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  • Members invited to participate in Communities of Practice for Telus PS, OSCAR, Accuro, and P&P EMRs

    What is an EMR Community of Practice (CoP)?

    An EMR CoP is a group that seeks to optimize use of their EMR. We do this by continuously engaging EMR vendors, super-users, clinicians, QIDS Specialists and other team members to strengthen collective knowledge, expertise and problem solving capability in EMR offerings. Our EMR Communities of Practice collaborate closely with vendors to improve their understanding of AFHTO member requirements and to facilitate resolution of common problems in a mutually-agreed priority order. Several success stories have emerged from the EMR CoPs, illustrating the role they play in the spread of improvements, change in behaviours and expectations, and impact beyond their own boundaries. Unlike most EMR user groups, the communities of practice have the following characteristics:

    • Equality among members
    • Focus on issues in common
    • Led by users (QIDS Specialists, physicians, etc.)
    • Priorities set collectively via action item list
    • Problems solved collaboratively through sharing of best practices
    • Accountable to the community
    • Their own social networking platform
    • Regular meetings (via web or teleconference)

    Goals of the EMR Communities of Practice

    • Leverage the wisdom of the field
    • Change conversations with EMR vendors to expedite improvement
    • Identify data extraction tools and processes

    AFHTO members and staff support 4 EMR Communities of Practice:

    • Accuro
    • OSCAR
    • P&P
    • TELUS PS

    Want to join an EMR CoP? Please contact us for more information.      

  • Governance Webcast Series: Board Orientation and Education

    Looking to strengthen your board? This webcast reviewed why board orientation and education is important. Speakers were Catherine Anastakis from Collaborative Solutions and three family health team executive directors.

    Leading practices and tools were discussed, and sample resources from teams were reviewed to see how boards can excel. A toolkit has been designed to support teams’ ongoing efforts to design and conduct orientation for new board members.

    The presentations from three executive directors on their local board orientation and education processes are here:

    The recording of the webcast is here:

    Speakers:

    Catherine Anastakis, Collaborative Solutions; Lori Richey, ED, Peterborough FHT; Kelly Griffiths, ED, Tilbury District FHT; Sandy Scapillati, ED, Etobicoke Medical Centre FHT.

    This is part of the “Raising the Bar on Governance – Webcast Series,” which has been developed in response to new governance requirements, ongoing member feedback and advice from our Board Chair Leadership Council.

  • OCFP Honours Central Lambton FHT Physicians

    Sarnia This Week article published December 4, 2018 By Sarnia This Week  Four doctors from the Central Lambton Family Health Team (CLFHT) were honoured in November, given a prestigious designation by the College of Family Physicians of Canada (CFPC) recognizing the outstanding contributions the doctors made to the field of family medicine. Dr. Firas Al-Dhahar, Dr. John Butler, Dr. Enoch Daniel and Dr. Angela Wang were presented with Fellowship Designations at the CFPC convocation ceremony on Nov. 17. To receive a Fellowship Designation, doctors must be in practice in good standing with the college for ten years and distinguish themselves with superlative contributions to their communities, to their colleagues and to the discipline of family medicine. CLFHT executive director Sarah Milner said she expressed her support for the doctors who worked on behalf of the community. “It is a reaffirmation of all the hard work our doctors put in to making certain we are cared for,” she said. Dr. Wang said she was humbled to receive the fellowship. “As a family physician, I am humbled, honoured and in awe of the amount of trust that patients have in me,” she said. “The fellowship that was bestowed on us is recognition of lifelong learning and dedication to patient care and community health. Thank you to all my patients, family and colleagues who have and continue to support my journey.” Wang’s colleague, Dr. Daniel said he was proud of the family health team’s achievements across Lambton County. “Daily I count my blessings when I think of Petrolia, Lambton County, my patients, my staff and my colleagues,” he said. “I remember the struggles that we have had as a community to establish equality of health care for our rural patients. All of this has brought about an exemplary rural health delivery model that will be duplicated by other communities. To us as physicians of the CLFHT, the work that we do here is our life’s work and we will continue to respond to our community’s needs.” Relevant Links

    Click here to access the Sarnia This Week article  

  • Bits & Pieces: palliative and end-of-life care mentoring network, Spine online & more

