Tag: reports and relevant news

More Ontarians are filling opioid prescriptions now than ever before according to a recent report by Health Quality Ontario. Nearly two out of every 1,000 Ontarians visited an emergency department within a week of being dispensed an opioid and the death rate from opioid overdoses has nearly quadrupled in Ontario in the last 25 years. A first-of-its-kind program, Mentoring, Education, and Clinical Tools for Addiction: Primary Care-Hospital Integration (META:PHI), reduces emergency room visits for opioid and alcohol addictions and improves patient care. META:PHI provides patient’s with easy and fast referral between emergency departments, addiction specialists and family physicians. Developed by Dr. Meldon Kahan and his team at Women’s College Hospital, in Toronto, the program’s rapid-access clinics have spread to seven additional communities across Ontario thanks to support from Adopting Research to Improve Care (ARTIC) – a program of the Council of Academic Hospitals of Ontario (CAHO) and Health Quality Ontario with the mandate of accelerating the spread of programs which have been shown to improve care. Patients have reported the clinic’s patient-centred approach made them feel less stigmatized – something patients living with addiction often feel. The program is expected to spread more in years to come. Relevant Links

• ARTIC News Release (PDF)
• META:PHI Results (PDF)

  Today, the Ontario government announced new investments in interprofessional primary care. In the 2017 Ontario Budget, the Wynne government committed $145 million in addition to the $85 million announced last year.

• The government is “investing an additional $145 million over the next 3 years to effectively recruit and retain nurses, nurse practitioners, dietitians, social workers, pharmacists, reception staff and other care providers who provide valuable services alongside family doctors on these teams. This is in addition to the $85 million in investments in interprofessional teams announced in the 2016 budget.”
• In addition to the base funding increases, the government has promised to expand access to interprofessional teams: “In 2017, Ontario will invest an additional $15 million annualized in team-based primary care to create new or expand existing interprofessional care teams so that all 76 sub regions across the province have a team.”

The Association of Ontario Health Centres (AOHC), the Association of Family Health Teams of Ontario (AFHTO) and the Nurse Practitioners’ Association of Ontario (NPAO) appreciate this financial commitment. This investment will help address recruitment and retention challenges, build strong interprofessional primary care teams and ensure high-quality, people-centred primary health care delivery in Ontario. The new retention and recruitment investment will be implemented over 3 years and will mean $73 million annualized by 2019-2020. In addition to the $9.5 million per year announced in the 2016 budget, this means approximately:

•  A total of $24 million in annualized funding in 2017-2018
• A total of $48 million in annualized funding by 2018-2019
• A total of $73 million in annualized funding by 2019-2020

The three associations will be working with the Ministry over the next few weeks to work out the details of this funding and to flow the money as quickly as possible. We will also be conducting a market refresh for 2017 rates to inform our Phase Three campaign to narrow the gap to current rates. “In Phase One of our recruitment and retention campaign, we achieved $31.5 million annualized for interprofessional primary health care teams. In Phase Two, we have achieved another $73 million annualized. Together, this brings us to over $100 million annualized in our quest for fair compensation,” said Kavita Mehta, AFHTO CEO. “While it came short of our campaign ask, the new investment would not have been possible without the active participation of our members, who have spent the last few months writing letters, collecting petitions and meeting with their MPPs.” The new investment moves us closer to $130 million needed to bring over 7,500 health care professionals working in over 400 interprofessional primary health care teams to competitive rates. This will significantly address the gap with hospitals, Community Care Access Centres (CCACs) and public health and to address retention and recruitment challenges faced by interprofessional primary care organizations. “New funding for interprofessional primary care is a welcome step, but additional investments are required to achieve Minister Hoskins’ vision as articulated in Patients First. Today’s announcement is welcome news for primary care teams and the millions of Ontarians they serve,” said NPAO CEO Theresa Agnew. “The investments in this year’s health budget signal the government’s growing recognition that primary care is the foundation of our health system. We are pleased to see this new funding, especially in the context of other health announcements that impact the determinants of community health and wellbeing,” said Adrianna Tetley, AOHC CEO. AFHTO, AOHC and NPAO are gearing up for the work ahead. We will continue working together to bring all staff working in interprofessional primary care teams to competitive salary rates, and to ensure that people in Ontario have access to comprehensive, interprofessional, team-based care. We will keep members informed of any future developments. More in-depth budget analyses from each association will be available by Monday, May 1. Sincerely,

Ontario clinicians deliver quality care by reducing unnecessary care: new report When it comes to medical tests and procedures, less can sometimes be better. According to a new report released this week, Ontario health care providers are successfully working to provide and improve quality care by reducing unnecessary care to patients across Ontario. Released by Health Quality Ontario and Choosing Wisely Canada, the report, Spotlight on Leaders of Change: Implementing Choosing Wisely Canada Recommendations in Ontario to Improve Quality of Care, includes examples of successful programs implemented by clinical leaders to address unnecessary care in hospitals, primary and long-term care settings, including AFHTO member North York FHT. There is growing recognition that unnecessary care is common in health systems around the world, including Canada. The American-based Institute of Medicine estimates that up to 30% of medical care may be classified as unnecessary, at times introducing preventable risks associated with that care. Unnecessary care is defined as care in which there is a lack of benefit or in which benefits are outweighed by the potential risks, including patient inconvenience, increased cost to the health care system, and even potential harm to patients. Choosing Wisely Canada launched a national, clinician-led campaign in 2014 to help patients and clinicians talk more openly about tests, treatments and procedures so that they, and their families, can make informed choices about the care they receive. Over the last two years, Ontario researchers have worked with Health Quality Ontario and Choosing Wisely Canada to measure how common unnecessary care is in Ontario. This work has shown, for example, that 30% of Ontarians received potentially unnecessary cardiac tests and blood work before low risk, non-cardiac surgery. And, according to the report, unnecessary tests are not confined to hospitals. The report also notes that in primary care, 21% of Ontarians had bone mineral density testing not covered by practice guidelines. Reducing unnecessary care also saves money. Savings from ordering tests and procedures only when they are needed can be redirected to other needed patient care. Many clinicians in Ontario have contributed to the national effort to develop the Choosing Wisely Canada recommendations. Efforts in Ontario will now focus on how recommendations can be adopted. To learn more about the Choosing Wisely Canada recommendations being implemented by Ontario’s clinical community, read the full report.

The Ministry of Health and Long-Term Care (MOHLTC) is inviting patients, families, and caregivers to apply to be a member of the new provincial Patient and Family Advisory Council. No experience is necessary — you simply need to be 18 years of age or older and live in Ontario. Over the course of 18 months, the Council will advise on:

• Changes in how care is delivered
• New initiatives being planned by the Ministry
• How the Ministry can better engage with members of the public.

The aim is to involve patients, families, and caregivers in the policy development process, ensure their needs and concerns are understood, and help the health system become more responsive, transparent and accountable. Fifteen members will be chosen through an open public process and will represent Ontarians from across the province. There is no cost to be a member of the Council — meals, travel, and accommodation when needed, will be paid for. The deadline to apply is April 10, 2017. Relevant Links:

• Patient and Family Advisory Council – MOHLTC site

AFHTO submitted its recommendations to the Standing Committee on Finance and Economic Affairs as part of the 2017 Ontario Pre-Budget Consultations on Jan. 20, 2017. In this upcoming provincial budget, we call on the government to strengthen primary care so that it can deliver on its commitments outlined in the Patients First Act and ensure all Ontarians receive access to high quality, comprehensive, interprofessional team-based care. Key recommendations include:

• Continue on the path to stabilize the primary care workforce – invest in the people needed to lead successful change.
• Broaden access to interprofessional team-based care teams – optimize the ability of professions to collaborate and create a culture of trust
• Ensure seamless transition of care coordinators into primary care
• Invest in meaningful and measurable measurement

Relevant Links

• AFHTO 2017 Pre-Budget Submission to the Standing Committee on Finance and Economic Affairs (PDF) – Jan. 20, 2017
• Primary care must lead care coordination – June 1, 2016
• Optimizing value of and access to team-based primary care – June 4, 2015
• Team-based Primary Care: Higher Quality and Lower Cost (PDF)

Toronto, Jan. 6, 2017 – The Association of Family of Health Teams of Ontario (AFHTO) is strongly urging a return to the table between the federal and provincial governments to negotiate a health agreement that will ensure we have a long-term sustainable health system today and for future generations.  The proposed offer by the federal government on December 19^th, 2016 of a 3.5% annual increase in the Canada Health Transfer (CHT), plus limited targeted funding over 10 years, did not take into account the growing health care needs, the increasing complexity of our health care system or the funding needed for true system transformation. As a result, AFHTO supports the province in its call for an increase in CHT by a minimum of 5.2%, an evidence-based figure that is supported by the Conference Board of Canada and the Parliamentary Budget Officer. AFHTO is pleased with the targeted priorities identified by both levels of government in the areas of mental health, palliative care and home care, all of which is managed and coordinated in primary care. Primary care, the long-term relationship each person has with their family doctor or nurse practitioner, is key to keeping people healthy and to keeping health system costs in check. Coordinating patient care is a fundamental role of primary care, which is the foundation of Ontario’s complex health system… however, patients do not always move through the system as smoothly as they could and often fall through the cracks of our complex systems. Increasing access to interprofessional team-based primary care by strengthening mental health programming and service delivery and building capacity for more home care services and caregiver support is very much needed – evidence demonstrates that investment in primary care is associated with improved system quality, equity and efficiency (reduced cost). And most importantly, a better health experience for our patients as they become partners in their own health, alongside their providers and health care teams. AFHTO calls for the federal and provincial governments to collaborate on an agreement that will support a patient-focused health care system that will sustain health care for the long term and be accessible and available for all Canadians when they need it. Association of Family Health Teams of Ontario AFHTO is the advocate, network and resource for team-based primary care in Ontario. Primary care teams speed up access to care and offer a wider range of programs and services to promote health and manage chronic disease. They bring together the variety of skills needed to help people stay as healthy as possible. Relevant Links:

• AFHTO Press Release re Canada Health Transfer (PDF) – January 6, 2017

Minister Eric Hoskins and eHealth Ontario have now received Ed Clark’s review of Ontario’s Digital Health Assets, which confirms the significant and ongoing value of digital health infrastructure, and have accepted all of his recommendations in principle. In October the provincial government requested the Premier’s Business Advisor, Mr. Ed Clark, assess the value of ehealth in Ontario, specifically “provide the government with a value assessment of Ontario’s digital health assets and all related intellectual property and infrastructure” and “provide us with recommendations related to how to maximize the value of these assets for Ontarians”. AFHTO was one of 30 organizations who sent their own submissions to Mr. Clark, aligned with the collective goal as stated in the Patients First Action Plan, “to make Ontario the healthiest place to grow up and grow old.” Highlights from the AFHTO submission include: Current demonstrated value:

• Primary care – the “home” and the coordinator for health care over each person’s lifetime – and the primary care EMR are the basic building blocks for the health system and for EHRs.
• Primary care providers in Ontario’s interprofessional teams (including one-quarter of all family physicians) use EMRs and continue to move to higher levels of EMR maturity.
• EMRs are essential to meaningful measurement and improvement, and higher primary care quality is associated with decreasing total cost of care for patients.
• Connectivity among providers is critical to primary care coordination.

To get much more value from EMRs and connectivity:

• Stable funding is needed to enable all primary care teams and family physicians to license and maintain their EMRs and upgrade as needed to optimize their role in achieving the objectives to “access, connect, inform and protect”.
• People and processes are essential to reaping the value of EMRs for better care. The Quality Improvement Decision Support (QIDS) Partnerships are a proven model for advancing use of EMRs and data; this model is highly amenable to spread.
• Build a vision and strategy for patient ehealth to move beyond “pockets” of innovation.

With these in mind, Ontario can refine its digital health strategy to help “improve access to care, connect services, inform people to make the right decisions about their care, and protect our universal public health care system by making decisions based on value and quality.” Related Links:

• AFHTO submission regarding value of eHealth in Ontario (PDF) – Oct. 31, 2016
• Value and Opportunities Created by Ontario’s Digital Health Assets – Report, Premier’s Business Advisor and Chair of the Advisory Council on Government Assets, Nov. 22, 2016
• Open letter to Ed Clark– Oct. 7, 2016