Ultimate Blogging Championship

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  • EMR queries for D2D 2.0

    EMR queries to assist members to participate in D2D 2.0 Childhood Immunization Data Telus PS EMR: If your team is billing for vaccines and documenting them in the IMMU field in the patient profile, the Preventive Care Summary report can be used. If this is not the case, you might consider using the searches (.srx files) contained in this folder that will extract data for the numerator and denominator for all children and rostered children with up-to-date immunizations. Save these searches to your desktop and import into your EMR. You might need the help of your QIDSS, IT staff or other person who usually runs queries in your EMR. For more details about the searches and instructions on how to import them into your EMR click here.  Please contact Marg Leyland if you have any questions. Accuro EMR: If your team is billing for vaccines the Cumulative Preventive Care Bonus report can be used. This will give you data for an individual physician for rostered children only (not all children). If you are not consistently billing for vaccines you might consider building you own queries for childhood immunization rates. Please check out this guide for information about the criteria to use in your queries. You might need the help of your QIDSS, IT staff or any other person who usually runs queries in your EMR. Please contact Marg Leyland if you have any questions. Nightingale EMR:  Teams using Nightingale may not be able submit childhood immunization data. The criteria used in the Health Maintenance Compliance Report does not match the D2D 2.0 definition which is based on the MOH preventive care bonus schedule. To the best of our knowledge a query in Data Miner is not available. The vendor is aware of this situation and we will continue discussions with them. Please contact Marg Leyland if you have any questions. OSCAR EMR: Two queries have been created for teams using OSCAR. One query generates % of all active children with up-to-date vaccines, the other generates % of active rostered children with up-to-date vaccines. The queries and criteria used can be found here. Please contact Marg Leyland if you have any questions.  P&P EMR:  Queries are being finalized – please check back soon or contact Marg Leyland with any questions. EMR Data Quality Indicator – Cervical and Colorectal Cancer Screening Telus PS EMR: The Preventive Care Summary report can be used to generate data for your cervical (Pap) screening rates. Unfortunately this report cannot be used for colorectal screening rates because the criteria used does not match the SAR criteria. You might consider creating your own search for colorectal screening data – click here to see an example of the colorectal screening search. Please contact Marg Leyland if you have any questions. Accuro EMR: Unfortunately the Cumulative Preventive Care Bonus reports cannot be used to generate data for your cervical or colorectal screening rates. The criteria used in the EMR reports do not match the SAR criteria. You might consider creating your own searches for cervical and colorectal screening data – click to see examples of how to build these searches for colorectal screening searches and cervical screening searches. Please contact Marg Leyland if you have any questions. Nightingale EMR:  Teams using Nightingale may not be able submit cancer screening data. The criteria used in the Health Maintenance Compliance Report does not match the SAR definition for cervical cancer screening (age range differs) or colorectal screening (exclusions differ). To the best of our knowledge a query in Data Miner is not available. The vendor is aware of this situation and we will continue discussions with them. Please contact Marg Leyland if you have any questions. OSCAR EMR:  Two searches have been created to generate data for the cervical and colorectal screening rates. Please find both searches here. Contact Marg Leyland if you have any questions. P&P EMR:  Queries are being finalized – please check back soon or contact Marg Leyland with any questions. EMR Data for Expanded Data Submission for Quality Roll-up Indicator Telus PS EMR: The Telus PS searches (.srx files) available in this folder will extract data for the EMR-based quality roll-up indicators (high priority indicators only). Save these searches to your desktop and import into your EMR. You might need the help of your QIDSS, IT staff or other person who usually runs queries in your EMR. For more details about these searches click here. Please contact Marg Leyland if you have any questions. Note: Searches for the other EMRs are not yet available. Please consider creating your own searches using similar criteria in the Telus PS notes.            

  • Data to Decisions eBulletin #12 – May 28, 2015

    EXTENDED deadline: D2D data submission due JUNE 1, 2015 Click here for data submission instructions and here for webinar recording or contact Greg Mitchell. EMR queries to collect data for D2D core indicators Click here to access queries for childhood immunization and EMR data quality or contact Marg Leyland. Want to know more about the quality roll-up indicator? To know more about how this indicator better reflects comprehensive primary care in a way that also considers what is important to both patients and providers, click here or contact Carol Mulder. D2D impact assessment starting soon – watch for survey next week A survey will be released to EDs next week to estimate the impact of D2D and to support planning for D2D 3.0. Patient experience surveys by phone? Click here to find out how teams are seeing an improvement in patient survey response rates using the patient contact system pilot or contact Marg Leyland. Do you want other people on your team to get the eBulletin? If you think others on your team might also want the eBulletin invite them to click here. 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.

  • Patient Contact System – Pilot Project

    The goal of this project is to make it easier for teams to administer ongoing, consistent, patient experience surveys and otherwise engage patients in their care in meaningful ways. 10 teams are currently piloting the system. For more information check out the pilot project announcement and the FAQs or contact Marg Leyland. Keep an eye on this page for updates and success stories.

    Sept. 10, 2015: Data are starting to come in

    Five pilot teams have successfully implemented the automated patient contact system (all use Telus PS EMR) – 3 more teams (Accuro and Telus PS users) are scheduled to go live in the next 3 weeks. The system runs automatically from the EMR and is configured to contact 10 patients with recent appointments by phone a day. Typically 4-5 survey questions are asked per patient. To-date 1,842 patients have been contacted with an overall survey completion rate of 37%. If necessary, the system contacts each patient twice, with 66% of the first attempts being successful. For some reason, Thursday also seems to be a good day to get a complete survey. We are continuing to gather team and patient feedback this week to summarize the lessons learned and potential value of the system for other teams.

    May 28, 2015: Patient experience surveys by phone?

    Patients are responding nicely to surveys administered by the patient contact system being piloted by 10 of our teams. Preliminary results from 1 team indicate a 50% survey completion rate – an improvement over the 30% rate typically expected for surveys administered inside the practice.

  • D2D Submission deadline June 1, 2015: 1 week left to submit data to D2D 2.0

    D2D 2.0 is an opportunity to see how your team compares to your peers. Over half of AFHTO members have already signed up!!

    June 1 at 5:00 PM is the deadline to submit your team’s data for D2D 2.0

    Remember to get approval from your team’s leaders before submitting the data. Data to Decisions 2.0 will be posted on the AFHTO’s members-only website on June 18, 2015! All AFHTO members will be able to view the data. Teams that contributed data will be able to see how their team compares to peers. Consider joining one of two webinars on June 18 for a guide to D2D 2.0. Learn how to navigate the report and see how you compare to your peers. Register to attend either of the webinars at 12 noon or 4:30 p.m. If you have any questions about the submissions process or the webinar, please contact Carol Mulder.

  • St. Michael’s Academic FHT expanding poverty treatment program

    May 25 – St. Michael’s Academic Hospital Family Health Team’s focus on treating poverty as a root cause of poor health continues to grow as profiled in the Toronto Star. The innovative process starts from screening for poverty during admission through to potential visits with an income security health promoter, social worker or lawyer and can include a prescription for children’s books. To further enhance their services, an employment program for patients is also being developed. Read the full article.

  • Member News: D2D submission form under maintenance, funding opportunities & news from Ontario, HQO, NPAO & more

    See below for more information on the following:

    • D2D Submission Tool unavailable until Monday, May 25
    • Government of Ontario:
      • Employees to be given a copy of the employment standards poster – deadline June 19, 2015
      • Call for proposals: Local Poverty Reduction Fund – deadline June 10, 2015
      • CMOH Memo: Liberia not removed from list of EVD countries
      • Community Hub Framework Advisory Group seeking feedback
    • HQO:
      • Primary Care Patient Experience Survey
      • Report on antipsychotic medication use in long-term care homes
    • New clinical toolkit for primary care: KidneyWise Clinical Toolkit
    • Information to share with Patients – Strengthening the patient voice:
      • NPAO Patient Choice Award – deadline June 10, 2015
      • Volunteers needed for HQO Patient, Family and Public Advisors Council – deadline June 19, 2015

    D2D Submission Tool unavailable until Monday, May 25, 2015

    The data submission form is currently under maintenance to remove glitches identified by members. The tool will be back in service on Monday, May 25, 2015. If you’ve already entered your data, you may review it at that time to ensure it matches your entry if you so choose. We apologize for any inconvenience this may cause. As a result of this unscheduled delay, and in response to requests from members, the deadline to submit data has been extended to June 1, 2015.