    Your Weekly News & Updates
    OCFP palliative and end-of-life care mentoring network The Ontario College of Family Physicians (OCFP) has launched a mentoring program to support clinicians in the delivery of high-quality Palliative and End-of -Life Care. This builds on the successful work of the OCFP’s mentoring networks in mental health and addictions and pain. Initial groups will start in the South West and Hamilton, Niagara, Haldimand, Brant LHINs (Group 1); Central East and South East LHINs (Group 2); and North East and North West LHINs (Group 3). Please visit the mentoring network webpage.  The team can be reached at ocfpmentoring@ocfp.on.ca.     In this Issue: OCFP palliative and end-of-life care mentoring network Addictions and mental health call for abstracts Community Health Ontario Group Insurance Plan (CHOGIP) Patient and caregiver declaration of rights at end-of-life consultation Spine Online e-course now available DDO risk management for health care charities webinar series New quality standard for chronic obstructive pulmonary disease Upcoming events regarding board orientation and more
    Addictions and mental health call for abstracts Addictions and Mental Health Ontario’s conference is taking place May 26, 27 and 28, 2019 and they’re currently seeking abstracts. Deadline Jan. 4, 2019.
    Community Health Ontario Group Insurance Plan (CHOGIP) CHOGIP is offered jointly through the Alliance for Healthier Communities (Alliance), Addictions and Mental Health Ontario (AMHO) and Association of Family Health Teams of Ontario (AFHTO), and is offered only to not-for-profit, community-based organizations. Click here to learn more.
    Patient and caregiver declaration of rights at end-of-life consultation The Quality Hospice Palliative Care Coalition of Ontario (QHPCCO) is conducting a Patient and Caregiver Declaration of Rights at End-of-Life consultation. It’s the outcome of a recommendation to the QHPCCO in the Advancing High-Quality High Value Palliative Care in Ontario – A Declaration of Partnership and Commitment to Action Report (December 2011), to develop a “patient and caregiver declaration of rights” that builds on existing legislation. Its purpose is to help empower patients and caregivers and embed these commitments in service plans to clarify expectations and accountability for all partners to support informal caregiving and build on existing legislative rights. They’re particularly interested in receiving feedback from patients and caregivers. The deadline to complete the survey is Friday, December 14, 2018. If you have any questions, please contact Julie Darnay, Manager, Partnerships & Communities of Practice, Hospice Palliative Care Ontario at jdarnay@hpco.ca.
    Spine Online e-course now available Developed by the Centre for Effective Practice (CEP) and funded by the Ministry of Health and Long-Term Care (MOHLTC), as part of the Knowledge Translation in Primary Care Initiative, this course aims to familiarize primary care providers with current guidelines for evidence-based assessment and treatment of patients with low back and/or neck pain. The CORE Back and CORE Neck Tools are incorporated, so you can easily translate this knowledge into practice and use them to maintain and re-frame your practice care pathways. This Self-Learning program has been certified by the College of Family Physicians of Canada for up to 4 Mainpro+ credits
    DDO risk management for health care charities webinar series DDO Health Law’s 6-part webinar series, Risk Management for Health Care Charities, starting November 2018 to April 2019, is focused on:

    • Privacy (Archived Access)
    • Board Oversight (December 5)
    • Reputation (January 9)
    • Events (February 6)
    • Clients, Families & Staff (March 6)
    • Governance (April 3)
    • Plus, a bonus 1-hour webinar on April 17 updating charities on emerging areas of law including cannabis, medical assistance in dying, and big data.

    Visit www.healthcarecharities.ca for more information, pricing and to register or contact Franca at flatino@ddohealthlaw.com
    COPD_quality_standard_EN New quality standard for chronic obstructive pulmonary disease Health Quality Ontario has released a new quality standard: Chronic Obstructive Pulmonary Disease For more information about quality standards, visit their website.
    Reflections on Using Data for Improvement, Dec. 6, 2018 Dr. Tara Kiran (Family Physician at St. Michael’s Hospital Academic Family Health Team) will share her experiences using data to drive quality improvement in primary care. Learn more here. Sweden-Canada Digital Health Initiative, Dec. 5, 2018 Share knowledge and discuss Ontario & Sweden’s digital health strategies and the challenges with implementing digital health solutions. Learn more here.
    Governance Webcast Series: Board Orientation and Education, Dec. 6, 2018 Learn why board orientation and education is important. Register now! Beyond Silence Mental Health Training for 2019 Dates from Jan-May 2019 for Toronto, Cobourg, Chatham, Thunder Bay & Hamilton developed by McMaster University. Learn more here.

     

  • Patient Story: Stephen

    Watch this video to see an example of the benefits of interprofessional team-based care for Stephen, a patient with rheumatoid arthritis. Courtesy of Dufferin Area FHT

  • Annual AFHTO Leadership Session Reports

    Every year, leaders from AFHTO member teams (board members, EDs/Admin Leads, and lead MDs/NPs) meet in advance of the annual conference. Below are links to past leadership session reports, along with the leadership themes from each year’s conference.

