Ultimate Blogging Championship

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  • Don’t wait until summer’s over – register for the AFHTO 2015 Conference today to access “early-bird” rates

    Plan your trip to the AFHTO 2015 Conference today!

    Register today for “early-bird” rates (applicable until September 28th)

    NEW – Earn education credits by attending the AFHTO 2015 Conference: Physicians: This program has been reviewed by the College of Family Physicians of Canada and is awaiting final accreditation by the College’s Ontario Chapter. 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. Conference highlights:

    Visit our conference page to learn more about this year’s program – including IHP Community of Practice learning and networking sessions; EMR sessions, and our closing plenary discussion on the current state of primary care in Ontario.  

  • EMR queries for D2D – Childhood Immunization

    The EMR queries below were developed by QIDSS and the EMR Communities of Practice to help you extract data for submission to D2D.

    Telus PS Accuro Nightingale OSCAR P&P

     

    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. 

      The query criteria for childhood immunizations now reflect team-based care better:

    D2D results for this indicator may be lower than expected due to inclusion of this optional vaccine. Consider sharing your challenges and successes with your EMR Community of Practice or contact improve@afhto.ca.

    Telus PS  

    The D2D- Childhood Immunization v1 searches (.srx files) will extract data for the numerator and denominator for all children with up-to-date immunizations. Save these searches to your desktop and import into your EMR. This guide provides instructions for importing the searches along with screenshots of the searches.  You might need the help of your QIDSS, IT staff or other persons who usually run queries in your EMR. . Consider sharing your challenges and successes with the Telus PS CoP or contact  improve@afhto.ca

    Accuro 

    Please download the D2D- Childhood Immunization v1 queries from the publisher. You may need the help of your QIDSS, IT staff or any other person who usually runs queries in your EMR. Consider sharing your challenges and successes with the Accuro CoP or contact  improve@afhto.ca

    Nightingale 

    It appears that the Cumulative Bonus Report for childhood immunizations almost matches the current D2D definition. These instructions show you how to access the immunization data using the Health Maintenance (HM) report. To learn how to clean up immunization data so the HM report works effectively, have a look at this guide. Please consider sharing any feedback you might have with the Nightingale CoP or contact  improve@afhto.ca

    OSCAR 

    The D2D-Childhood Immunization v1 query generates the number and percentage of active patients 30-42 months (inclusive) who are up-to-date with immunizations. Please save the query to your computer and import into your EMR. You might need the help of your QIDSS, IT staff or any other person who usually run queries in your EMR to install the query into your EMR. Please consider sharing your challenges and successes running this query with the OSCAR CoP or contact  improve@afhto.ca

    P&P 

    If you have access to backend data for your P&P EMR, use this updated query – Childhood Immunization V2. It was originally developed by West Carleton FHT for D2D 3.0 (2015). and was updated by P&P in July 2018. Please consider sharing any front end workarounds you might have with the P&P CoP or contact  improve@afhto.ca

  • Data to Decisions eBulletin #15 – July 23, 2015

    Last call for clinicians – please remind your clinicians to join the conversations by tomorrow, July 24, 2015 to come up with better indicators for Emergency visits, 7-day follow-up and other clinical measures to be included in D2D. Moving on to D2D 3.0: Start preparing now for D2D 3.0 to be launched in Jan 2016. Do your physicians want their own data? You can help them get it 3 different ways! Need a hand building a registry of patients? Check out this guide for creating EMR queries on COPD and (coming soon) Diabetes. Free e-learning video series on Measurement in Primary Care from the University of Toronto. Check out the YouTube channel to start watching. Register for the AFHTO 2015 Conference! October 28 & 29, 2015 – Westin Harbour Castle. 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.

  • D2D 2.0 report release: AFHTO members advance primary care measurement

    AFHTO members are leading the way to advance manageable and meaningful measurement across primary care. This work is critical. Around the world, cost-effective, high-performing health systems are based on a strong foundation of comprehensive primary care; robust measurement is a mandatory ingredient for strengthening that foundation.

    D2D 2.0 demonstrates significant progress in this journey:

    • More than 100 family health teams and nurse practitioner-led clinics have voluntarily submitted their data.
    • This gives insight into the care of over 1.7 million Ontarians.
    • Comparative analyses indicate the results are representative of the full AFHTO membership of Family Health Teams (FHTs) and Nurse Practitioner-Led Clinics (NPLCs).

    The D2D journey is revealing how to get better at measuring what matters most:

    • AFHTO members are shaping implementation of Health Quality Ontario’s Primary Care Performance Measurement Framework (PCPMF) – in identifying priority measures for system and practice level and in refining these measures.
    • Working with the Institute for Clinical Evaluative Sciences (ICES), AFHTO members are leading the way to measure the average cost of all health care received by the panel of patients served by each team, adjusted for the characteristics of that patient panel.  This measure is highly important since it:
      • Can be calculated for the panel of patients in any type of primary care practice in the province.
      • Enables cost to be monitored over time to better understand the impact of improvements in quality of primary care and the health of patients on the sustainability of health care system.
    • To better reflect the many facets of comprehensive primary care that matter to both patients and providers, AFHTO members have completed their first iteration of a composite measure of quality.
    • Working across such a large number of primary care teams is enabling innovation to simplify data extraction from EMRs and improvement in data quality.

    D2D 2.0 shows encouraging results for AFHTO members and provides guidance for further improvement (click here for table):

    • Overall, AFHTO members are performing better than the provincial average on same day/next day access (40% better), cancer screening (10% better), and patient satisfaction with their involvement in decision-making (4% better).
    • There are preliminary indications that patient satisfaction with the courtesy of office staff has improved over the past 3 years (20% improvement).
    • Most teams rank high on some indicators and lower on others. D2D enables teams to compare themselves to their peers and pinpoint their improvement activity.

    AFHTO has created a series of handouts that highlight some of the exciting results we have seen to date and illustrate how we got there.

    The D2D journey continues. Measures will continue to be refined to become more and more meaningful to providers and their patients, and acted upon to improve care. Watch for the next iteration in January 2016.    

  • Accessing physician-specific data

    Over 100 teams contributed to D2D 2.0 in June 2015 and it looks like people are using it! Readership stats show that there is an increase in regular viewing of the D2D 2.0 webpage over that of D2D 1.0. One thing we know is that people end up wanting to drill down into their data – often with physician-specific data.

    Here are 3 ways your team can access physician-specific data:

    1. Sign up physicians for access to their breast, cervical, and colorectal screening rates through the CCO Screening Activity Report (SAR) portal.
    2. Sign up physicians for their own Primary Care Practice Report from the HQO portal to compare their data to regional and provincial sources (this report contains most of the D2D indicators that came from ICES data).
    3. Enrol your team in EMRALD  or CPCSSN for better access to EMR data to improve performance.
      1. EMRALD is a database, housed at ICES, derived from electronic medical records (EMRs) maintained by family physicians. Data collection occurs twice a year and does not interfere with day-to-day clinic operations. Details on how to participate are on the ICES website.
      2. CPCSSN is the first pan-Canadian multi-disease public and population health surveillance system. CPCSSN networks across the country collect health data from EMRs every three months, which allows for health patterns to be detected in a timely way. To participate in CPCSSN contact your regional network.

    ContactCarol Mulder for more information.

  • St. Michael’s Hospital Academic FHT Filling the Gap in Regent Park

    July 16 – St. Michael’s Hospital Academic FHT has opened the Sumac Creek Health Centre to help serve Toronto’s downtown east region, including Regent Park, Moss Park and St. James Town. A densely populated area, it’s been underserved with an estimated 10,000 unattached patients who don’t have a primary care provider. A community engagement specialist will help determine the area’s specific needs and ensure the clinic is connected with other community agencies to provide more holistic health care. The centre will also house the Flexible Outreach Community Urban Support (FOCUS) program. A partnership program with community-based organization Cota, it offers 24-7 support for those dealing with complex mental health and addiction issues. For further details you can click on the links below:

  • Member News: HQO abstract submission, grant opportunities, IHP & physician input needed & more

    Please share with other members of your team who may be interested. See below for more information on the following:

    • HQO’s Health Quality Transformation 2015 accepting abstracts until July 30, 2015
    • Ontario Patient Ombudsman: Encourage patients to participate in consultation by August 31
    • Grant opportunity coming soon: Canadian Breast Cancer Foundation Grant for IHPs and Physicians
    • Primary Care participation needed:
      • Toronto Western specialists seeking family physician input on specialty referrals
      • Canadian Public Health Association – STBBI Stigma Questionnaire Pilot
      • Atrial Fibrillation screening study
      • Volunteer family physicians in Toronto needed for Yonge Street Mission

    HQO’s Health Quality Transformation 2015 accepting abstracts until July 30, 2015

    Submit an abstract or visit the conference website for submission guidelines. This is an opportunity for AFHTO 2015 Conference presenters to preview your presentations while increasing exposure for your initiatives (time and budget permitting).

    Ontario Patient Ombudsman: Encourage patients to participate in consultation by August 31

    The province is inviting the public to share their ideas on what skills, experience and personality traits they’d like to see in Ontario’s first Patient Ombudsman. Invite patients to participate by:

    1. Reading Ontario’s First Patient Ombudsman.
    2. Reflecting on their experiences, within the health care system, as a current or former patient, caregiver or decision-maker for a patient.
    3. Share feedback online by August 31, 2015. The survey should take about 10 minutes.

    For further detail and to participate please visit the website.

    Grant opportunity coming soon: Canadian Breast Cancer Foundation Grant for IHPs and Physicians

    Canadian Breast Cancer Foundation (CBCF) Ontario Region has given advanced notice for its Fall 2015 Call for Proposals to be released in mid-August. IHPS and physicians working with breast cancer initiatives may be eligible for the Research Grants and Fellowship Programs. To find out more, please contact cbcfallocations@cbcf.org.

    Primary Care Participation needed:

    Toronto Western Specialists seeking family physician input on specialty referrals

    “Unfortunately too often, as specialists, we are guilty of failing to adequately address the needs of our family physician colleagues in how we collectively care for our patients by providing consultation support, and we hope to remedy this.” As a result, Toronto Western Hospital internists are conducting a 5-minute survey in a bid to find new ways of providing consultation services to family physicians. They hope to use this information to inform a pilot program. For further details you can read the research proposal.

    Canadian Public Health Association (CPHCA) – STBBI stigma questionnaire pilot

    CPHA is seeking participation from front-line health and social service providers (including administration staff) who may come into contact with individuals living with or at risk of sexually transmitted and blood borne infections (STBBIs). Participants will be testing the Health and Social Service Provider Attitudes and Beliefs About People at Risk of or Living with STBBIs Questionnaire. For further details, please contact Rachel MacLean at rmaclean@cpha.ca.

    Atrial Fibrillation screening study seeking primary care participation

    Canadian Stroke Prevention Intervention Network (C-SPIN) is looking for primary care clinics interested in participating in a randomized trial investigating new technology for screening patients for early detection of atrial fibrillation (AF).  The trial is being led by Drs. David Gladstone, Noah Ivers, Russell Quinn and Jeff Healey. For further information, you can read this project summary or email Project Manager Alex Grinvalds at alex.grinvalds@phri.ca.

    Volunteer family physicians in Toronto needed for Yonge Street Mission

    Yonge Street Mission is seeking Toronto family physicians to volunteer with a health clinic for one or two afternoons a month. They work with youth ages 16-24 that are marginalized and who need access to doctors in a non-judgmental and safe environment. If interested, please contact Kristin Hersey, Volunteer Resources Coordinator at 416-929-9614 x 4284 or khersey@ysm.ca.  

  • Case Study: Integrating Staff & Operations

    Building an effective, collaborative, interdisciplinary team is essential to the success of your primary care teams. Combining a team with a physician group, particularly if that group has an existing staff complement, can present unique challenges for the organization. The following case studies reflect the efforts of four family health teams (FHTs) and affiliated physician groups (FHOs, RNPGAs) to integrate components of their respective operations to build a stronger team and enhance patient care. By harmonizing such things as procurement, staffing and strategic planning, these FHTs have improved the quality of patient care they provide, and leveraged their combined resources. Click on the links below to find the four case studies and the key tools used by these teams to integrate their teams:

    Thamesview FHT

    A rural/urban FHT that is currently working to align FHT and FHO staff salaries to enhance the working relationship between FHT and FHO staff Key tools they used include:

    • A cost-sharing agreement between the physicians and the FHT for clinical and office supplies
    • A data sharing and privacy agreement **

    South East Toronto FHT

    An urban, academic Family Health Team that has leveraged multiple sources of revenue and several distinct staff groups to produce one staff team Key tools they used include:

    Northeastern Manitoulin FHT

    A rural FHT associated with physicians in a Rural and Northern Practice Group Agreement (RNPGA) that has harmonized staffing and procurement to improve patient care Key tools they used include:

    Mount Forest FHT

    A small, rural FHT that has integrated staff from 6 employers into one integrated team Key tools they used include:

    • Two legal agreements **
    • Shared services and privacy agreement **

    ** Confidential documents. For more information contact the individual FHT for details Some of the lessons learned from these case studies include the following:

    • Integrating and harmonizing people and processes takes time; it requires planning, commitment, and most importantly leadership from the FHT Executive Director and the FHO physicians.
    • Physician commitment is key
    • Understanding and managing change is important
    • Communication and transparency are essential
    • Solid expertise in Human Resources is helpful (this may come from the Executive Director, a dedicated staff position, an external consultant, or a partner)
    • There is no single solution; the process requires planning, time and patience. A Plan-Do-Study-Act (PDSA) approach can be helpful.

    AFHTO welcomes the input of other teams that have integrated or begun integrating their staff teams.  Please send your comments or suggestions to Bryn.Hamilton@afhto.ca.

    Learning from your peers: additional case studies

    AFHO has developed a series of case studies for our members to share the experience of colleagues on topics identified as being important to you:

  • Four Family Health Teams share how they integrated their staff and operations

    AFHTO profiles the efforts of four family health teams (FHTs) and affiliated physician groups (FHOs, RNPGAs) as they integrated components of their respective operations such as procurement, staffing and strategic planning. Building an effective, collaborative, interdisciplinary team is essential to your success in delivering primary care. Combining people – physicians, IHPs and admin staff – presents added challenges when they come from different entities with different policies and ways of doing things. Learn how they managed to do this – log-in to Members Only then click here to read these case studies and access the tools they used.

  • Data to Decisions eBulletin #14: Using D2D in clinical practice

    Calling all clinicians! Make sure D2D makes good clinical sense – join the conversations by July 24, 2015 to come up with better indicators for Emergency visits, 7-day follow up and other clinical measures. How are teams using data to improve? Consider sharing YOUR story as well! Questions about the Quality roll-up indicator? See frequently asked questions to learn more. Check out the new section on training and hosting a student or contact Greg Mitchell with any questions. Register for the AFHTO 2015 Conference! October 28 & 29, 2015 – Westin Harbour Castle. Little innovations, big impact. Nominate an outstanding team or individual today! Deadline to submit an AFHTO 2015 “Bright Lights” Awards nomination is August 7, 2015. 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.