    Government of Ontario:

    Employees to be given a copy of the employment standards poster – deadline June 19, 2015

    Changes to Ontario’s Employment Standards Act came into effect earlier this week requiring employers to provide employees with a copy of the employment standards poster, as well as continuing to post it in the workplace where it is likely to be seen. Employers have until June 19, 2015to ensure the poster has been distributed. Visit the province’s website for further information.

    Call for proposals for the Local Poverty Reduction Fund- deadline June 10, 2015

    The province has sent out a call for proposals for the Local Poverty Reduction Fund. It provides funding to community organizations and municipalities to support and evaluate their poverty reduction initiatives, create partnerships and build a body of evidence of programs that work for Ontarians living in poverty. According to the application guide: “Applications that show partnerships with a wide variety of players are required. This could involve community organizations, academics, municipalities, foundations, social enterprise, business or other service providers, etc.” Visit the website to see which projects are eligible and more.

    CMOH Memo – Liberia not removed from list of EVD countries

    The Chief Medical Officer of Health (CMOH) has released a memo (in English and French) regarding Liberia not being removed from the list of countries affected by Ebola virus disease. Although there have been no new cases since March, Liberia will remain on the list until further notice.

    Community Hub Framework Advisory Group seeking feedback

    The Premier’s Community Hub Framework Advisory Group will be reviewing provincial policies and developing a framework for adapting existing public assets to become community hubs. A hub can be a school, a neighbourhood centre or another public space that offers coordinated services such as education, health care and social services. To design effective hubs with the needs of local communities in mind, the group is seeking your insights. Visit the website to learn more.

    HQO:

    Primary Care Patient Experience Survey

    A standard Primary Care Patient Experience Survey has been developed by Health Quality Ontario (HQO) with input from partners including AFHTO. Teams who are looking to build a new patient experience survey OR changing questions in existing surveys can use the wording in the HQO template as a start although it is not meant to replace existing patient experience surveys. The survey is designed to support existing quality improvement initiatives and Quality Improvement Plans (QIPs).

    Report on antipsychotic medication use in long-term care homes

    Earlier this week HQO released Looking for Balance: Antipsychotic Medication Use in Ontario Long-Term Care Homes. It found wide variation in the percentage of residents being prescribed antipsychotic medications across the province’s long-term care homes. The report highlights the current state of antipsychotic medication use and also identifies learning opportunities for care teams.

    New clinical toolkit for primary care: KidneyWise Clinical Toolkit

    Ontario Renal Network has launched the KidneyWise Clinical Toolkit. Developed with the aid of Markham FHT’s Lead Physician and AFHTO board member, Dr. Allan Grill, the toolkit assists primary care providers in identifying patients at high risk of developing chronic kidney disease (CKD) and provides recommendations on how to properly diagnose and best manage the patient to reduce the risk for further disease progression.

    Information to share with Patients- strengthening their voice:

    NPAO Patient Choice Award- deadline is June 10, 2015

    Nurse Practitioner’s Association of Ontario (NPAO) members are eligible for the new Patient Choice Award. Patients submit nominations describing their nurse’s professional qualities, approach to patient care and specific stories of dedication and how the nurse has made a difference in their lives or the lives of others. It will be presented at an Awards/Celebration Dinner at the 2015 Annual NPAO Conference on Friday, September 25, 2015. Let your patients know they can nominate an NP who has provided excellent care. The deadline is June 10, 2015.

    Volunteers needed for HQO Patient, Family and Public Advisors Council- deadline June 19, 2015

    HQO is looking for patient and family volunteers to become part of a Patient, Family and Public Advisors Council. Volunteer advisors would share their experiences with Ontario’s health care system and be a part of HQO’s work in improving Ontario’s health care quality. Here’s a poster you can use to publicise this in your office. The deadline to apply is June 19, 2015.

  • “Many moving parts”: update from May 19 PHC Branch meeting

    Discussion at the May 19 quarterly meeting of AFHTO and MOHLTC Primary Health Care Branch covered:

    1. Parameters and next steps for developing new contract templates, given the ministry’s intent to:
      1. Conduct a review of all interprofessional primary care models
      2. Move toward “comprehensive regionally governed, population-based primary health services for Ontarians”
      3. Implement policy directions emerging from sources such as the Expert Panel on Primary Care (Price Report)
    2. Next steps regarding performance reporting and the schedules in the contract
    3. Commitment to improve Schedule A as a tool for meaningful program planning and reporting
    4. Re-purposing funds (e.g. for telemedicine programs)

    1.  Developing new contract templates amidst the “many moving parts”

    AFHTO has been keeping members informed on what is emerging about the province’s policy direction for primary care. (Click here and here for past reports.) The ministry’s desire to move toward a “comprehensive regionally governed, population-based primary health services for Ontarians” is given – implementation questions include how this will affect the organization of primary care, how it is resourced, and what will be the reporting relationships. The review of interprofessional teams can be expected to inform these decisions; however AFHTO anticipates it will be well over a year before there are any results since the details of this review are under development. We understand this review will look at performance and accountability, funding, and use of interprofessional teams (recruitment and retention, ratios of team members, opportunity to leverage these resources). Meanwhile, the current 5-year FHT contracts expire at the end of this fiscal and to that end work to redevelop the contract templates will proceed. Because of these “many moving parts”, the contracts could potentially need further updates going forward. Members may feel unsettled by this uncertainty – understandably so.  Keep in mind the province is well aware that:

    • Quality patient care must continue.
    • Ontario needs AFHTO members – the innovators and leaders in improving comprehensive primary care – in order to succeed in whatever direction the ministry may want to take with primary care.
    • AFHTO members have a very strong voice – through their collective work in this association – and must be engaged in finding the workable solutions for moving forward.

    Next steps:

    • AFHTO has pressed the need for the leaders of our member organizations to receive more information about the direction the province is taking. We have been told the Expert Panel report will be shared, possibly in a few weeks’ time.
    • As reported in the ED Advisory Council news, a work group of AFHTO members will begin the process of reviewing the contract, guided by the principles identified by FHT and NPLC leaders last fall, to identify issues that need to be addressed and begin strategizing.

    2.   Performance reporting and the schedules in the contract

    As reported in the most recent ED Advisory Council news, PHC Branch has agreed to recommendations from AFHTO to:

    • Retain Schedule A – program planning and reporting. (Improvements are required – see the next section below.)
    • Eliminate reporting that is not meaningful, i.e. activity reporting found in Schedule E. (The current contract states Schedule E is required. Contract needs to be changed, but given this direction, AFHTO anticipates compliance is unlikely to be pursued.)
    • In place of Schedule E, leverage work of D2D and to select 6-10 meaningful measures to be included in the next contract agreement.  Ministry priorities would also add:
      • One or two chronic disease measures (AFHTO thinks this is doable in the next iteration of D2D)
      • 7-day follow up (Adopted in the D2D 2.0 list as developmental, since AFHTO Indicators Working Group identified a number of current limitations in this measure that need further refinement)
      • Avoidable ED use (AFHTO Indicators Working Group had concluded this is not a good measure as it is right now. This needs further investigation.)

    3.   Commitment to improve Schedule A as a tool for meaningful program planning and reporting

    All agree that Schedule A has the potential to promote stronger program planning, coordination and evaluation; however many FHT/NPLC EDs have called for improvements to the Schedule A template, instructions and education. Next steps: PHC Branch and AFHTO will put together a joint working group to:

    • Improve Schedule A as a useful tool for program planning and reporting.
    • Do a joint presentation at the AFHTO conference on how to do effective program planning and evaluation, ministry needs for reporting, and how to use Schedule A effectively.

    4.   Re-purposing funds

    AFHTO followed up on a question from our previous meeting with PHC Branch regarding funding to replace telemedicine equipment. The response was that, for everyone who had asked, the ministry was able to help the FHT/NPLC identify existing funds to re-purpose to purchase replacement equipment. PHC Branch reps said this was also true for those who asked to re-purpose funds to cover sessional costs for these telemedicine consults. We were told that, for the past fiscal year, there are still some FHTs and NPLCs returning unspent funds to the Province. Next steps:

    • As reported from the Nov. 21 AFHTO-PHC Branch meeting, FHTs and NPLCs are encouraged to request reallocation of approved budgets to meet needs.
    • When it comes to telemedicine programs, AFHTO has reminded PHC Branch of the need to address the policy question as to how this need can be supported in a sustainable fashion.

    Participants in the May 19, 2015 meeting AFHTO was represented by:

    • Randy Belair (AFHTO President and ED, Sunset Country FHT, Kenora)
    • Sean Blaine (AFHTO Vice President and Lead MD, STAR FHT, Stratford)
    • Ross Kirkconnell (Secretary + QIDS Steering Committee Chair and ED, Guelph FHT)
    • Kavita Mehta (ED Advisory Council Chair and ED, South East Toronto FHT)
    • Angie Heydon (AFHTO Executive Director)

    MOHLTC’s PHC Branch representatives were:

    • Nadia Surani (Senior Manager, Interprofessional Programs Unit, PHC Branch)
    • Fernando Tavares (Program Manager, Interprofessional Programs)
    • Debbie Lora (Senior Program Consultant)

  • AFHTO 2015 Conference: Thank you to everyone who submitted an abstract!

    Over 170 submissions were received for concurrent session and poster presentations at the AFHTO 2015 Conference. Thank you to all those who applied!

    A confirmation e-mail has been sent to the contact person for each abstract submission. If you are part of a group that has prepared an abstract, please ensure your group contact has received the e-mail with the subject: “AFHTO 2015 Conference: thank you for submitting your abstract”.

    If your contact person has NOT received this confirmation, please contact info@afhto.ca by Friday, May 22, 2015 at 1:00 PM (EST). The confirmation e-mail is your assurance that your abstract has been received and will be reviewed by a working group for presentation at the conference.

    Final concurrent session and poster presentations will be selected by June 8, 2015. The program will be announced when registration opens in late June 2015.

    We look forward to seeing you at the AFHTO 2015 Conference! Team-Based Primary Care: The Foundation of a Sustainable Health System October 28 & 29, 2015 Westin Harbour Castle, One Harbour Square, Toronto

  • Data to Decisions (D2D) 2.0: Data submission form now available – submit all data by May 28

    Start inputting data through the D2D Submission Form today! All data for D2D is to be submitted by May 28, 2015.

    Enter your team’s data through the D2D Submission Form using your team’s unique code:

    • If you’ve already created your team code, you are ready to submit data through the D2D Submission Form. Input your Team Code and start submitting data.
    • If you have not yet created your team code, input the code you would like to use and the form will prompt you to register it. From there you can start submitting your team’s data.

    Resources for Contributing Data:

    Why participate in D2D? Click here for a video to help EDs, physicians, Boards and QIDSS start discussing D2D and how your team can participate.  D2D 2.0 is a membership-wide summary of performance on a small number of indicators that are both possible for members to measure and meaningful to them.

  • Review D2D 2.0

    WHY: To compare progress to peers, using your team’s code (entered during the data submission process). WHAT: Teams not contributing data can still view aggregate results on D2D and compare to their own local sources of team data (e.g. QIP, annual report etc.).

    • Review final D2D 2.0 report via Members-only page of AFHTO web site.

    WHEN: Mid-June 2015