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  • EDAC News: The Primary Care Context, Strengthening Governance & Recognizing Progress

    E-mail sent to EDs of all AFHTO member organizations AFHTO’s Executive Director Advisory Council (EDAC) met on February 10th. This update provides an overview and highlights key items discussed (scroll below for more information):

    • Evolution of Primary Care & Current Context
    • Accountability Reform Initiative
    • AFHTO Updates
    • PHC Branch Meeting
    • QIDS Program Update

    Evolution of Primary Care & Current Context

    EDAC members reviewed a slide presentation that summarizes the current political and stakeholder environment that is shaping and influencing the primary health care change agenda.  Discussions centered around: Physician Services Agreement Once negotiations ended on January 15th 2015, the Ministry announced a Ten-Point Plan. We are awaiting details with respect to implementation. One of the points — only areas with a high need for physician services will get new Family Health Organisations and Family Health Teams – raised specific concern amongst EDAC. AFHTO will continue to keep all members informed as further details are released. Key reports to be released by Minister MOHLTC’s Expert Advisory Committee on Strengthening Primary Health Care in Ontario – When these findings are released, AFHTO will work with and on behalf of members to identify the potential impacts and opportunities. Home and Community Care Expert Panel – This report included a look at the intersection of primary care and home and community care, and may also have an impact on the delivery of interprofessional primary care. Call for Expressions of Interest (EOI) for Integrated Funding Models – Members asked about an Expression of Interest (EOI) the ministry recently issued for models that will test innovative approaches to integrate funding over a patient’s episode of care, regardless of who is providing the care, or the location where care is provided. Click here for a recording of the ministry’s information session on Integrated Funding Models (1hr 11min). Evolution of Primary Care & Access to Team Based Care The Minister recently announced his Patients First: Action Plan for Health Care. Recent addresses by the Minister and Deputy Minister have focused on person-centredness, system integration, accountability, increasing health and wellness, and ensuring sustainability and quality. The Deputy has also referenced the need to improve access to interprofessional care. Recruitment & Retention This continues to be the area of primary focus for advocacy by AFHTO, in collaboration with AOHC and NPAO. Click here for AFHTO’s latest update.

    The Accountability Reform Initiative (ARI)

    To date the ARI applies to FHTs only, however the requirement to complete a Governance Compliance Checklist applies to both NPLCs and FHTs. Members reviewed a briefing note provided by the Primary Health Care Branch outlining an analysis of ARI submissions in FHTs and the status of ARI approvals. More than 60% of FHTs applied for ARI, 52% of whom were approved. A number of opportunities for FHTs to strengthen governance practices were highlighted:

    • Strategic Planning
    • Performance Measure Monitoring
    • Risk Management
    • General Board Policies

    To support members completing the governance checklist and possibly applying for ARI, AFHTO is pleased to be offering a series of free educational webinars to help primary care leaders meet the requirements of ARI and the Governance & Compliance Attestation, and share best practice strategies to improve governance.

    AFHTO Updates

    AFHTO provided the council with a number of updates, including: Physician Leadership Council (PLC) – The PLC held its inaugural meeting on January 28th. With 23 physician leaders representing 12 of the 14 geographical regions, this council creates a new platform for physician leaders to advance best practice knowledge transfer, enhance collaborations and to work together to surface operational, governance and other FHT issues. PLC has identified 4 work streams of focus:

    • Ministry-FHT Contract Renewal in 2016 & Focus on Manageable, Meaningful Measurement
    • Harmonizing FHT Relations and Practices
    • Access to Team-based Care
    • Governance and Leadership

    For a list of members and draft Terms of Reference click here. Members of EDAC noted there are a number of overlapping priority areas for EDAC and PLC resulting in potential opportunities to work collaboratively to enhance the collective impact. ED Resource Toolkit – AFHTO has recently partnered with the Osborne Group and members of the ED Advisory Council to assemble and develop the Executive Director Resource Toolkit. Its objective is to orient new EDs of FHTs and NPLCs to their role and provide all EDs with easy access to a comprehensive collection of tools, resources and templates that will allow them to manage their operations effectively. A recent ‘Request for Feedback’ was circulated to all EDs in AFHTO membership requesting their support in the Toolkit development. Effective Governance for Quality Work Shops – Members were reminded of the two workshops being offered in late March free of charge to AFHTO member board members, executive directors and lead clinicians on Effective Governance for Quality in Primary Care. The workshops are evidence-based training programs for FHTs and NPLCs, delivered by peer leaders and will cover separate content than the 6 webinars being offered in support of the ARI initiative. Click for more information and registration details. Health Links Community of Practice – The Health Link CoP has been re-launched and will hold a kick off meeting for all AFHTO members that are leading Health Links on February 18th. If your organization is leading a Health Link and you’re not yet on our distribution list, please contact Bryn Hamilton, Provincial Lead Governance & Leadership (bryn.hamilton@afhto.ca).

    Meetings with the Ministry’s PHC Branch

    The next quarterly meeting between AFHTO and the Primary Health Care (PHC) Branch will be held on March 5th. EDAC discussed a number of items to be raised with the branch: 2015/16 Annual Operating Plan Submission Package The Interprofessional Programs Unit emailed the FHT and NPLC Annual Operating Plan Submission Packages to all FHTs and NPLCs on February 9th. Of key interest was the deadline for submission being extended to April 17, 2015 – in accordance with the strong feedback provided by EDAC and NPLC members!   Premise Costs Members commented on the rental increases their FHTs/NPLCs are currently facing and the change in Ministry direction to cover these associated costs.  Members who previously received ministry funding to cover rental increases are now being directed to find the extra money within their current budgets – a difficult task to make such late notice adjustments! There are also further examples of mixed messaging being received from Ministry consultants with respect to making reallocation requests. The PHC branch has been very clear that if members can demonstrate effective use of funding, then all requests will be strongly considered. AFHTO will be taking this message forward to PHC Branch to work together to improve consistent messaging and to identify ways we can better prepare for any significant changes to the way members are funded. OTN A number of members are being faced with the issue of vendors declaring ‘end of service’ for their telemedicine equipment and finding themselves with the financial responsibility to replace this equipment. Without access to a designated funding envelope, renewing OTN equipment is a significant cost burden and places a tremendous amount of risk to patients if access to the equipment or service is compromised. EDAC members agreed that we must work with the Ministry to develop a unified plan and approach to determine if there can be a one-time allocation of funds for assistance with this issue.

    QIDS Program Update

    Key highlights were presented, in particular, progress toward completing D2D 2.0, to be launched in May. Click here to access the most recent D2D bulletin. The next meeting of EDAC will be held in April. For any further questions, please contact your EDAC representative (click here for list) or:

    Kavita Mehta (Chair, EDAC) Executive Director, SETFHT kavita.mehta@setfht.on.ca Bryn Hamilton Provincial Lead, Governance & Leadership Program 647-234-8601 Bryn.Hamilton@afhto.ca

     

  • CMOH Memo Feb 11, 2015 Re: Measles Activity

    Click here for the memo from the Chief Medical Officer of Health regarding provincial and international measles activity as of February 11, 2015.

  • Governance education webinars for primary care leaders

    AFHTO is offering free educational webinars for our members over the next few weeks to: 1)      Help primary care leaders meet the requirements in the ministry’s Accountability Reform Initiative and the Governance and Compliance Attestation; 2)      Share best practice and strategies to improve governance; 3)      Identify and address common issues in FHT/NPLC governance.   There are 3 separate 90 min webinars, each webinar will be offered twice and posted on the AFHTO members only website. Please register in advance – space is limited.  See below for webinar details and to register. REMINDER: Registration is also open for the Effective Governance for Quality Workshops.   

    Session 1:  Getting Started

    • Wednesday, February 18 from 12:15 – 1:45pm OR
    • Friday, February 20 from 8:00 – 9:30 am

    Click here to register
    Learning Objectives Topics to be Covered
    What the Ministry expects from FHTs and NPLCs and whyUnderstanding the basics of good governance
    • The Ministry’s Accountability Reform Initiative (ARI) – what is it and why is it important?
    • What is “governance and compliance attestation”?
    • Effective Board structures (e.g. Committees)
    • Effective meetings and process (Board meetings; Annual meetings)
    • Bylaws
    • Roles and responsibilities, job descriptions
    • Managing important relationships
      • MOHLTC, FHT, FHO
      • Board Chair & Executive Director
    Session 2:  The Board’s Responsibilities

    • Monday, February 23 from 12:15 – 1:45pm OR
    • Friday, February 27 from 8:00 – 9:30am

    Click here to register
    Learning Objectives Topics to be Covered
    Understanding the Board’s role and responsibilities
    • Directors’ obligations (individual & collective)
    • Fiduciary responsibility
    • Governance policies
    • Creating an effective Board
      • Recruitment
      • Orientation & training
      • Board Chair
      • Conflict of interest
      • Code of conduct
      • Oversight and monitoring
        • Finance
        • Human Resources
        • Quality
    Session 3:  Looking Forward – using good governance to enhance organizational performance
    • Monday, March 2 from 12:15 – 1:45pm OR
    • Wednesday, March 4 from 8:00 – 9:30am

    Click here to register
    Learning Objectives Topics to be Covered
    Understanding some of the more advanced elements of good governance and how they impact organizational performance
    • Strategic planning
      • Strategic plans, operational plans, and KPIs
      • Partnerships and community linkages
      • Board evaluation
      • Public complaints and resolution policy
      • Governing for safety and quality
      • Generative governance
    The webinars will be provided in partnership with peer leaders from FHT teams and  the Osborne Group, and will leverage the tools and resources to strengthen governance structures and processes found within the ‘Fundamentals of Governance Program’ that was developed in 2014.
    REMINDER In-Person Training: Effective Governance for Quality Workshops
    Program registration is free of charge and open to board members, executive directors and lead clinicians of all AFHTO member organizations. It is recommended that each organization send more than one board member to the program to fully benefit from the training. Click here for more information about the workshops.

    Register for one of the sessions below before Friday, March 13, 2015):

    The Governance for Quality in Primary Care workshops are now accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to 5 Mainpro-M1 credits. If you have any questions, please contact Bryn Hamilton, Provincial Lead – Governance & Leadership (bryn.hamilton@afhto.ca)

  • Data to Decisions eBulletin #4

    Data to Decisions eBulletin #4 – Feb 5, 2015

    The D2D eBulletin has moved to a dedicated distribution list. You are signed up to receive future issues. If you’d like to opt out of receiving the eBulletin, please indicate this using the ‘unsubscribe’ option at the bottom of this e-mail. All those not on the distribution list can sign-up for future eBulletins by clicking here. Please forward this to interested members of your team to give them the opportunity to receive the latest updates.

    Contributing to D2D 2.0

    Indicator selection: The indicators proposed for D2D 2.0 are under consideration by the QIDS Steering Committee and will be released to members, probably in the next ebulletin (Feb 19) if not before! D2D 2.0 data submission and presentation tool: A prototype of the tool for teams to submit data to D2D 2.0 will be available to QIDSS for testing in mid-to-late February.  Contact Puja Ahluwalia or Greg Mitchell for more information.

    Using D2D 1.0 to improve data quality and care

    Improving quality of clinical data in EMRs: Cancer Care Ontario (CCO) hosted the first of four or five regional sessions this week with QIDSS and the CCO Regional Primary Care Leads, supporting improvements in the quality of cancer screening data in EMRs and the progress in cancer screening efforts. Next week, QIDSS and leaders from CPCSSN and EMRALD are joining forces to extend the logic from CPCSSN/EMRALD case definitions to queries that AFHTO members can use in their own EMRs, even if they are not part of CPCSSN or EMRALD. Contact Carol Mulder for more information about either initiative. Automating patient experience surveys: AFHTO is inviting quotes for a service for members that will take much of the work out of administering patient experience surveys, while at the same time will increase the consistency of both the content and process for the surveys.  Please see the Request For Quotes on the web site for more details. Tool kit to help you recruit summer students: A tool kit that will assist AFHTO members on recruiting summer students for EMR data cleaning projects will be available in the next few weeks on the AFHTO members-only website. It is based on input from QIDSS and AFHTO members who have had success with this in the past.

     Other news about manageable meaningful measurement

    Success!! Accessing clinical data in PSS: Almost overnight, nearly 50 AFHTO members have taken up a new tool to extract data from any custom forms in PS, something that was not possible for teams to do previously. The tool emerged from the Innovation project developed by the East Wellington FHT and has spread like wildfire via the QIDSS.  As a result, Dr. Kevin Samson and Hope Latam (QIDSS) have been invited to present their work on this to the national Practice Solutions (PS) forum this spring. To learn more about this story click here. Interested AFHTO members can find out more from Marg Leyland. Physician Leadership Council: AFHTO is pleased to announce the inaugural meeting of the Physician Leadership Council (PLC) that took place on January 28th. The newly created PLC plays a significant role in enabling physician leaders from across the province to provide a sounding board on FHT-related matters and give advice to the AFHTO board and staff as needed. For the first time physician leaders now have a platform to create a collective impact that can optimize FHT value, function and operations. Click here for the draft Terms of Reference and membership listing. Contact Bryn Hamilton for more information on the discussion and decisions. Effective Governance for Quality in Primary Care Workshops: An evidence-based training program for FHTs and NPLCs, delivered by peer leaders from these organizations will be offered in two workshops this March. The sessions are intended for board members, executive directors and quality improvement leaders in AFHTO’s member organizations. If you would like to attend one of these two workshops or for more information, click here. Patient-doctor partnership composite indicator development:  In order to develop a tool to measure the indicator, a draft patient questionnaire will be tested among QIDSS in the upcoming weeks and will be available to interested parties to try after that. Contact Puja Ahluwalia for more details. EMR migration survey to be completed by executive directors, lead physicians, board chairs and QIDSS by February 25, 2015: Migrating from one EMR to another is a challenge no team takes lightly.  This survey is intended to compile the experiences of AFHTO members so that all can learn from the experiences of those who have gone before.  We hope this might ease the transitions for those teams planning to change EMRs.

    What do you think?

    We hope you find value in the D2D eBulletin and will continue to subscribe to it. Other members of your team can sign up by clicking here. Once they complete the sign-up form, a confirmation e-mail will be sent within 24 hours. In the meantime, if you have any comments or questions about the eBulletin, please let us know by e-mail to improve@afhto.ca. 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 web site for more information

  • Minister releases action plan for health care: highlights for AFHTO members

    On February 2, 2015 the Honourable Minister Dr. Eric Hoskins presented his plan for health care — Patients First: Action Plan for Health Care – on four themes: access, connecting patients to the services they need in their community, informing and educating patients on health care options, and protecting the quality, value and sustainability of health care services. There is one specific mention of primary care in the Action Plan. It reads – Quality Primary Care We know that access to quality primary care varies across the province. Some Ontarians have timely access to a family doctor, nurse practitioner and integrated health care teams and some do not. Together with our partners, we will bring forward a plan to ensure our primary care providers are organized around the needs of our population, such as those in northern, rural and fast-growing communities, focussing on greater accountability and access for these individuals and families. The plan does not go into any detail. The Minister did note in his speech the need to ensure access to “team-based, integrated, coordinated primary care,” and stated the report of the Expert Advisory Committee on Strengthening Primary Health, co-chaired by David Price and Elizabeth Baker would point the way. The Home & Community Care Expert Panel, chaired by Gail Donner, will also speak to the role of primary care. The Minister has received reports from both of these expert groups and we anticipate they will be released in the next month. The action plan does not mention recruitment and retention in primary care. Immediately after the speech, AFHTO’s Executive Director had the opportunity for a brief chat with the Minister. Before she said anything, the Minister’s first words were, “Recruitment and retention in primary care … we have to act on this.” A follow-up meeting with staff in the Premier’s Office and Minister’s Office is being organized. Additional items for AFHTO members to note are the province’s commitment to:

    • Increase access to primary care providers and same day/next day appointments.
    • Expand Health Links in more communities across Ontario.
    • Integrate physiotherapists and other types of health care providers into the family health practice.
    • Allow nurse practitioners to prescribe assistive devices.
    • Explore ways to improve dementia supports, including new memory clinics.
    • Increase transparent reporting on the quality and value of care to ensure the sustainability of the health system.

    There are many details that are not yet known. AFHTO will continue to work with and on behalf of members to monitor, consult, advocate, inform and support you as events unfold. Links:

  • Register for Effective Governance for Quality in Primary Care Workshop in March 2015

    The Governance for Quality in Primary Care workshops are now accredited by the College of Family Physicians of Canada and the Ontario Chapter for up to 5 Mainpro-M1 credits. Register for one of these workshops: Workshop #1:

    • Wednesday March 25th from 10:30 to 4:30pm – Sheraton Gateway Hotel in Toronto International Airport (Skywalk connects the hotel to Terminal 3)

    Click here to register for this workshop. Workshop #2:

    • Monday March 30th from 10:30 am to 4:30 pm – Eaton Chelsea, 33 Gerrard Street West Toronto, Ontario (Next to Eaton Centre- closest subway Dundas or College station)

    Click here to register for this workshop. Click here to go back for more information page about this program. This session is FREE for board chairs/members, executive directors and lead MD/NPs of AFHTO member organizations.

     

  • Report on the inaugural meeting of the Physician Leadership Council

    To: Physician Leaders in all AFHTO member organizations AFHTO is pleased to announce the inaugural meeting of the Physician Leadership Council (PLC) took place on January 28th. This email provides an overview and highlights key items discussed:

    • Physician Leadership Council: Creating Collective Impact
    • The Provincial Primary Care Environment
    • The FHT Context
    • PLC Priority Areas of Focus

    Physician Leadership Council: Creating Collective Impact

    The newly created PLC plays a significant role in enabling Physician leaders from across the FHTs to provide a sounding board on FHT related matters and give advice to the AFHTO board and staff as needed. For the first time, Physician leaders now have a platform to advance best practice knowledge transfer, enhance collaborations and to work together to surface operational, governance and other FHT issues. A draft Terms of Reference has been developed to guide the work of PLC and to clearly identify its purpose, roles and responsibilities, and structure. The TOR may be amended as the Council evolves and work progresses. The PLC is an opportunity for lead Physicians to create a collective impact that can optimize FHT value, function and operations. Members of the Council will communicate, engage and consult with their physician colleagues to create strong communication mechanisms and a better understanding of current challenges and/or opportunities within FHT practices. The Council will provide leadership to harmonize working relationships to ensure optimal interprofessional comprehensive primary care delivery.

    The Provincial Primary Care Environment

    There are a number of current provincial factors that are shaping and influencing the primary health care change agenda. Members discussed the potential role the PLC may play in responding and advising on the following items:

    • OMA-MOHLTC Negotiations

    On January 15th 2015, the Ontario Medical Association held a press conference announcing that they will not accept the government’s offer reached through the current negotiation and conciliation process. The parties have reached the point where government is now in a position to impose a contract. The Ministry announced a Ten-Point Plan, but we are awaiting details with respect to implementation. One of the points — Only areas with a high need for physician services will get new Family Health Organisations and Family Health Teams — caused a number of concerns to be raised by PLC.  AFHTO will continue to keep all members informed as further details are released and will work with PLC to determine the impact the changes may have on FHTs and the delivery of interprofessional primary care.

    • MOHLTC’s Expert Advisory Committee on Strengthening Primary Health Care in Ontario

    It is expected that the Advisory Committee will define a future strategic vision, goals and objectives to advance Ontario’s primary health care sector and make recommendations around the design of the PHC system. When these findings are released, PLC and AFHTO will work to identify the potential impacts and opportunities for FHTs.

    • Evolution of Primary Care & Access to Team Based Care

    Recent addresses by the Minister and Deputy Minister focus on person-centredness, system integration, accountability, increasing health and wellness, and ensuring sustainability and quality. The Deputy has also referenced the need to improve access to interprofessional care. PLC members also spoke about the evolution of Health Links and how this may influence the direction of primary care.

    The FHT Context

    The FHT approach involves considerable changes in the provision of care for family physicians; working in an interprofessional care delivery system requires members to explicitly reflect upon and address how to work as a team and introduces the concept of shared responsibility. Members reviewed the clear evidence of the solid relationship between governance, leadership and performance:

    • Soon-to-be published research by the Ontario College of Family Physicians on characteristics of high-performing FHTs identifies strong leadership, governance and team collaboration to be highly correlated with quality outcomes.
    • The recently released FHT Evaluation Report found that governance, leadership, use of patient data and quality improvement as critically important contributors to stronger performance.

    Based on the results of the Leadership survey provided to board chairs, lead MD/NP’s and executive director of each AFHTO member organization, members also reviewed the following statement of adopted principles:

    • Governance Principles
    • Accountability and Reporting Principles
    • Principles for Determining Accountability Measures

    Click here to see the principles.

    PLC Priority Areas of Focus

    Based on the provincial and current FHT environment, members agreed on a number of priority areas of focus for the PLC:

    • Ministry-FHT Contract Renewal in 2016 & Focus on Manageable, Meaningful Measurement

    Contracts between MOHLTC and FHTs expire on March 31, 2016. The contract defines the terms and conditions and the legal framework under which funding is provided to the FHTs. The Ministry has been clear that ongoing FHT funding will be tied to accountability measures as set out in the next contract agreement. The renewal of the contracts will provide an opportunity for the PLC to advocate for changes that can influence the next stage of evolution for interprofessional primary care. The PLC will also have a role to play in shaping and influencing the measures selected to reflect the value FHTs deliver. There is significant work being done by the QSC and Indicators Working Group that will benefit from continued physician engagement.

    • Harmonizing FHT Relations and Practices

    The September 2014 AFHTO leadership survey found that 80% of respondents agreed that “greater harmony between the physician-funded groups and the FHT-funded groups is essential to the FHTs moving forward to ensure optimal interprofessional comprehensive primary care.” PLC members agreed on the opportunity to assists FHTs in harmonizing working relationships and practices for effective and efficient teamwork.

    • Access to Interprofessional Health Providers (IHP)

    The OMA is in the process of consulting with its members on access to IHP services to address priority populations. The OMA provided a draft paper to PLC members, and a collective response will be generated.  In the next 2-3 weeks, AFHTO will send you the draft paper and PLC’s response. OMA welcomes any of its members to provide individual or group feedback by Feb. 23 to Peter.Brown@oma.org.

    • Governance and Leadership

    Physician leadership, strong governance and effective working relations are the building blocks to achieving high-performing primary healthcare teams. The PLC will reinforce excellence in team performance by acting as a vehicle for communication, collaboration and problem solving.  The formation of regional networks for FHT physicians will be explored. The PLC also provides the opportunity for FHT physician leaders to give voice, not only to AFHTO but to external bodies as well. The next meeting of the Physician Leadership Council will be held in late March/early April. Click here for the list of members. For further information, please contact:

    Sean Blaine, MD Chair, Physician Leadership Council Lead Physician, STAR FHT blaines@sympatico.ca Bryn Hamilton, MHSc, CHE Provincial Lead, Governance & Leadership Program 647-234-8601 Bryn.Hamilton@afhto.ca

  • Ensuring access to team-based primary care

    AFHTO continues to give top priority to advocacy for increased funding to enable our members to recruit and retain the staff needed to deliver comprehensive team-based primary care. AFHTO members have been highly effective in meeting with their local MPPs to raise awareness and political pressure.  AFHTO, together with our collaborators in interprofessional primary care – AOHC and NPAO – continue to find every opportunity to press the issue, together with our recommended solution. Today, AFHTO presented to the Ontario Legislature’s Standing Committee on Finance and Economic Affairs regarding the Pre-Budget Consultations on the urgent need for sufficient funding to enable primary care organizations to attract and keep these professionals. Click here to access AFHTO’s submission.

    On February 5, AFHTO responded to a column in the Toronto Star about home and community care and the current strike by workers in 10 Community Care Access Centres – Eric Hoskins’ best chance to fix the ailing health system. Our letter emphasizes the critical role of primary care, and points out how the work of primary care teams has been grossly undervalued in relation to other parts of Ontario’s health system.

    Please continue to do your part in this campaign. Click here to access resources to help you as you meet with or write to your local MPP.

    Ontario Budget Talks portal: AFHTO members have your say and ask the government to address recruitment and retention The Ontario government has recently opened Budget Talks 2015, an online portal for Ontarians to offer feedback to the government on 2015/16 budget planning. In keeping with the work already begun, you can visit Budget Talks 2015 to lend your voice to the call to support recruitment and retention in primary care teams and/or vote for messages posted by your peers:

  • Data to Decisions eBulletin #3: Encourage team members to sign-up for future updates

    Data to Decisions eBulletin #3 – Jan 22, 2015

    The D2D eBulletin is moving to a dedicated distribution list. You are signed up to receive future issues, if you’d like to opt out of receiving the eBulletin, an ‘unsubscribe’ option will be provided in the next issue. All those not on AFHTO’s distribution list can sign-up for future eBulletins by clicking here. Please forward this to interested members of your team to give them the opportunity to receive the latest updates 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.  D2D 2.0 is the second iteration of the report, tentatively planned for May 2015.  See the D2D page on AFHTO’s web site for more information about D2D and manageable meaningful measurement.  See below for updates about D2D and opportunities for you to be part of the process. The bulletins are being released every other Thursday. They capture important developments emerging from the AFHTO members across the province and shared through the weekly QIDS Specialist web conferences.  Past issues are posted on the QIDS Program page of AFHTO’s members only web site to make it easier for you to find all the relevant information related to D2D in one place.  For more information, please contact improve@afhto.ca.

    Contributing to D2D 2.0

    LAST DAY REMINDER!! Complete the indicator selection survey by Jan 23, 2015: Please review the instructions for working with your team to provide input about which indicators should be included in D2D 2.0. QIDS steering committee meeting Feb 10, 2015: The committee will decide on the indicators to be included in D2D 2.0 from the results of the survey, among other things. Construction underway for D2D 2.0 data submission and presentation tool: A small team of QIDSS and AFHTO staff are working with a technical service provider to develop a user-friendly sustainable tool for data submission and presentation.  Contact Puja Ahluwalia or Greg Mitchell for more information.

    Using D2D 1.0 to improve data quality and care

    Improving quality of clinical data in EMRs: Over the next 2 months, QIDSS are participating in two initiatives to advance their collective efforts to increase consistency of clinical data capture and/or extraction.

    1. The first involves a small team of QIDSS and leaders from CPCSSN and EMRALD collaborating to expand and implement the work of the algorithm team which has been attempting to extend the logic from the CPCSSN/EMRALD case definitions to EMR queries.
    2. The second initiative is a series of regional sessions sponsored by CCO.  The goal is to facilitate collaboration between QIDSS and their respective CCO primary care leads in improving the quality of cancer screening data in EMRs and support improvements in cancer screening efforts.

    Contact Carol Mulder for more information about either initiative.

    Other news about manageable meaningful measurement

    Leadership opportunities: Thanks for volunteering!!  AFHTO is in the process of connecting with those who will be filling the vacancies in the Physician Leadership council, the QIDS steering committee, Indicators Working Group, the D2D advisory panel and the EMR Data Management subcommittee.  Thanks in advance for your time and commitment. Patient-doctor partnership composite indicator development: Work continues with Patients Canada, QIDSS and others to develop a tool to measure the patient-doctor partnership.  The tool is intended to be available to interested parties to try possibly by March 2015. See project outline or contact Puja Ahluwalia for more details 7 Innovation Projects to inspire you: Check out the findings from the innovation projects funded by the QIDS program for ideas that are already spreading across the membership to improve capacity for measurement and improvement.

    What do you think?

    We hope you find value in the D2D eBulletin and will continue to subscribe to this newsletter. If you’d like to opt out of receiving it, an ‘unsubscribe’ option will be provided in the next issue. Other members of your team can sign up by clicking here. Once they complete the sign-up form a confirmation e-mail will be sent within 24 hours. In the meantime, if you have any comments or questions about the eBulletin, please let us know by e-mail to improve@afhto.ca.

  • OMA Rejects Provincial Government Offer; Government expected to impose contract

    Yesterday afternoon the Ontario Medical Association held a press conference announcing that they will not accept the government’s offer reached through the current negotiation and conciliation process. This was followed by the Minister’s press conference about 1 1/2 hours later. The parties have reached the point where government is now in a position to impose a contract. Click here to read:

    What does this mean for interprofessional primary care in Ontario? The OMA’s release states: The government’s offer will cover less than half of the funding required for new doctors who are needed to treat current patients already struggling to access the care they need, for new patients coming into the health care system, as well as the more complex care required for our aging population. The following points in the ministry’s Ten-Point Plan  will affect primary care physicians:

    • The fee for a walk-in visit on weekends or holidays will be reduced to become comparable to the fee for a visit to a patient’s own family doctor.
    • Elimination of funding for doctors to attend courses and events that are considered part of their continuing medical education.
    • Income stabilization payments for doctors who work in underserviced areas will continue, while doctors who work in over-serviced areas will no longer benefit from the payments.
    • Only areas with a high need for physician services will get new Family Health Organisations and Family Health Teams.
    • Additional funding to support the care for complex patients is to be restructured to directly target their care.  Until a new funding model is developed that more accurately reflects patient care complexity, this additional funding will not be applied.
    • The ministry will apply a 2.65 per cent discount to all fee for service physician payments, effective February 1, 2015 and apply the reduction to non-fee-for-service payment contracts after the respective requirements for providing notice are met. The ministry will work with the OMA on a savings methodology that results in a higher proportion of savings from higher paid specialties.

    AFHTO is following up on the items that could impact the organization and delivery of comprehensive interprofessional primary care, and will keep the membership informed.