    2018 – Addressing Mental Health and Addictions Needs in Primary Care

    • In this year we partnered with the Canadian Mental Health Association, Ontario, and co-designed a session to focus on mental health and primary care integration. Leaders from the CMHA chapters across the province  joined us  –  leaders in primary care – to discuss how both sectors can work more closely together to ensure patients receive timely access to care. The session was kicked off by our CEO, Kavita Mehta, and Camille Quenneville, CEO of the CMHA, Ontario. There were group discussions, followed by break-outs by region. We addressed the question “How do we ensure that we provide seamless care for our patients and create a well integrated system of care.” From this discussion, we took away action items to help teams be leaders in local change, as well as a set of recommendations to provide policy makers. Ministry officials also joined the discussion.

    2017- The Way Forward: Care Coordination Being Led by Primary Care

    • This year’s focus for the Leadership Triad Session was on care coordination and building primary care as the foundation of the health care system, such that more Ontarians have access to comprehensive primary care and coordination of care through primary care teams. Given the Minister’s LHIN mandate letter from May 1 2017 “to develop and implement a plan with input from primary care providers, patients, caregivers and partners that embeds care coordinators and system navigators in primary care to ensure smooth transitions of care between home and community care and other health and social services as required”, we believe care coordination to be a relevant and timely topic for both LHIN and AFHTO leaders.

    2016: Tackling the big issues: relationship and accountability questions in Ministry contracts

    • The objective of this leadership session was to find common ground and guide AFHTO’s position on particularly challenging issues related to the FHT contract, as informed by membership consultation over the preceding summer. Major themes were: standardizing FHT contracts; fostering teamwork and defining the”team”; defining the “population” for which governors are accountable, defining minimum standards of governance/addressing conflict of interest; and accountability and dispute resolution.

    2015: Leading Primary Care through the Next Stage

    • This Leadership Session was designed to identify issues and shape the direction to be taken by this sector, supported by the advocacy, networking and knowledge-sharing made possible through AFHTO. This year, the session focused on the question of a population-based approach to primary care.

    2014: Toward the Next Ministry Contract

    • This Leadership Session was part of a comprehensive process of working with AFHTO membership to identify the key principles to guide the journey toward more mature relationships, including contracts that support high-quality comprehensive interprofessional primary care. The report summarizes the outcomes of the entire process, including the leadership session.

    2013: Leadership in Health Care for Ontarians

    • Summarizes the key messages and insights into primary care leadership gleaned from the AFHTO 2013 Conference – including the Leadership Session, concurrent sessions within the leadership theme, and plenary sessions.

    2012: Priorities, Goals, and Actions

    • Leaders delved into the question of “How do we continue to build a stronger primary care foundation and work in a more integrated manner within the LHIN to ensure coordinated and seamless care for our patients?” The resulting Priorities, Goals and Actions report  lists the priorities and cross-cutting themes that emerged across all LHIN groups and documents the priorities, goals and short-term actions identified by the leaders from each LHIN.

  • Evaluation of the McMaster Family Health Team: results and practical implications for quality improvement

    By Laila Nasser, Alix Stosic, David Price; McMaster FHT Abstract Purpose: To evaluate the McMaster Family Health Team (MFHT) as part of a Continuous Quality Improvement initiative using a set of provincial performance metrics to demonstrate which measures of assessment are actually clinically meaningful in context and where system-level changes might be implemented to improve operational practice. Methods: Measures were selected from the Primary Care Performance Measurement Framework based on data availability for the MFHT and provincial comparators. The measures explored in this paper are those that were deemed to have actionable properties. Data were extracted from billing reports, electronic medical records and information collated for the Association of Family Health Teams of Ontario Data to Decisions database. Metrics were then examined to demonstrate the importance of interpretation in clinical context. Conclusions: Quantitative assessment of performance based on standardized measures is a suitable starting point when evaluating a practice, however it is not appropriate as a stand-alone report card of practice performance. Rather, quantitative measures must be of clinical relevance and applicable to the patient populations of interest in order to create conversation and impact change. Thus, the focus of quality improvement should not be to improve numbers relating to efficiency, patient satisfaction and continuity of care, but rather to determine what drives those numbers and how changes might be made at a system or practice level that will optimize clinician buy-in. Click here for access to full article (PDF)

  • CBC profiles Marathon FHT’s Bright Lights Award for Safer Opioid Prescription (HARMS) Program

    CBC News article published on November 27, 2018 By CBC News A clinic in a small northwestern Ontario town is enjoying some recognition after taking a chance on an unusual approach to opioid prescription. For the past several years, the Marathon Family Health Team, located in Marathon, Ont., has required urine drug tests of every patient prescribed opioids for chronic pain. The tests are used to better understand whether patients will be helped, or harmed by a prescription, said Dr. Ryan Patchett-Marble, a family doctor at the clinic and lead on the HARMS (or High-yield Approach to Risk Mitigation and Safety) program. “There’s no perfect test to show someone’s in pain and there’s no perfect test to show that somebody’s addicted,” he said. “There is something that can help us know, and that’s urine drug testing.” If the tests reveal traces of other concerning drugs — cocaine, for example, or opioids that were not prescribed — then doctors take note. “Those things suggest the person’s at higher risk of opioid addiction, overdose and death,” he explained, “and so urine drug tests can help us know who we’re harming, and affect [whether] we prescribe opioids at all, and if we do, how.” While there was some initial pushback from patients worried that the drug testing may turn out to be punitive, over time that concern dissipated, Patchett-Marble said, as people came to understand that the tests were being applied across-the-board as a safety measure.

    Drug test results changed care for one in five

    The urine drug testing system was implemented about four years ago, but it was studied in 2016 and 2017 when a group of patients, considered to be low-risk, were followed over a 12-month period. The study revealed that the system was having an even bigger impact than expected. It found that one in five patients had a drug test result that “directly changed management,” meaning doctors altered the patient’s care by starting the patient on addiction treatment, weaning them off medication or taking other measures. “I assumed it would have a high detection rate, but one in five is actually quite astounding because we’d already weeded out the people that were considered high-risk,” said Patchett-Marble. “So we were quite surprised.”

    Provincial recognition

    Others are now starting to pay attention to the HARMS system, and its potential, said Patchett-Marble, who recently gave a talk on the program at a family medicine forum in Toronto. This year it received an award from the Association of Family Health Teams of Ontario. The Bright Lights scalable pilot program award recognizes a project with potential for expansion. Expansion to other clinics is the next step, said Patchett-Marble, adding that they also plan to more thoroughly study the program and its impacts. “Up to this point, drug testing hasn’t been studied very well, as it’s used for chronic pain, and we’d like to, during this expansion, also evaluate and say ‘hey, does this actually work?’ “Does a clinic that does drug testing as a safety measure with opioids, do they have lower rates of addiction? Or higher rates of detection of addiction? Do they have lower rates of overdose? Lower rates of death?” Patchett-Marble said the recognition for a program run by a small team in a small town with minimal resources, has been gratifying. “So we’re kind of getting on the map a little bit, I guess. But our whole team has worked really hard to do this.” Click here to access the CBC News article

  • Espanola & Area FHT Implements New Addictions Service

    Access to PDF Flyer for Espanola & Area FHT RAAM Clinic Espanola & Area Family Health Team has implemented a new program to enhance services offered at their clinic. The Rapid Access Addiction Medicine (RAAM) Clinic serves those with substance abuse issues, primarily addictions to opioids and alcohol.  The purpose of the clinic is to provide quick access to care for addiction issues, including assessments, counselling and prescriptions for medications that may help with lessening cravings and withdrawal symptoms. The RAAM Clinic will also help patients to navigate access to other addiction services in our community and provide support through transitions. How this Program helps… The RAAM Clinic helps those with alcohol and substance use disorders in a timely way by:

    • Offering rapid assessment:  Patients will be seen by an Addiction Worker within 24-48 hours after referral. Patients will be screened and assessed for substance use disorder. They will then be seen by the Addiction Specialist to create and implement a treatment and medication plan.
    • Offering pharmacological treatment:  While not everyone with addictions requires pharmacological treatment, some may benefit from prescription medications that may help with lessening cravings and withdrawal symptoms.  Additionally, the RAAM Clinic will support family physicians to ensure they are able to help with pharmacological treatment for addictions. An example of a pharmacological treatment for addiction is the prescribing of anti-craving or abstinence medications.
    • Offering connections to community treatment programs: The RAAM Clinic will help patients successfully connect with community-based mental health and addiction services. The clinic addiction worker will help the patient navigate through the transitioning to community programs.

    Contact Phone: (705) 862-7991 ext. 4245 (Monday to Friday, 8:30 am – 4:30 pm) Click here to view the My Espanola Now Article

  • Bits & Pieces: Longwoods call for abstracts, Bill 47, complex patient management & more

    Your Weekly News & Updates
    Building Effective Primary Care Systems- call for abstracts Longwoods’ Healthcare Quarterly will have a special edition that will focus on building effective primary care systems. Given the amazing work our members do, think about submitting an abstract in the following themes: – Collaborative models of care including discussion of benefits and challenges. – Innovative examples of care delivery in long-term and palliative care. –  Implementation of a successful medical home – with outcomes analyses. –  How to implement and use supports for patients, such as electronic medical records, email, etc. – Examples of how to keep older people out of hospital. – What should be included in a full-service family practice and why? Abstracts are due December 4th – for more information please click here.     In this Issue: Building Effective Primary Care Systems- call for abstracts What Bill 47- changes to the Ontario Employment Standards Act, 2000 mean for your team ECHO Ontario complex patient management Opioid tapering and tools slides and video Making the case for nutrition screening in team-based primary care to meet the needs of your frail clients Patient story: Dufferin Area FHT Hypertension Canada adds clinical-grade BPM to recommended list Opioids Clinical Primer Speak Up Ontario website updated Upcoming events regarding board orientation and more
    What Bill 47- changes to the Ontario Employment Standards Act, 2000 mean for your team What do the Ontario Government’s changes to the Ontario Employment Standards Act, 2000 mean for your team, especially your leave of absence policies? Maria McDonald of McDonald HR Law fills us in.
    ECHO Ontario complex patient management Are you looking for support managing your most complex patients? You can apply for ECHO Ontario Complex Patient Management. FREE and virtual interactive sessions will take place on Fridays from 12:00-1:00 PM EST from January 18 – March 22, 2019. Identifying the most effective mental and physical health interventions can be challenging.  The program connects you virtually with the expertise of leading clinicians and a panel of your peers to review your most complex patients. By learning together, you won’t be alone in finding the best path ahead for your patients. Spots are limited. Apply now.
    Opioid tapering and tools slides and video On Nov. 19, Dr. Andrea Furlan, co-chair of ECHO Ontario Chronic Pain and Opioid Stewardship, spoke to our members about opioid tapering and tools for use in clinical practice. You can see the presentation and recording here. Making the case for nutrition screening in team-based primary care to meet the needs of your frail clients On Nov. 21, Dr. Heather Keller focused on nutrition screening as a means of shifting primary care to ‘upstream’ prevention of undernutrition and eventual frailty. You can see the recording she presented with members here.
    Patient story: Dufferin Area FHT Watch this video to see an example of the benefits of interprofessional team-based care for Stephen, a patient with rheumatoid arthritis. We’ll also share this on social media this week. Have similar stories? Share them with us, your MPP and the public to highlight the great work you do!  
    Patient story: Stephen
     Patient story: Stephen
    Hypertension Canada adds clinical-grade BPM to recommended list Hypertension Canada has added clinical-grade choices to Recommended Blood Pressure Measurement (BPM) Devices List, to assist you in your purchasing decisions. They’re confirmed as having met prevailing BPM accuracy standards, to support diagnosis and in monitoring how patients’ blood pressure responds to lifestyle changes and medications. You can view the full list at hypertension.ca.     Opioids Clinical Primer Machealth has launched the Opioids Clinical Primer, a free, certified online program to educate health professionals in Ontario about safe opioid risk reduction and addressing opioid use disorder by reducing harm including overdose and dependence by recognizing and treating opioid use disorder. Two of the six courses are currently available: Primary Care: Principles of Assessing and Managing Opioid Use Disorder; and Managing Patients with Opioid Use Disorder in Primary Care with Buprenorphine. The primer is integrated with the suite of programs collectively described as Ontario Pain Management Resources: a partnership to help clinicians support their patients. You can learn more at opioids.machealth.ca
    Speak Up Ontario website updated
    Speak Up Ontario is an initiative of Hospice Palliative Care Ontario (HPCO) to improve awareness and understanding of Health Care Consent (HCC), Advance Care Planning (ACP) and Goals of Care (GoC) in the Province of Ontario. HPCO updated their site to provide easier access to resources such as their workbook, resource guide, videos, posters and post cards You can learn more here or visit their website.
    Reflections on Using Data for Improvement, Dec. 6, 2018 This webinar will discuss how data and listening to patients support QI. Learn more here. ACLS Courses for 2019 The Sunnybrook ALS Educator Program has released their 2019 course schedule. For more information, see here.
    Governance Webcast Series: Board Orientation and Education, Dec. 6, 2018 Learn why board orientation and education is important. Register now! IPAC-CEO and PHO Education Day 2018, November 29, 2018 Learn the steps and implications for IPAC in this session held in Whitby. Learn more here.