Ultimate Blogging Championship

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  • Season’s Greetings | Holiday Hours Inside

    holiday card pic-website

    For help with questions regarding data submissions for D2D during this period, please contact Greg Mitchell, greg.mitchell@afhto.ca.

  • AFHTO’s initial response to Patients First Discussion Paper

    On December 17, 2015, Ontario’s Ministry of Health and Long-Term Care released its discussion paper Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario. On its release, AFHTO issued the statement below from Dr. Sean Blaine, AFHTO President and Clinical Lead, STAR Family Health Team in Stratford ON. This was published in various newspapers including The Kingston Whig-Standard, Woodstock Sentinel Review and Beacon Herald in January. AFHTO will be working with its members in each region of the province to develop a more detailed response to the questions posed in the discussion paper. Particular attention will be paid to those areas where great care must be taken to gain the most benefit for patients and communities, and avoid unintended negative consequences.

    AFHTO’s statement on the release of 

    Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario

    Comparative studies tell us our health system is not performing as well as it could. How can we make it better? We need to have the right people in the right place at the right time to deliver the most appropriate care. This requires effective planning, strong relationships, meaningful measurement and engaged leadership from health professionals. Across the world, cost-effective and high-performing health systems are built on a strong foundation of comprehensive primary care. Over the past decade, Ontario has taken steps to strengthen primary care. Family health teams and nurse practitioner-led clinics emerged as innovative models for bringing together health professionals – doctors, nurses, pharmacists, dietitians, for example – to deliver such care. Unfortunately, only 25% of Ontarians receive their care from such team-based models. Ontario also aimed to improve planning, relationships and performance by setting up Local Health Integration Networks (LHINs). But two parts most critical to keeping people healthy – primary care and public health – were left off the LHINs’ mandate. More needs to be done to ensure people can get the appropriate care and support they need when they need it. With the Patients First proposal, the Ontario government launches the next phase of health system evolution. The proposal would bring all parts of the health system under a single jurisdiction for planning and performance reporting, and focus attention on how best to meet the needs of people living in each community. It pays particular attention to strengthening primary care. These are absolutely critical steps toward ensuring more comprehensive and equitable health care services for all Ontarians. Public health departments must be connected to LHINs. These organizations are focused on understanding whole communities to prevent sickness and the spread of communicable diseases. Public health professionals analyze communities to identify and monitor health risks, and target public education and other programs to promote health wellness and illness prevention within a population. Equally important is the ongoing care individuals and their families receive over their lifetimes. This is primary care – your “medical home” – delivered by family doctors, nurse practitioners and primary care teams who know you, care for you, and coordinate specialized health services when you need them. The proposal also merges community care access centres (CCACs) into the LHINs enabling greater local coordination of care, and more efficient use of health resources. If LHINs then deploy care coordination expertise into primary care settings, it will help patients and families identify a single point of contact to navigate and access programs and services. As a family doctor working in a family health team, I can see the potential in this proposal, as well as some cautions:

    • Greater consistency: Right now we see significant variation in the access, experience and cost of health care in Ontario. Many of these variations are the result of unique local problems. By planning and monitoring at the local level, gaps can be identified and local solutions can be found – but only if local leadership is engaged and empowered to harness all sectors of the health system to address the unique needs of that community.
    • Better coordination of care for patients: Moving care coordinators from the CCAC to the LHIN could help break down silos that have long separated my patients from getting care they need. But the LHIN will have to ensure these care coordinators work much more closely with family doctors and nurse practitioners; otherwise, this just moves one bureaucracy into another.
    • Measurement for improvement: This is critical to assessing and improving quality of care. While many primary care teams have been measuring performance, this will be new for the majority of our primary care colleagues. As we’ve learned – there’s nothing to fear from being held accountable. But clinicians will need to receive support to help identify and capture the most meaningful and manageable data to improve care for patients.
    • Spreading best practice: Performance measures must be consistent and comparable across the province, to help clinicians learn from one another. By identifying those who excel at care delivery, we can spread and scale up improvements to providers in a positive and not punitive way.

    Every region of this province empowered to bring together all local health system players to focus on every community’s true health needs. Primary care strengthened and supported to wrap the most appropriate care around each person. If well implemented, Patients First is an important next step to improve our health system for better health for all Ontarians. Sean Blaine MD Family Physician, Stratford, Ontario Clinical Lead, STAR Family Health Team President, Association of Family Health Teams of Ontario (AFHTO) Note: This statement was published in various newspapers including The Kingston Whig-Standard, Woodstock Sentinel Review and Beacon Herald in January.

  • Data to Decisions eBulletin #25: release of HQO-ICES data planned for today!

    Release of the HQO-ICES data for D2D 3.0 is planned for today, Friday Dec.18 via the HQO portal – pending confirmation by HQO. EDs will receive notice from HQO directly about when to access the report. Here’s how to find the D2D 3.0 indicators in a sample report. Compiling data for the “time spent delivering primary care” indicator? FAQs are now available! Queries for the D2D 3.0 EMR-based indicators can be accessed quickly here in a new table. Check out the new report released by HQO and ICES about variation in the quality of mental health services across the province. Need more D2D friends to share the work? Invite others to sign up for the e-Bulletin online to expand your D2D work team. Getting too many emails? Scroll to the bottom of the original email for the unsubscribe link.

  • Ministry releases Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario

    On December 17, 2015, Ontario’s Ministry of Health and Long-Term Care released its discussion paper – Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario. The paper addresses four components:

    1. More effective integration of services and greater equity
    2. Timely access to primary care and seamless links between primary care and other services
    3. More consistent and accessible home and community care
    4. Stronger links between population and public health and other health services.

    The Ministry is requesting feedback on this discussion paper over the next two months or so. AFHTO will be working with its members in each region of the province to develop a more detailed response to the questions posed in the discussion paper. Particular attention will be paid to those areas where great care must be taken to gain the most benefit for patients and communities, and avoid unintended negative consequences.

  • HQO & ICES Report on Quality of Mental Health Services in Ontario

    Health Quality Ontario (HQO) and the Institute for Clinical Evaluative Sciences (ICES) released Taking Stock: A report on the quality of mental health and addictions services in Ontario. The report finds variation both in access to and quality of mental health services across the province. Key Findings

    • Visits to physicians’ offices for mental illness or addiction account for about 10% of all visits in Ontario.
    • People in rural areas are less likely to have a follow-up visit with a physician within seven days of leaving the hospital after admission for mental illness or addiction than urban residents (23.1% compared to 30.4%).
    • People with the lowest incomes are less likely to have a follow-up visit with a physician within seven days of leaving the hospital after admission for mental illness or addiction than those with the highest incomes (26.9% visit compared to 32.5%).
    • Youth are more likely to visit an emergency medical department for mental illness or addiction without first having contact for these issues with a physician (42.7% of people 16-24 years old vs. 29.8% those aged 25 and above).

    To learn more about the status of mental health services in Ontario, please click on the links below. Relevant links

  • Program planning and reporting

    In an effort of continuous quality improvement, AFHTO has established a joint Work Group with MOHLTC Primary Health Care Branch to:

    1. Support FHTs/NPLCS in their program planning and evaluation processes,
    2. Promote the delivery of high quality programs based on population needs, and
    3. Enhance program reporting practices.

    The joint FHT/Ministry work group has been working collaboratively with QIDS Specialists to develop:

    • Program Planning & Evaluation Framework to promote population-based planning and support the delivery of effective programs
    • Indicator Catalogue to help teams in their indicator selection process (will include most common programs FHTs/NPLCs report on, along with program objectives linked to performance measures that are based on best practice clinical guidelines)
    • Additional recommendations to improve the Schedule A template for reporting program plans.

    Coming Soon….The Framework, Catalogue and Schedule A will be made available and an overview provided via webinar in early February. The top 15 priority programs reported by FHTs/NPLCs across the province have been identified (see list below).

    Top 15 program priorities:

    1. Mental Health
    2. Diabetes
    3. Smoking Cessation
    4. COPD and Respiratory Illness
    5. Seniors Health
    6. Hypertension
    7. Preventive/Cancer Screening
    8. Nutrition
    9. Immunizations
    10. Cardiac/Heart health
    11. Memory/Cognitive
    12. Chiropody
    13. Well Baby
    14. Medications/Pharmacy
    15. Acute/Episodic

  • EDAC News: Ministry transformation plans / indicators for contracts

    AFHTO’s Executive Director Advisory Council (EDAC) met on December 10th. This email highlights key items:

    Ministry’s discussion paper on transformation plans is anticipated in next week or two. Response period is expected to run until the end of February.

    In readiness, AFHTO members have taken a stand: AFHTO released statements on population-based primary care and transitioning care coordination resources to primary care based on input received from over 200 leaders from AFHTO member organizations during the October 28, 2015 Leadership Session. These new statements, with a reminder of related AFHTO statements on recruitment and retention and optimizing access to teams, were sent to the Minister, Deputy Minister and their staff, forwarded to LHIN CEOs and other health system stakeholders, and publicly posted on AFHTO’s Policy Positions web page.

    Regional meetings to build relations and receive member input:

    • 1hr web calls are being called for the “Leadership Triad” (EDs, Lead MD/NPs, and Board Chairs) from each region to hear initial response to the Ministry’s plans, and to determine FHT/NPLC leadership opportunities and support needs at the local level. Web calls are taking place the first two weeks of January – look for your calendar invite!
    • Following advice and requests from EDAC and the Physician Leadership Council (PLC), AFHTO has facilitated initial meetings of small groups of FHT/NPLC leaders and their respective LHIN CEOs in 8 LHINs (North West, Central East, South West, Waterloo Wellington, Central, Erie St.Clair, Mississauga Halton, Toronto Central).

    Indicators to be recommended for MOHLTC-FHT contract: Following from the membership vote, the AFHTO board approved a set of seven indicators to recommend to the Ministry as the replacement for Schedule E. Ministry will make final decisions. EDAC members were briefed on the membership survey results. The indicators, all from Data to Decisions (D2D) are: Patients Involved, Cervical Screening, Colorectal Screening, Childhood Immunization, Same/Next Day Appointment, Reasonable Wait, Diabetes Care. (Click here for data definitions.)

    Program planning and reporting: A joint FHT/Ministry work group and QIDS Specialists have been working collaboratively to develop:

    • Program Planning & Evaluation Framework to promote population-based planning and support the delivery of effective programs
    • Indicator Catalogue to help teams in their indicator selection process (will include most common programs FHTs/NPLCs report on, along with program objectives linked to performance measures that are based on best practice clinical guidelines)
    • Additional recommendations to improve the Schedule A template for reporting program plans.

    Coming Soon….The Framework, Catalogue and Schedule A will be made available and an overview provided via webinar in early February.

    Call for ED Mentor Volunteers: AFHTO has launched the ED Mentorship Program! Volunteer to be an ED Mentor and support the development of strong leadership across FHTs/NPLCs. Once mentors are selected, mentees will be identified and buddied up with a mentor in the New Year!

    For “Privacy” Sake…Save the Date: AFHTO has partnered with DDO Health Law to offer FREE Privacy training & tools for EDs and Board Chairs to assist in their understanding of the Office of the Information and Privacy Commissioner of Ontario’s (IPC/O) new privacy expectations. REGISTER NOW.

    D2D 3.0 – 120+ teams have signed up…nearly 70% of FHT/NPLC members! It’s not too late to participate- click here or contact Greg Mitchell for resources. Check out the instructional webinar recording  with a walkthrough of the D2D submission form, data dictionary and toolkit, all available online.

    Up-to-date list of EDAC members can be found here.

  • ED Mentorship Program – request for volunteers!

    AFHTO is pleased to announce the launch of the ED Mentorship Program…and we’re looking for volunteers to become Mentors!

    The Executive Director Advisory Council (EDAC) identified a need for a program that would provide assistance to new Executive Directors and those who would benefit from mentorship. AFHTO’s ED Mentorship Program is designed to fill this need. Mentoring is about supporting people to develop more effectively. It is a relationship based on trust, designed to build confidence and to help a mentee take increasing initiative. New EDs and those who would benefit from mentoring can learn from others who already have the experience and who are willing to provide the skills, knowledge and wisdom they have learned.

    • Volunteer to become a Mentor and to complete the volunteer application form
      (please apply by January 6th 2015).
    • ED Mentorship Program Overview, includes descriptions of the experience of an ideal Mentor and benefits to Mentors and Mentees.
    • Access the ED Mentorship Checklist, developed as a guidance document to assist Mentors when working with new EDs or those who would benefit from mentorship.
    • A process to identify mentees will be launched once mentors have been selected.

    Thank you in advance for your continued support and encouragement to other members. It’s an interesting time for primary care and we hope the development of the ED Mentorship Program will continue to build upon the strong leadership we have within the field. All Mentorship applications will be reviewed and those that apply will be contacted once all Mentors have been chosen (mid-January).

  • EMR queries for D2D – Expanded Indicators

    A number of additional EMR-based indicators are included in the expanded indicators. Teams are encouraged to contribute data for as many of the D2D indicators as possible to help refine the  Quality Roll-up Indicator. Please find below some queries created for these indicators. If you’d like to contribute more queries (and for other EMRs) – or have any questions  – please contact us.

    NOTE: All queries are tested and validated prior to release. However, changes that take place after the queries are released may affect how accurate they are. Such changes could include EMR software updates, new medications, and changes to standard clinical definitions. They may result in false positives, that is, patients being flagged who do not have the specified condition. They may also result in false negatives, that is, patients not being flagged who do have the condition. Queries are also limited by the quality of your EMR data. 

      Telus PS  A set of searches (.srx files) for the additional indicators for quality roll-up are available for download from this folder. The searches are for: Coumadin Management, Diabetes – screening, blood sugar management, cholesterol management, Hypertension Screening, and Influenza vaccinations. Please review the screenshots of these searches  – you may choose to use these searches or create own.      

  • Free Privacy Training for AFHTO members

    FOR “PRIVACY” SAKE…SAVE THE DATE!

    AFHTO is pleased to share that we have partnered with DDO Law to provide our members with FREE Privacy Training & Tools.

    The Office of the Information and Privacy Commissioner of Ontario (IPC/O) has provided further guidance as to their expectations for Health Information Custodians (and specifically with respect to physician practices and Family Health Teams). To assist our members in meeting and understanding the new privacy criteria, the following will be made available:

    • A 1hr Privacy Training Webinar for Executive Directors – 12-1pm WEDNESDAY JANUARY 27th 2016 – click here to register
    • A 1hr Privacy Training Webinar for Board Chairs – NEW DATE– 12-1pm WEDNESDAY, FEBRUARY 3rd, 2016 – click here to register
    • Privacy Tools: To answer the top 5 privacy questions asked by FHTs and FHT staff – tools/templates to be released in JANUARY 2016

    Further details will be provided closer to the date of the webinars – please hold the appropriate dates/times in your calendars.

    As a reminder, AFHTO has numerous related privacy resources currently available to members on the website, including: