team, to identify the patients in their FHT that have depression. Our depression search tool has been developed using the CPCSSN case definition and the input from subject-matter experts at Hamilton FHT and St Michaels’ Hospital. The tool has been tested, revised, and validated using the eHealth Centre of Excellence EMR environment. The depression search tool is comprehensive, does not require any data cleaning prior to use, and is plug-and-play. At final testing, the tool achieved 96% sensitivity and 62% positive predictive value (PPV); in simple terms, this means that if the search tool identifies 100 patients, 62 patients will actually have depression. This is a starting point for a manual validation of a depression registry. Query criteria (click to see larger view)            

    The Depression query is intended for teams that do not yet have a reliable list of patients with depression and don’t have the time or resources to start from scratch in reviewing all their patients to generate such a list.  Right now, it is also only for teams with PSS or Accuro although work is continuing to expand the standardized query to OSCAR and Nightingale. The following steps will help your team use the query to generate a list of CHF patients, starting from your EMR.  

    Step 1. Estimate how many patients you think this will affect.  Multiply the number of patients your team serves by 0.05 (the average rate of depression in Ontario) to get a rough idea of how many of your patients likely have depression.  If you still think this is a big enough group of patients for you to generate a registry for, carry on to step 2.

    Step 2. Import the query into your EMR.  Right now, you can only do this if you have either Telus PSS or QHR Technologies Accuro EMRs.  You will likely need the help of your QIDSS, IT staff or other person who usually works with your EMR to do this.

    • For PSS, import the PSS SRX file into your EMR. Contact improve@afhto.ca for the file.
    • For Accuro, download the query “AFHTO Depression Frontend Search”from their publisher.

    We are in the process of creating similar queries for OSCAR. Contact improve@afhto.ca for more information.

    Step 3.  Run the query in your EMR.  Again, you might need the help of your QIDSS, IT staff or other person who usually runs queries in your EMR. Running the query will produce a list of patients with depression. The list will not be perfect – probably 38% of the patients identified by the query will NOT have depression. The query gets you STARTED in building the depression registry but doesn’t do the whole job for you.

    Step 4. Find the patients who might not have depression. Review the list of patients generated by the query to separate out those patients that are clearly already coded as having depression. What’s left will the list of patients who MIGHT have depression based on other data in the EMR besides formal coding.

    Step 5. Prepare your physicians to review the list  Subdivide the list of possible patients with depression into separate, shorter lists for each physician. Work with your physicians to find out if they would prefer a list on paper or electronically and how they might like it sorted (i.e. by name or most recent visit or some other parameter).

    Step 6.  Invite each physician to review their list of patients.  They know their patients best and can likely quickly confirm which ones do or do not have depression, even though that information might not be easy for others to find in the EMR.

    Step 7.  Clean up your EMR data.  Add depression codes to the EMR for each patient that the physician confirms as having depression. This so-called “data cleaning” work is a great job for a student.  AFHTO has created a toolkit to assist members in recruiting and using students for data clean-up. Click here for the toolkit.

    Step 8.  Re-run the query. After you have corrected the EMR, re-run the query to generate a list of patients with depression. This is your new depression patient registry. Going forward, you can run the query anytime you need to generate a list of patients with depression.  You can use the list to invite patients to a depression program, track progress with outcomes on these patients or any other purpose.   Once identified, you can recruit patients to your depression program and improve patient prognosis, management, and overall care. Here are some example outcome measures to apply for this program:

    • % of patients who show an improvement in PHQ-9 score
    • % of patients who show improvement on CES-D
    • % of patients hospitalized
    • % of patients with action plans
    • % of patients self-identifying as satisfied after a group session

    See this space for more on resources and contacts in supporting teams set up care programs for depression. This query was produced by and for QIDSS with assistance from eHealth Centre of Excellence in support of all AFHTO members.  If you have any questions, please contact improve@afhto.ca. 

  • Powassan and Area FHT wins Poster of Distinction award at HQT

    Congratulations to Anna Gibson-Olajos and Meghan Peters, who were awarded Poster of Distinction at Health Quality Ontario’s Health Quality Transformation conference on October 20, 2016. Their poster Because You Care: Using Your EMR Data to Save Lives tells the story of how D2D helped the Powassan and Area Family Health Team (PAAFHT) identify a serious issue in their data quality for colorectal cancer screening rates. PAAFHT was able to address this issue through a number of change ideas, which in turn had a significant impact on patient care. This story was also presented at the AFHTO 2016 Conference as a concurrent session.

  • QIDS Specialists access to the EMR Progress Assessment tool: An AFHTO & OntarioMD collaboration

    The OntarioMD/AFHTO EPA collaboration is a project designed to provide QIDS Specialists access to a customized version of the OntarioMD EMR Progress Assessment (EPA). The EPA can then be employed by physicians to assess their current and desired level of EMR maturity. The EPA helps identify areas of improvement and serves as a starting point for conversations about EMR optimization, both at the individual and practice level. The results of the EPA act as a benchmark from which physicians, QIDS Specialists and OntarioMD Practice Enhancement Consultants (PECs) can begin developing a plan to increase practice efficiency and clinical quality. members Objectives

    • Promote the EPA within your FHTs.
    • Assist physicians with EPA completion.
    • Promote EMR Practice Enhancement Program (EPEP) and PEC services.
    • Prepare to work collaboratively with PECs to assist with data capture work.
    • Help support and sustain change (i.e., tools, custom forms, stamps, macros, etc.).

    How to Get Access to the EPA

    Step 1 – Get a Sponsored Account

    • Identify a physician and approach them about becoming your sponsor.
    • Explain the EMR Progress Assessment (EPA) initiative and provide them with a copy of the Sponsored Accounts – Physician Guide.
    • Advise that OntarioMD will provide support throughout the Sponsored Account process.
    Step 2 – Create a Portal Account

    Step 3 – Register for the EPA Webinar

    • OntarioMD will host an online training session to discuss the EPA, the practice/physician engagement process, and answer any questions about this initiative.
    • Session dates will be announced as new accounts are created.
    Step 4 – Ask Questions

    See the attached guides for creating an OntarioMD sponsored account:

    Not sure how to get started? Find a Champion

    • Use your existing relationships within the practice to identify someone willing to complete and promote the EPA to the group (e.g. Executive Director, Lead MD, EMR Champion).

    Create Awareness

    • Educate the group about the benefits of the EPA.
    • Share the results of your EPA to raise awareness and inspire the group to complete their own.
    • Promote the OntarioMD EMR Practice Enhancement Program and Peer Leader Program as services which use the EPA as a starting point in their optimization work.

    Provide Support

    • Advise and re-assure the group that you can support their completion of the EPA (i.e., interpreting the clinical questions, rating EMR maturity, etc.).

    Engage OntarioMD

    • PECs are ready to work collaboratively with QIDS Specialists and the practice on EMR enhancement projects to bridge the gap between “Where I am Now” and “Where I Want to be Next”.

  • AFHTO Members on the 2016 Minister’s Medals Honour Roll

    Several AFHTO member teams were honoured as honour roll applicants for the 2016 Minister’s Medals in Health Quality and Safety , announced at today’s Health Quality Transformation conference.

    About the Minister’s Medals and the Honour Roll

    The 2016 Minister’s Medal is a competitive, annual program designed to recognize the excellent work that health care providers do every day. The Minister’s Medal provides an opportunity to recognize system champions who place the patient at the centre of the circle of care and have demonstrated exceptional work in collaboration and achieved sustainable results, while promoting system value and quality in the health care system. The teams named below demonstrated outstanding performance across the Medal criteria. Their applications made it to the final stages of the review process and are recognized as honour roll applicants.

    Congratulations to the 2016 Recipients

    The Carefirst Family Health Team  was named to the Team Honour Roll for developing the  Seamless/Timely/All-Inclusive/Right-Scaled (STAR) program – a care coordination and integrated hub that enables the Scarborough Hospital to discharge patients to a virtual ward composed of community care services within the community. The Carefirst FHT is partnered with the Scarborough Hospital, the Scarborough Doctors Family Health Organization and the Central East community care access centre to support patient transitions through the program. STAR provides access to home and community care, primary care, chronic disease management, short-stay respite care, and acute care. The Champlain BASE™ eConsult service was named to the Team Honour Roll for Building Access to Specialists through eConsultation. The service, developed by Drs. Clare Liddy and Erin Keely of The Ottawa Hospital Academic Family Health Team is a secure, web-based tool that allows primary care providers quick access to speciality care for their patients, often avoiding the need for the patient to be referred for a face-to-face visit. The eConsult service helps improves timely access to specialists; connects primary care providers and specialists; informs and supports patients, primary care providers and specialists; and protects patients by improving patient safety. Drs. Liddy and Keely were recognized with a 2016 AFHTO Bright Lights Award for this program. Suzanne Singh, a pharmacist with the Mount Sinai Academic Family Health Team, was named to the Individual Champion Honour Roll for being a passionate advocate of optimizing medication management in primary care through collaborative partnerships with patients and health care providers. She steers patient care initiatives focused on vulnerable patient populations at risk of medication-related problems and provides clinical expertise related to managing high-alert medications. She has also chaired the Mount Sinai Academic Family Health Team’s Complex Patient Care Rounds and the Interprofessional Health Provider Committee. One key example of this is her leadership in developing the Brown-Bag Medication Check-Up Program, for which the Mount Sinai Academic FHT won an AFHTO Bright Lights Award in 2015.  

  • AFHTO 2016 Conference: Presentations have been posted

    “What leaders really do is prepare organizations for change. Leaders, by definition, work in the realm of unknowability and wrestle with complexity.”
    – Colleen Grady and Marion Howell, Iris Group, at Physicians in the Lead workshop

    “It is exciting and re-energizing that the focus is back on primary care – and it’s back on things that our members have been doing for years: focusing on population health.”
    – Kavita Mehta, incoming AFHTO CEO, during opening plenary remarks

    “We need to be bold enough to truly own the vision of our organizations; we need to ensure that we are equipping clinical leaders well; and we need to allow for comfort with uncertainty, to create safe spaces for experimenting and learning, and do more celebrating of success.”
    – Dr. Sarah-Lynn Newbury, OCFP President, during closing plenary remarks

    “Our members are already developing initiatives that work. When we spread these initiatives, we’ll be leaders in the province.”
    – Dr. Rob Annis, incoming AFHTO Vice President, at Governance for Quality workshop

    Over 850 people took part in the AFHTO 2016 Conference, Leading primary care to strengthen a population-focused health system.

    Effective leadership requires a willingness to move forward in the context of uncertainty; and it is in the context of change and uncertainty that leaders shine brightest. Throughout the conference, we explored the question of what it will mean to lead the transformation to population-focused primary care, and we considered the role of a leader as one in helping others navigate change.

    To lead effectively, we must continue to measure the effectiveness of our work, using what we learn to drive our improvement efforts, and we must connect with colleagues within and beyond AFHTO to ensure the spread of successful innovations. And we must not forget that leadership is a collective responsibility we all share.

    In examining the nature of population-focused health, we were reminded of our shared vision for all Ontarians to have access to coordinated, comprehensive primary care rooted in life-long relationships. An equitable system is one in which access is not measured in the number of people who can get to a doctor but in the degree to which everyone’s needs can be met.

    The value of the AFHTO 2016 Conference continues.

    Click below to access resources from the conference:

    The AFHTO 2016 Conference is accredited by the Canadian College of Health Leaders for up to 7.5 Category II credits and by the College of Family Physicians of Canada and the Ontario office for up to 16.25 Group Learning credits. Download the application for your certificate of attendance here.

    Looking ahead

    AFHTO’s annual conference is the best learning and networking opportunity for people who work in and with primary care teams. Please help us to continue, and to continuously improve:

    Congratulations to the AFHTO 2016-17 Board of Directors

    Our 2016 conference marks the beginning of the term for our new Board of Directors. Special congratulations to our incoming president and chair, Marg Alfieri from the Centre for Family Medicine FHT.

    Thanks to our volunteers, sponsors, and exhibitors

    Thank you once again to the volunteers who contributed to the success of the AFHTO 2016 Conference – speakers, working group members, program hosts, IHP community of practice leads, and registration desk volunteers. Thank you as well to our sponsors and exhibitors. It’s truly an honour and pleasure to work with so many highly talented, enthusiastic and committed people across the AFHTO community.

    We look forward to seeing you next year – October 25 & 26, 2017!

  • 2016 Poster Gallery

    Thank you to all of our poster presenters who came to the AFHTO 2016 conference. Posters were submitted by interprofessional health teams across the province. Like the concurrent session presentations, they represent the full breadth of professions within collaborative primary care and showcase evidence-based, impactful innovations that will be useful to other teams.

    2016 Posters Displays

    [table id=62 /]

  • 2016 Concurrent Sessions Slides & Materials

    Thank you to all of our concurrent session presenters who came to the AFHTO 2016 conference. We will be uploading the concurrent session slides we’ve received within the next two weeks. Our concurrent session presentations are organized into six 45-minute timeslots (3 per day) and seven themes. We have arranged the sessions by timeslot and theme in the table below.

    [table id=63 /]

    Concurrent Session Selection

    Concurrent session presentations were chosen by working groups consisting of AFHTO members across Ontario, representing the full breadth of professions within collaborative primary care. Submissions were chosen for reflecting the conference theme, usefulness/applicability to interprofessional primary care teams, innovativeness, evidence of impact, and clear learning objectives.

  • AFHTO 2016 Conference on October 17 & 18

    Leading primary care to strengthen a population-focused health system

    “What leaders really do is prepare organizations for change. Leaders, by definition, work in the realm of unknowability and wrestle with complexity.” – Colleen Grady and Marion Howell, Iris Group, at Physicians in the Lead worksho “It is exciting and re-energizing that the focus is back on primary care – and it’s back on things that our members have been doing for years: focusing on population health.” – Kavita Mehta, incoming AFHTO CEO, during opening plenary remarks “We need to be bold enough to truly own the vision of our organizations; we need to ensure that we are equipping clinical leaders well; and we need to allow for comfort with uncertainty, to create safe spaces for experimenting and learning, and do more celebrating of success.” – Dr. Sarah-Lynn Newbury, OCFP President, during closing plenary remarks “Our members are already developing initiatives that work. When we spread these initiatives, we’ll be leaders in the province.” – Dr. Rob Annis, AFHTO Vice President, at Governance for Quality workshop

    Over 850 people took part in the AFHTO 2016 Conference, Leading primary care to strengthen a population-focused health system.

    Effective leadership requires a willingness to move forward in the context of uncertainty; and it is in the context of change and uncertainty that leaders shine brightest. Throughout the conference, we explored the question of what it will mean to lead the transformation to population-focused primary care, and we considered the role of a leader as one in helping others navigate change. To lead effectively, we must continue to measure the effectiveness of our work, using what we learn to drive our improvement efforts, and we must connect with colleagues within and beyond AFHTO to ensure the spread of successful innovations. And we must not forget that leadership is a collective responsibility we all share. In examining the nature of population-focused health, we were reminded of our shared vision for all Ontarians to have access to coordinated, comprehensive primary care rooted in life-long relationships. An equitable system is one in which access is not measured in the number of people who can get to a doctor but in the degree to which everyone’s needs can be met.

    The value of the AFHTO 2016 Conference continues.

    Click below to access resources from the conference:

    Accreditation

    The AFHTO 2016 Conference is accredited by the Canadian College of Health Leaders for up to 7.5 Category II credits and by the College of Family Physicians of Canada and the Ontario office for up to 16.25 Group Learning credits. Download the application for your certificate of attendance here.

    Looking ahead

    AFHTO’s annual conference is the best learning and networking opportunity for people who work in and with primary care teams. Please help us to continue, and to continuously improve:

    Congratulations to the AFHTO 2016-17 Board of Directors

    Our 2016 conference marks the beginning of the term for our new Board of Directors. Special congratulations to our incoming president and chair, Marg Alfieri from the Centre for Family Medicine FHT.

    Thanks to our volunteers, sponsors, and exhibitors

    Thank you once again to the volunteers who contributed to the success of the AFHTO 2016 Conference – speakers, working group members, program hosts, IHP community of practice leads, and registration desk volunteers. Thank you as well to our sponsors and exhibitors. It’s truly an honour and pleasure to work with so many highly talented, enthusiastic and committed people across the AFHTO community.

    We look forward to seeing you next year – October 25 & 26, 2017!

    Future AFHTO Conferences:

    For the forward planners, AFHTO’s conference dates for future years are listed below. Click on the dates to add these to your calendar: