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  • Member News: Women’s health grants, IHP & Physician fellowship programs & more

    See below for more information on the following:

    • Grant and Fellowship Opportunities:
      • Research Grants for Local Women’s Health Issues – notice of intent due September 1st
      • Grants for IHPs & Physicians from the Canadian Breast Cancer Foundation (multiple deadlines)
    • Clinical Resources & Training:
      • Perinatal mental health support online (consultation, assessment & ongoing care)
      • CIHI Web Conference Series – Meeting the Needs of Health Care’s Highest Users
    • Government of Ontario:
      • Community Hub Framework Advisory Group Releases Report
      • Ontario Retirement Pension Plan Details Released

    Grant and Fellowship Opportunities:

    Grants for Local Women’s Health Issues – notice of intent due September 1st

    AFHTO members partnered with community organizations may be eligible to apply for $15,000 in one-time one year (non-renewable) grants to support research projects that advance the health of women and girls at the local level. Offered by Women’s Xchange, see below for relevant deadlines:

    • September 1, 2015 at 4:00pm – deadline for a notice of intent (necessary for application)
    • October 1, 2015 at 4:00pm – deadline to apply for funding

    To learn more including how to apply, you can visit their site.

    Canadian Breast Cancer Foundation – 2015 Call for Proposals Grant for IHPs and Physicians

    Canadian Breast Cancer Foundation (CBCF) Ontario Region has now released its Fall 2015 Call for Proposals. IHPs and physicians working with breast cancer initiatives may be eligible for the Research Grants and Fellowship Programs.

    Clinical Resources & Training:

    Perinatal mental health support available online (consultation, assessment & ongoing care)

    Mount Sinai Hospital has increased capacity to support women with perinatal mental health problems through the use of advanced video technology. They can offer consultation, assessment and ongoing patient care, either in a health care provider’s office or in the patient’s home via a new Ontario Telemedicine Network (OTN) program, Guest Link. With this program neither the patient nor health care provider needs to be a registered OTN member. Services are OHIP billable. For further information, you can visit their program website. If you have any questions, please contact Natasha Persaud, Clinical Nurse Specialist, Perinatal Mental Health at 416-586-4800 ext. 8630 or npersaud@mtsinai.on.ca.

    CIHI Web Conference Series – Meeting the Needs of Health Care’s Highest Users

    Canadian Institute for Health Information (CIHI)’s is launching a web conference series From definitions to action: meeting the needs of health care’s highest users. This series reviews examples of different approaches to defining “high users”, the contexts in which the various definitions are being used and some of the implications of using these definitions. For more program information, please visit the conferences website. If you have any questions, you can also email conferences@cihi.ca.

    Government of Ontario:

    Community Hub Framework Advisory Group Releases Report

    The Premier’s Community Hub Framework Advisory Group has now released its report, Community Hubs in Ontario: A Strategic Framework and Action Plan, outlining eight recommendations for the creation of community hubs, which have been accepted by the province. These recommendations, among others, could have implications for community coordination of patient care. To learn more or provide further input, please visit the site.

    Ontario Retirement Pension Plan Details Released

    Premier Kathleen Wynne released some key details on the province’s plan to expand pension coverage through creation of the Ontario Retirement Pension Plan (ORPP). These include timelines for implementation and eligibility including:

    • The ORPP would not apply to those currently in a comparable workplace pension plan.
    • It will be funded by equal co-contributions from both employers and employees.
    • Enrolment and contributions would be phased, with the latter reaching 1.9 per cent each from employers and employees by 2021.
    • Benefits would be earned as contributions are made and would be paid starting in 2022.

    For further details, including the definition of “comparable plan”, you can visit the site.

  • AFHTO 2015 Conference: Education opportunity for the whole team. Register now!

    The AFHTO annual conference offers unparalleled educational value. More than any other event, it is truly interprofessional, providing opportunities for everyone in primary care to learn and share innovations with their colleagues from across Ontario. This year’s sessions offer a range of topics for everyone within the primary care team, such as:

    • Planning and integrating care based on community/population needs
    • Optimizing team care for medically complex patients
    • Understanding and transforming the patient experience
    • Reducing hospital readmissions

    Don’t miss out! Register today!

    Last year attendees agreed:

    • 96.5% of respondents told us the conference “provided a valuable opportunity to share and learn about innovations, best practices and research findings to improve care and value in primary care”
    • 93.4% said that what they learned and experienced would be useful in their future practice.

    Now accredited by CFPC* and CCHL‡. Physicians can earn up to 17 Mainpro-1 credits, and CCHL members can earn up to 8 MOC-II credits.

    Members: Get even more educational value from #afhto2015 by signing up for one of our FREE pre-conference sessions!

    “Early-bird” registration ends on September 28th

    Visit our conference page to learn more about this year’s program.  We hope to see you there! *Physicians: This program has been accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to 17 Mainpro-M1 credits. ‡Health Leaders: Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 2.5 Category II credits for Oct 27th Governance in Primary Care; 1.5 Category II credits for Oct 28th pre-conference (Leadership and IHP Sessions); 4 Category II credits for the Conference towards for their maintenance of certification requirement.

  • Forging Ahead: AFHTO members preparing for next stage of primary care evolution

    Government announcements are anticipated in early September. This email summarizes priorities for AFHTO, set through the ED Advisory Council (interview results and July 28th meeting), Physician Leadership Council (July 30th meeting) and AFHTO Board (August 12th). In light of government’s communications to date, the 5 priorities identified for AFHTO were:

    1. Developing and strengthening relationships with (and education for) LHINs, in anticipation of a tighter relationship between LHINs and primary care.
    2. Addressing the province’s intent to broaden access to teams while ensuring teams can continue to deliver quality care.
    3. Determining how to measure “Capacity” – a fundamental component in assuring quality care.
    4. Shaping what it means to take a “Population-Based Approach to Primary Care”.
    5. Strengthening governance of teams – a critical requirement for leading this next stage in primary care’s evolution.

    Scroll down to read more about these priorities.

    Stay Tuned:

    • Sept. 17 — The ED Advisory and Physician Leadership Councils will meet together to review further developments from government and plan next steps.
    • Oct. 28 — Leadership session at the AFHTO conference is open to leaders of all member organizations.
    • November through February — AFHTO is organizing “Regional Leadership Sessions” – to include AFHTO leadership, FHT/NPLC EDs, Lead Physicians, Board Chairs, LHIN leadership, and other stakeholders deemed appropriate within each LHIN region.

    What can you do now? Relationships are fundamental…start getting to know the FHTs/NPLCs in your region, think about how you could strengthen partnerships with the LHIN or how AFHTO might assist! Moving Forward – AFHTO will continue to engage our membership and keep everyone informed as soon as formal announcements are made or direction is received.  Working together we will identify and provide the necessary education, training and guidance needed to lead the way for comprehensive, high-quality, team-based primary care.

    1.    Relationship with/Education for LHINs

    All members – EDAC, PLC and the AFHTO board – as a priority to be addressed immediately, to prepare for the evolution ahead. Next Steps:

    • To build profile for FHTs and NPLCs with each LHIN CEO, ED Advisory Council reps have been invited to join with AFHTO’s ED (and one or two other EDs/Lead MDs) in meeting with their respective LHIN CEOs.
    • To foster greater understanding about primary care across LHIN staff, AFHTO has initiated development of educational material together with the LHIN Collaborative.
    • These two activities will help set the stage for Regional Leadership Sessions in each LHIN (November through February).

    2.   Broadening Access to Teams

    The Ministry has been clear on a shift toward improving “Access to team-based primary care for all Ontarians who would most benefit” – currently only a quarter of the population is served by FHTs/NPLCs and have access to IHPs within team based care. HOW this is done, lends itself to a number of challenges and potential opportunities. How primary care is organized going forward, the possible role of the LHIN, and expectations of FHTs/NPLCs will be key factors in determining how we can broaden access to team based care. Next Steps:

    • AFHTO’s paper on optimizing value of and access to team-based primary care presents evidence-informed advice on how to spread access to high-quality team-based primary care in a way that achieves the best value, and provides a number of recommendations to the Ministry.
    • The joint EDAC/PLC in-person meeting on September 17th will identify areas for further recommendations for the Ministry and members on approaches to broadening access to teams (including addressing challenges such as liability).

    3.   Advancing Capacity Measurement

    Team capacity has been the core issue for FHTs and NPLCs seeking Ministry funding to meet patient needs. As the province calls for broader access to teams, this will be THE number one issue – what can teams take on while assuring quality of care? Quality, capacity and total cost of care are the core concepts for measurement in the “Starfield Principles”, adopted by AFHTO. Through D2D 2.0, we have progressed in measuring cost and quality. AFHTO members, staff and other stakeholders are working to find meaningful ways to measure capacity. Expanding access to teams only makes sense where capacity is sufficiently developed. Next Steps:

    • In-depth clinical consultations are underway on capacity measurement (and other strategic indicators). Click here to participate.
    • Aiming to include a capacity measure in D2D 3.0 (launching January 2016).

    4.   Population-based Approach to Primary Care

    MOHLTC leaders have consistently used the term “population-based primary health services for Ontarians”. Working collaboratively to plan and offer programs and services that are designed to meet the specific needs of the patient population will be central to implementing a population based approach. Next Steps

    • AFHTO will continue to work with the Ministry and other stakeholders to establish a clear definition and principles of a population-based approach to primary care.
    • AFHTO is establishing a joint Work Group with MOHLTC PHC Branch to improve the approach to program planning and the ministry’s template for reporting on program plans (Schedule A in FHT contracts/Schedule E in NPLC contracts). A workshop will be provided at the AFHTO 2015 conference with a focus on: what constitutes a program; key elements of a well-designed population-based approach to program planning; how to conduct a needs assessment; goal setting; performance measurement principles and evaluation; and how to use the reporting tool effectively.
    • Members are encouraged to start looking at their own communities, to get to know the teams in the same geographic region, and to begin to explore ways that teams can reach out to larger segments of the population that are not formally rostered patients.

    5.    Governance of Teams

    Given the Ministry’s anticipated announcement, strong governance and leadership practices will be even more paramount for FHTs/NPLCs to successfully navigate the upcoming transition and change. Next Steps:

    • AFHTO is offering the Effective Governance for Quality in Primary Care workshop to AFHTO member board members, executive directors and lead clinicians on October 27th (one day prior to the AFHTO conference).
    • AFHTO will work with the Ministry to target FHTs/NPLCs who may benefit from individualized plans to develop effective governance practices and leadership capabilities.
    • Through the work of D2D, AFHTO will begin looking at the correlation between high performing teams and associated governance structures.

    AFHTO is supporting the development of an ‘ED Mentorship Program’ as a way to provide support and encourage knowledge translation for new EDs and EDs requiring additional guidance.

  • AFHTO Bright Lights Awards – thank you to all who submitted nominations

    Thank you to all who submitted nominations to highlight significant achievements being made in primary care. The hard work and thoughtful innovations of our members are truly inspiring. Next steps for awards selection:

    • All nominees received a confirmation e-mail on August 11. This e-mail is your assurance that the nomination was received and will be reviewed.
    • If you didn’t receive the confirmation e-mail, please e-mail conference@afhto.ca to confirm the status of your submission. Please identify the title, name and other nominee details.
    • All nominations received are now being sent to the Bright Lights Review Committee.
    • All award winners will be announced at the Bright Lights Awards Dinner on October 28.

    Thanks once again to all of you for your daily contributions to strengthening primary care. We look forward to celebrating all the winners and nominees at the Bright Lights Awards Dinner on October 28.

  • Last Chance! Bright Lights Nominations due by noon tomorrow

    Don’t forget to send in your nominations and supporting documents for the 2015 Bright Lights Awards. The deadline is 12:00 pm tomorrow (Tuesday, August 11). We look forward to hearing your stories!

    Experiencing issues submitting your nomination form? Due to the high volume of responses coming in today there may be delays submitting your Bright Lights nomination. If the nomination doesn’t go through on the first try, please try again a little later. As a backup to your submission, send a Word version of your nomination with your supporting materials to info@afhto.ca before noon tomorrow. If you have any questions or concerns please contact us, we’ll be happy to assist.

  • Data to Decisions eBulletin #16: EMR Queries for D2D Data

    EMR queries for D2D data, including diabetes, ready for your consideration: check out the queries here and let us know what you think. D2D’s impact spreads west! Following our survey on patient expectations conducted in partnership with Patients Canada (see “Partnering with patients on measurement works” ), Carol Mulder was interviewed about it for their blog. This interview has now been picked up by Health Quality Council of Saskatchewan. Congratulations to all involved! Are you doing patient experience surveys this summer? Consider including the D2D questions described here. Has your team made the most of your EMR? Improved data entry, collection, or reporting? Submit a Bright Lights award nomination in the Advancing manageable meaningful measurement category by 12 noon on Tuesday, August 11 for a chance to win a $3000 education grant from Merck Canada. Visit our site for more details. Help spread the word. Invite others to sign up for the eBulletin online.  What is D2D? Data to Decisions (D2D) is a member-wide summary of performance on indicators that are both possible for members to measure and that are meaningful to members. See the D2D page on AFHTO’s website for more information.

  • Getting started on a diabetes registry

    This document explains how to use a standardized query of your EMR to start building a diabetes registry.  It is intended for teams that do not yet have a reliable list of diabetes patients 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, Accuro and OSCAR. The following steps will help your team use the query to generate a list of diabetes 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 0.10 (the average rate of diabetes in Ontario) to get a rough idea of how many of your patients likely have diabetes.  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 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, click here. 
      • Click here for the case definition 
      • Click here for the screenshots of the query 
    • For Accuro, download the query “AFHTO Diabetes Frontend Search” from their publisher.
      • Click here for the case definition 
    • For OSCAR download the query and save locally to your computer.  Instructions on how to import the query into your OSCAR EMR can be found here.

    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 diabetes. The list will not be perfect – probably 15% of the patients identified by the query will NOT have diabetes. The query gets you STARTED in building the diabetes registry but doesn’t do the whole job for you.

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

    Step 5. Prepare your physicians to review the list  Subdivide the list of possible diabetes patients 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 diabetes, even though that information might not be easy for others to find in the EMR.

    Step 7.  Clean up your EMR data.  Add diabetes codes to the EMR for each patient that the physician confirms as having diabetes. 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 diabetes. This is your new diabetes patient registry. Going forward, you can run the query anytime you need to generate a list of diabetes patients.  You can use the list to invite patients to a diabetes health program, track progress with outcomes on these patients once you have started such a program or any other purpose. This query was produced by and for QIDSS in support of all AFHTO members.

    If you have any questions please contact improve@afhto.ca..

  • EMR Data Quality Resources

    The EMR Data Quality Indicator consists of a number of components that reflect if and how well information is recorded in the EMR, which is distinct from how well care is delivered. The results of this indicator will support our work in showing the value of team-based care. EMRs are the only repository of data created and used by teams and therefore are the best source of data to reflect the contribution of the entire team to patient care. As well, EMRs are the most up-to-date source of data about the whole person available in primary care.  The goal is for teams to better understand the value and importance of having data in the EMR that is consistent, complete, and collectable. You may choose to submit data for one or all of the measures included in this roll-up indicator. Click on each measure below to access queries or further instructions on how to extract data for submission to D2D:

  • Deadline Extended – you now have until August 11 to nominate a Bright Light!

    In order to accommodate summer vacations and busy schedules, we have extended the deadline for Bright Lights nominations until 12 noon Tuesday, August 11.

    This is your opportunity to share your story with health teams from all across Ontario.

    To showcase the incredible diversity of our member teams, we want all of you to participate. Keep in mind that little innovations can have a huge impact, especially if they’re shared, so small teams are just as deserving of awards as big ones. We strongly encourage nominations from teams who have never submitted one before – and from those who have. Don’t be discouraged if you’ve previously submitted a nomination that did not receive an award; it may have been a strong contender. Consider nominating it again, and tell us how your innovation has grown or been refined since last time, and what results you’ve seen. Don’t miss out! Nominations close in a week. Winners in four categories will receive an education grant to help them build on their success. Relevant Links

    For more information you can also contact us at info@afhto.ca.

  • Supporting the Call for National Drug Coverage

    “When you can’t pay for the drugs you need to treat or manage your health conditions, you get sicker and develop more serious complications. Families, employers and communities are hurt as well. Primary care teams see this every day. We wholeheartedly support this campaign to move toward a national system of pharmacare.”- Angie Heydon, Executive Director The call to create a national drug coverage plan is gaining ground, and with the possibility of a federal election in a few short months, it can now make even greater strides with your support. Canada is the only industrialized country with universal health insurance that does not offer universal prescription drug coverage but we can change that. Health policy researchers and health organizations have started a Campaign for a National Drug Coverage. A national drug coverage plan which is public, affordable and safe, would mean that everyone in Canada would have access to the medicines they need. This campaign is aiming to build on the momentum following the recent Round Table Discussion on Pharmacare between Ontario’s Ministry of Health and Long-Term Care and other provinces. We’ve given our support and invite our members and all those interested in improving access to healthcare to do so as well. Find out more by visiting http://campaign4nationaldrugcoverage.ca/.