Ultimate Blogging Championship

Category: Uncategorized

  • Physician Leadership Council input on issues for Ministry-FHT Contract Renewal

    To the leaders of AFHTO’s member organizations,

    Ministry-FHT Contract Renewal: Guidance from PLC

    As the next MOHLTC-FHT contracts are set to expire on March 31st 2017, AFHTO has been working diligently on identifying and pursuing next steps in the contract renewal process. An important step was to obtain input from the Physician Leadership Council (PLC) on key areas of focus for the MOHTLC-FHT contract within the overall context of Patients First and the state of the tentative Physician Services Agreement (tPSA). (Note: PLC meeting took place before the Aug. 14 vote that ultimately turned down the tPSA.) PLC members were provided with a discussion document & poll questions to guide the conversation – to read the full report of items discussed and input received, click here. Top 3 points:

    • Harmonization between FHT and physician group(s) is an evolutionary process; strengthening team relations and dynamics should remain a central focus of AFHTO-led efforts. Learning what has worked well in other teams, sharing experiences, developing an AFHTO-led guide or work shop with suggestions on how to improve relations and bring groups together may be beneficial going forward.
    • Strong governance will be paramount for FHTs to navigate the changes ahead and to lead this next stage of primary care evolution. Including basic governance expectations within the FHT contract may help to promote consistent, effective governance practices across the province.
    • FHTs should be encouraged to play a strong leadership role in the sub-LHIN organizational approach, but before FHT governors can take on accountability for sub-LHIN populations, capacity and equity of resourcing must be addressed.

    Given that the tPSA included a commitment to review/re-negotiate terms of family physician contracts (FHO, FHG, etc.) by Nov. 1, PLC identified topics that AFHTO should seek to influence in these Ministry-OMA discussions. With the OMA membership’s rejection of the tPSA, it’s not clear when or how that will proceed; however, AFHTO will look for opportunities to advocate with MOHLTC and OMA for such things as support for physician work in non-clinical tasks such as Health Link development, Quality Improvement Plans, data collection, etc., and sustainable models for funding EMR infrastructure. Next Steps: Over the next few months we will be listening to our membership as we try to reach consensus on a number of important MOHTLC-FHT contractual elements. Based on the input received from PLC, the discussion guide will be updated and brought forward to a joint meeting of ED Advisory Council (EDAC) & PLC. Steps in the process include:

    • Mid-Aug to mid-Sep – AFHTO staff to meet with other key stakeholders (OMA, AOHC, OCFP) to exchange issues/perspectives/emerging positions
    • 16 – joint in-person meeting of the ED Advisory Council (EDAC) and Physician Leadership Council (PLC)
    • 20 – AFHTO board meeting to review input to date and provide further direction on consultation content and process.
    • Late Sep – option to test some ideas with broader membership via survey/web meeting
    • Oct. 17 – Leadership Triad Session before AFHTO conference – opportunity to build consensus and/or ratify positions on key issues with roughly 250 leaders of AFHTO-member organizations in attendance.

  • Physician Leadership Council input on issues for Ministry-FHT Contract Renewal

    To the leaders of AFHTO’s member organizations,

    Ministry-FHT Contract Renewal: Guidance from PLC

    As the next MOHLTC-FHT contracts are set to expire on March 31st 2017, AFHTO has been working diligently on identifying and pursuing next steps in the contract renewal process. An important step was to obtain input from the Physician Leadership Council (PLC) on key areas of focus for the MOHTLC-FHT contract within the overall context of Patients First and the state of the tentative Physician Services Agreement (tPSA). (Note: PLC meeting took place before the Aug. 14 vote that ultimately turned down the tPSA.)

    PLC members were provided with a discussion document & poll questions to guide the conversation – to read the full report of items discussed and input received, click here.

    Top 3 points:

    • Harmonization between FHT and physician group(s) is an evolutionary process; strengthening team relations and dynamics should remain a central focus of AFHTO-led efforts. Learning what has worked well in other teams, sharing experiences, developing an AFHTO-led guide or work shop with suggestions on how to improve relations and bring groups together may be beneficial going forward.
    • Strong governance will be paramount for FHTs to navigate the changes ahead and to lead this next stage of primary care evolution. Including basic governance expectations within the FHT contract may help to promote consistent, effective governance practices across the province.
    • FHTs should be encouraged to play a strong leadership role in the sub-LHIN organizational approach, but before FHT governors can take on accountability for sub-LHIN populations, capacity and equity of resourcing must be addressed.

    Given that the tPSA included a commitment to review/re-negotiate terms of family physician contracts (FHO, FHG, etc.) by Nov. 1, PLC identified topics that AFHTO should seek to influence in these Ministry-OMA discussions. With the OMA membership’s rejection of the tPSA, it’s not clear when or how that will proceed; however, AFHTO will look for opportunities to advocate with MOHLTC and OMA for such things as support for physician work in non-clinical tasks such as Health Link development, Quality Improvement Plans, data collection, etc., and sustainable models for funding EMR infrastructure.

    Next Steps:

    Over the next few months we will be listening to our membership as we try to reach consensus on a number of important MOHTLC-FHT contractual elements. Based on the input received from PLC, the discussion guide will be updated and brought forward to a joint meeting of ED Advisory Council (EDAC) & PLC. Steps in the process include:

    • Mid-Aug to mid-Sep – AFHTO staff to meet with other key stakeholders (OMA, AOHC, OCFP) to exchange issues/perspectives/emerging positions
    • 16 – joint in-person meeting of the ED Advisory Council (EDAC) and Physician Leadership Council (PLC)
    • 20 – AFHTO board meeting to review input to date and provide further direction on consultation content and process.
    • Late Sep – option to test some ideas with broader membership via survey/web meeting
    • Oct. 17 – Leadership Triad Session before AFHTO conference – opportunity to build consensus and/or ratify positions on key issues with roughly 250 leaders of AFHTO-member organizations in attendance.

  • Member Case Study: Building Collaboration (based on QIDS Partnerships)

    AFHTO Members: Experienced in Building Collaboration Patients First calls for collaboration across subLHIN regions. It also calls for spreading measurement for quality improvement and performance monitoring. AFHTO members’ experience in building QIDS partnerships (about 150 AFHTO member organizations are actively involved) provides a foundation for both these objectives. These QIDS partnerships have been a critical ingredient in the advances AFHTO members are making to meaningfully measure primary care. This new case study – Building Collaboration and Increased Capacity through QIDS Partnerships – illustrates three different approaches to organizing these partnerships. It describes each approach and then examines all three to identify the challenges they faced, the enablers for success and the lessons learned. This knowledge can be applied by primary care stakeholders to evaluate their own existing partnerships (e.g. Health Links and other community programs) and serve as an example of other areas of collaboration.

  • Member Case Study: Optimizing Interprofessional Resources & Spreading Access to Teams

    AFHTO Members Expanding Access Within Their Communities As government implements the vision of Patients First, the creation of sub-LHIN regions will enable a shift to a population-based approach to health care planning and delivery. It is hoped through these system-level changes patients will receive more timely access to, and better integration of, primary care, and better coordination and continuity of services. By looking at the needs of a defined population in sub regions, there is also opportunity to create more equitable access to care and to ensure appropriate care options are in place to meet community needs. Creating equitable access to team based primary care for those who would benefit Currently only 25-30% of Ontarians have access to team-based primary care. Evidence tells us with a team-based approach to primary care, patients experience more timely access to care, better care coordination and improved management of chronic diseases. The question is – How do we optimize the use of team resources to maximize access without causing undue stress on providers, unacceptable increases in wait times, and/or decreases in quality of care? In order to spread interdisciplinary team capacity more broadly in communities, careful consideration must be given to understanding population needs, making best use of existing resources, and ensuring sufficient resources to provide optimal access and quality of care. Case Study: Optimizing Interprofessional Resources & Spreading Access to Teams AFHTO, in partnership with the Osborne Group, has prepared a case study which looks at how two of our members (East GTA FHT and Guelph FHT) have expanded access in their community by providing programs and services to people who were not rostered to the FHT physicians. The case study is well aligned with AFHTO’s literature review and position paper “Optimizing value of and access to team-based primary care.” Sufficient capacity must be developed to spread access to all Ontarians Team-based primary care is already making a HUGE contribution in moving toward the vision expressed in Patients First. As we navigate through the reforms introduced we see the potential for much greater attention to the role and importance of primary care. It also reinforces the need – and creates possible mechanisms – for investment to expand team-based primary care and deliver on our membership’s vision that all Ontarians will have access to high-quality, comprehensive, interprofessional primary care.

  • D2D 4.0 submission platform now live. Submit your data by September 13.

    The submission platform for D2D 4.0 is up and ready for you to input your data. The submission platform will remain open until September 13.

    Data to Decisions (D2D) is a membership-wide report on performance in primary care. This tool allows you to enter and review your own data and compare it to an aggregate of data from your peers. As always, D2D is a come-as-you-are party; you can enter data for as many (or as few) indicators as are manageable and meaningful to your team.

    New and improved for this iteration:

    • You can record your LHIN region for more options in peer-group comparison.
    • The Diabetes Care composite indicator has been refined and now includes statin therapy (where appropriate) as a measure of care.
    • The EMR Data Quality indicator is expanded to include coded diagnosis of diabetes.
    • You can contribute to a new exploratory indicator – Follow-Up after Hospitalization.

    D2D data is your data, and it tells your story. Data about individual teams is never shared externally.

    Visit our D2D Planning and Preparation page for tips and tools to help you participate. There you’ll find the updated Data Dictionary, Step-by-Step Guide, and Data Input Toolkit, as well as links to external data sources.

    Questions? Comments? We’d love to hear from you!

  • Organizational and Operational Processes: Information Technology

  • D2D 4.0 Data Submission

    To share your team code, please e-mail greg.mitchell@afhto.ca. [input_data] To share your team code, please e-mail greg.mitchell@afhto.ca.

  • AFHTO President’s column on tentative physician services agreement published

    New deal serves doctors and patients alike

    Waterloo Region Record article published on Aug. 8, 2016. Article in full pasted below. Dr. Sean Blaine, Waterloo Region Record

    My patients are living with increasingly complex chronic medical conditions. It’s for the 2,400 patients in my family practice, and for patients across Ontario, that I add my voice in support of the new agreement between doctors and the government.

    Why? Because I believe it represents the foundation for a fresh start after two years of worsening acrimony. I believe the deal will serve the interests of physicians and patients alike.

    The tentative agreement guarantees a 2.5-per-cent increase in annual funding compared to the recommendation of 1.25 per cent that was endorsed by former Chief Justice Warren Winkler, in his report released last year.

    So contrary to some media reports, acceptance of the tentative deal will not reduce access to services in Ontario; it will instead provide funding to increase services based on population age and growth.

    I also serve as the President of the Association of Family Health Teams of Ontario. Our members share a compelling vision that one day soon, all Ontarians will have timely access to high-quality and comprehensive primary care.

    We strive to deliver health care that is anchored in an integrated and equitable health system. A system that promotes good health and seamless care for all patients. Looking ahead, I believe this deal makes that system more sustainable.

    How will this agreement help us move closer to that vision? The proposed increase provides us with double the growth rate and builds in the added opportunity for essential input from Ontario’s physicians through co-management.

    What does “co-management” mean and why does it matter? It’s means having joint responsibility for the ongoing monitoring of health care costs. It includes a responsibility to make some tough decisions in updating the way doctors are paid in a manner that provides value and the best health care for patients. And the embedding of co-management throughout the agreement strongly acknowledges the key role of physicians in our health care system.

    This clearly defined joint commitment to ongoing physician participation in health system transformation is essential for physicians and patients alike.

    The deal is not perfect. Doctors wanted to achieve binding arbitration from the government in settling contract disputes but were not able to achieve this yet.

    However, the Ontario Medical Association court case asking for binding arbitration continues to go forward. Many specific measures to modernize the fee schedule have yet to be worked out and there will be difficult choices to make. However, the government has committed to avoid further negative unilateral action during the four-year course of this agreement.

    Finally, and this is key — building a great health care system that works today is only part of the challenge that we all face.

    We need to also build our system for tomorrow.

    The deal that Ontario’s doctors will vote on will accomplish that by enhancing the sustainability of the system. With this deal, doctors working in a common partnership with the government will be able to ensure that health care in this province is efficiently delivered, appropriately resourced and provides the quality of care that our patients deserve.

    Dr. Sean Blaine is the president of the Association of Family Health Teams of Ontario. He works as a family physician and lead physician of STAR Family Health Team in Stratford. Click here to access the article on Waterloo Region Record website.

  • Diabetes Care Composite Indicator – D2D 3.0

    Click on the following links to access: 1. Technical notes 2. Interpretive notes 3. Data quality actions – Actions and ideas to consider and discuss with clinical leads and other members of the team 4. Potential actions related to processes of care – Actions and ideas to consider and discuss with clinical leads and other members of the team

  • Emergency department visits – all conditions

    Interpretive Notes Data Quality Actions Potential Actions Related to Quality of Care

    Information on this indicator related to D2D 3.0 can be found here. For technical notes, please see page 36 of the Data Dictionary.

    Interpretive Notes

    Tips to help you understand the data and put it in context.

    Data Quality Actions

    Tips to help you understand the quality of your data and, if necessary, take steps to improve it.

    Potential Actions Related to Processes of Care

    Concrete steps you can take to improve care, based on your data. Assuming you have established that the data are good enough to direct action AND that improving performance in this area is a priority for your team, you may wish to discuss the following options with your clinical leaders, Quality Improvement committees, team staff and/or patients: