Bridge the Continuity Gap! Edmonton Zone June 2020 Hear how - - PowerPoint PPT Presentation

▶
bridge the continuity gap
SMART_READER_LITE
LIVE PREVIEW

Bridge the Continuity Gap! Edmonton Zone June 2020 Hear how - - PowerPoint PPT Presentation

Mar 17, 2023 26 likes •723 views

Bridge the Continuity Gap! Edmonton Zone June 2020 Hear how community physicians are bridging the continuity gap through CII/CPAR 1 Welcome! Start Time: 5:30 PM promptly Please note: your mic and camera are disabled by default 2 Bridge the

slide-1
SLIDE 1

1

Bridge the Continuity Gap!

Edmonton Zone

June 2020 Hear how community physicians are bridging the continuity gap through

CII/CPAR

slide-2
SLIDE 2

2

Welcome!

Please note: your mic and camera are disabled by default Start Time: 5:30 PM promptly

slide-3
SLIDE 3

3

Bridge the Continuity Gap!

Edmonton Zone

June 2020 Hear how community physicians are bridging the continuity gap through

CII/CPAR

slide-4
SLIDE 4

4

Zoom technical support (+1.888.799.9666 ext. 2)

Adjusting Your Screen

slide-5
SLIDE 5

5

Asking Questions

  • At any time, type questions in the

Q & A

  • At the end we will also invite you

to ask live questions

  • Click on “Participants”
  • Use the ‘Raise Hand’ feature
  • Moderator will invite you to

unmute

To raise your hand

slide-6
SLIDE 6

6

Live Recording

  • Privacy Statement: Please note that the webinar

you are participating in is being recorded. By participating, you understand and consent to the webinar being made publicly available via a link on the Edmonton Southside PCN website for an undetermined length of time.

  • By participating in the live Q&A, your name as entered into the

Zoom sign-in may be visible to other participants during the webinar and/or in the recording.

slide-7
SLIDE 7

7

Land Acknowledgment

We would like to recognize that we are webcasting from, and to, many different parts of Alberta today. The province of Alberta is located on Treaty 6, Treaty 7 and Treaty 8 territory and is a traditional meeting ground and home for many Indigenous Peoples.

slide-8
SLIDE 8

8

Presenters

AMA – Accelerating Change Transformation Team

  • Sheena George - CII CPAR Primary Care Lead

Edmonton West PCN

  • Dr. Janet Craig – Glenora Medical Clinic & Edmonton Zone Physician Champion

Edmonton Southside PCN

  • Dr. Ghalib Ahmed - Ottewell Medical Clinic
  • Alma Woronuk – Clinic Manager
  • Gabriel Molley -PCN Panel Management Assistant/EMR Consultant
  • Leslie Bortolotto - PCN Improvement Facilitator

Edmonton North PCN

  • Dr. Chris Le – Ideal Medical Center
  • Tara Seibert – PCN Quality Improvement Facilitator
slide-9
SLIDE 9

9

Webinar Support

Southside PCN

  • Leslie Bortolotto, Improvement Facilitator
  • Brittany Faux, Improvement Facilitator

AMA Accelerating Change Transformation Team

  • Edna DeChamplain
  • Crystal Hall
  • Kylie Kidd Wagner
  • Barbra McCaffrey
  • Jessica Simpson
  • Anthonia Taiwo
  • Angille Heintzman
  • Sheena George
slide-10
SLIDE 10

10

Presenter Disclosures

Sheena George:

AMA – Accelerating Change Transformation Team

  • Dr. Janet Craig:

AMA-physician contractor, Honoraria - UofA, Custom Learning Systems, Alberta AIM, AMA, Edmonton West PCN

  • Dr. Ghalib Ahmed: Ottewell Medical Clinic; Speaker’s Bureau; Honoraria – MD

Briefcase, Canadian Heart Research Centre; multiple drug companies Alma Woronuk: Ottewell Medical Clinic

Gabriel Molley:

Edmonton Southside PCN

Leslie Bortolotto: Edmonton Southside PCN

  • Dr. Chris Le:

Ideal Medical Center

Tara Seibert:

Edmonton North PCN

slide-11
SLIDE 11

11

Moderator Disclosures

Edmonton Southside PCN

  • Leslie Bortolotto
  • Brittany Faux

AMA – Accelerating Change Transformation Team

  • Edna DeChamplain
  • Sheena George
  • Kylie Kidd Wagner
  • Barbra McCaffrey
slide-12
SLIDE 12

12

Disclosure of Financial Support

This program has not received any financial or in-kind support.

slide-13
SLIDE 13

13

CII/CPAR Overview

Sheena George CII/CPAR Primary Care Lead AMA - ACTT

slide-14
SLIDE 14

14

  • 1. CII/CPAR overview
  • 2. Edmonton zone priority

connections

  • 3. Benefits during COVID-19
  • 4. Three physician and team

stories

Agenda

  • 5. Edmonton zone milestones
  • 6. How to get involved
  • 7. Questions and answers
slide-15
SLIDE 15

15

Wayne’s Story

slide-16
SLIDE 16

16

Wayne’s Journey

Paneled with ++Relational Continuity Recorded in EMR Referred to Urologist Outpatient Procedure ER  Hospital UTI x 6 Urosepsis x 2 No notification to Family Physician ER docs had limited access to information Follow-up reliant on family, or…

slide-17
SLIDE 17

17

Continuity Defined

Continuity of Care: a multidisciplinary review, JL Haggerty et al, 2013

Quality of patient care

  • ver time with

a primary care provider Connection across health care events and providers

slide-18
SLIDE 18

18

What is CII/CPAR?

slide-19
SLIDE 19

19

CII is a system that collects select patient information from community Electronic Medical Records (EMRs) and shares it with

  • ther members of the patient’s care team through Alberta

Netcare.

Community Information Integration (CII)

Community Physician Office EMRs

CII Data Hub

Alberta Netcare Healthcare Data Repository Health Information Data Governance Committee

slide-20
SLIDE 20

20

  • A provincial system that captures the

confirmed relationship of a primary provider and their paneled patients.

  • Receives information automatically

from clinic EMRs on a monthly basis

  • Next logical step for practices that have

invested in panel management

  • Foundational for future enhancements
  • f informational continuity

Central Patient Attachment Registry (CPAR)

slide-21
SLIDE 21

21

CII/CPAR: What You Share, Receive & Enhance

Share  Confirmed Panel Lists  Patient Encounter Data  Consult Reports Receive Reports 1) Demographic Mismatch Report 2) Conflict Reports 3) eNotifications Enhance Netcare 4) Community Encounter Digest 5) Consult Reports

slide-22
SLIDE 22

22

Wayne’s Journey

Follow-up with Family Physician Paneled with ++Relational Continuity Recorded in EMR Referred to Urologist ER  Hospital UTI eNotification to Family Physician Outpatient Procedure

slide-23
SLIDE 23

23

Common CII/CPAR Questions

slide-24
SLIDE 24

24

Do patients need to be notified that I am participating in CII/CPAR?

slide-25
SLIDE 25

25

  • Only mapped fields in EMR flow to Netcare
  • Document confidential information in unmapped fields
  • Each EMR has confidentiality features
  • HIA requires Health Collection Notice Posters
  • Most patients do NOT ask questions
  • If they do, questions are about Netcare (HQCA survey)
  • Starting conversations with patients is NOT necessary

Privacy of Information

Clinic EMR

slide-26
SLIDE 26

26

11.0

Average # of e-Notifications per 7 days (week) per 1000 patients on panel

1.5

Average eNotifications physicians receive daily

As of May 2020…

slide-27
SLIDE 27

27

CII/CPAR EXPERIENCES

slide-28
SLIDE 28

28 28

Glenora Medical Clinic’s CII/CPAR Journey

  • Dr. Janet Craig

Edmonton Zone Physician Champion Edmonton West PCN

slide-29
SLIDE 29

29

CII/CPAR Alignment Zone Priorities

  • 1. Transitions of Care
  • 2. Specialty Access & Linkages
  • 3. Addictions & Mental Health

Patient’s Medical Home

slide-30
SLIDE 30

30

https://actt.albertadoctors.org/file/Clinical-Management-Algorithm-Primary-Specialty-Care-Teams.pdf

slide-31
SLIDE 31

31 31

  • Why we got involved
  • Who did what
  • Physicians
  • Clinic Manager
  • eHealth Consultant
  • PCN Practice Facilitator
  • ACTT Consultant

Our Story

slide-32
SLIDE 32

32 32

  • 1. Socialize what CII/CPAR is (and isn’t)

with your clinic team

  • 2. Leverage Microquest (HQ) knowledge

about data mapping options

  • 3. First demographic mismatch report

might be big, once cleaned up should be quite small

Lessons Learned

slide-33
SLIDE 33

33 33

“We went live with CII/CPAR during COVID-19 pandemic, so training and communication amongst team members were challenging because we weren’t all in the clinic at the same time”

Biggest Challenge

slide-34
SLIDE 34

34

CII/CPAR

OPTIMIZE INFORMATION EXCHANGE FOR CARE DELIVERY

slide-35
SLIDE 35

35 35

Ottewell Medical Clinic’s CII/CPAR Journey

slide-36
SLIDE 36

36

Gabriel Molley,

PMA/EMRc - ESPCN

Alma Woronuk,

Clinic Manager

OTTEWELL

  • Dr. D. Millard

Leslie Bortolotto,

Improvement Facilitator - ESPCN

  • Dr. C. Safranovich

Madeleine Fraser,

Nurse Practitioner - ESPCN

  • Dr. G. Ahmed
slide-37
SLIDE 37

37

slide-38
SLIDE 38

38

Roles

slide-39
SLIDE 39

39

Process Development

Mismatch report Conflict report

slide-40
SLIDE 40

40

eNotifications

slide-41
SLIDE 41

41

slide-42
SLIDE 42

42

slide-43
SLIDE 43

43

  • Community Encounter Digest identified Dr. Le

as a physician who treated the patient

  • Multiple substance use issues with concurrent

mental health issues

  • Cared for patient while in Poundmaker’s Lodge
  • Medication titration
  • eNotifications
  • Enable follow-up

My Win as a Physician

slide-44
SLIDE 44

44

Lessons Learned

Start with the willing CII/CPAR is a Team Sport

eHealth Support Services

Patience is key: start small and go forward at a pace that works for the team

slide-45
SLIDE 45

45

Getting Started

CoP form emailed to eHealth eHealth Privacy contacts SL to confirm PIA readiness

I’m your eHealth

  • consultant. I’ll

communicate with the Site Liaison and copy the PCN through go- live Let’s talk about your PIA

slide-46
SLIDE 46

46

Moving Forward

Log into CPAR Download Demographic Mismatch and Panel Conflict Reports Identify Team Roles and Responsibilities Draft process for managing Panel Conflicts

slide-47
SLIDE 47

47

Add Chart Note Discuss patient attachment Ask patient to complete Panel Confirmation (PC) Form Save PC Form to the patient’s chart Fax PC Form to the clinic(s) Receiving clinic removes patient from their panel list

Panel Conflict Management Process Improvement

slide-48
SLIDE 48

48

Challenges

  • Failed encounters due to a dash in the field for

Average BP

Only one Netcare Note was getting uploaded

Consult with Physician Specialist Patient Visit Consult with Pharmacist

  • Issue with uploading multiple patient

encounters on the same day; only one Netcare Note was getting uploaded

slide-49
SLIDE 49

49

Benefits

Can CII/CPAR enhance the data that physicians already have access to through the HQCA’s Primary Healthcare Panel Reports?

YES!

slide-50
SLIDE 50

50

Where are we at?

slide-51
SLIDE 51

51 51

301

Physicians

221

Family Physicians

80

Specialists

152

Allied Health Providers LIVE CLINICS

79

As of May 2020

CII/CPAR Across the Province

slide-52
SLIDE 52

52 52

Edmonton Zone CII/CPAR Milestones

  • 5. 2019 Edmonton North

1st PCN to form a CII CPAR engagement team

  • 7. 2020 Edmonton Southside 1st PCN to host a

zone wide engagement webinar (TODAY!)

  • 6. 2020 Edmonton West Edmonton Zone Physician

Champion goes live!

  • 4. 2019/20 Edmonton Oliver, WestView

1st Accuro test site

  • 3. 2018 Leduc Beaumont Devon

1st clinic to go live on CII/CPAR in testing phase

  • 2. 2017 St Albert Sturgeon – 1st PCN geriatric clinic

live on CII in test phase

  • 1. 2017 Sherwood Park Strathcona County 1st PCN

Clinic live on CII in test phase (won an award!) 2 5 7 6 4 3 1

slide-53
SLIDE 53

53

How do you get involved?

slide-54
SLIDE 54

54

CII/CPAR Prerequisites

  • 1. Netcare Live
  • 2. PIA is up to date
  • 3. Panel Ready

(for clinics with panels)

  • 4. Conformed

EMR

slide-55
SLIDE 55

55

Plaxedes Mhandu pmhandu@enpcn.com

AMA Consultant

Sheena George sheena.george@albertadoctors.org

PCN Support PCN

Sherwood Park

  • St. Albert

Sturgeon Edmonton North Edmonton West Westview

Leduc Beaumont Devon Edmonton Oliver

Edmonton Southside

Leslie Bortolotto Leslie.Bortolotto@espcn.ca Duncan Maguire DuncanM@saspcn.com Neil Neary neiln@saspcn.com Tracee Daschuk tdashchuk@eopcn.ca Sandee Foss sandee.foss@lbdpcn.com Anita Dalueg anita.dalueg@westviewpcn.ca Leeca Sonnema leeca.sonnema@ewpcn.com Farah Albert faraha@sherwoodparkpcn.com

Angille Heintzman angille.heintzman@albertadoctors.org Kylie Kidd Wagner kylie.kiddwagner @albertadoctors.org

slide-56
SLIDE 56

56

Questions?

slide-57
SLIDE 57

57

Thank you for Participating!

  • Get tools & resources from tonight: edmontonsouthsidepcn.ca
  • Register for other CII/CPAR events: actt.albertadoctors.org
  • Complete our session survey:
  • Click on the link in the Q&A box
  • Or use the QR Code
slide-58
SLIDE 58

58 58

Edmonton Zone PCN Deployment Status

Data supplied by eHealth Support Services June 10, 2020

slide-59
SLIDE 59

59

Panel Conflict Report

Report Headers Column Headers Conflicting provider is also participating in CPAR

slide-60
SLIDE 60

60

Demographic Mismatch Report – 2 pages

Date of Death

1 2 3 4 5 12345-1234(AB) 12345-2345(AB) 23456-3456(AB) 34567-4567(AB) 67891-3579(BC)

5 mismatches

slide-61
SLIDE 61

61

eNotifications

  • CPAR paneled patient has an ED

visit, hospital admit/discharge or day surgery from AHS facilities in Alberta (including urgent care)

  • Delivered twice daily at 6 am and

2 pm, 7 days a week

  • Appear similar to lab reports in

the EMR Example from Med Access

slide-62
SLIDE 62

62

eNotification - Example

Info includes:

  • Pt demographics
  • Facility location
  • Date/time
  • Attending provider
  • Admission reason
  • Additional providers

notified

If a patient is paneled in CPAR to more than one provider both providers receive the eNotification

The notice remains in a patient chart similar to a lab result.

slide-63
SLIDE 63

63

CED Sample

Community Encounters

  • Encounter Date
  • Location
  • Provider Name/Role
  • Reason for Encounter
  • Clinical Assessment

Health Concern History

  • Encounter Date
  • Health Concern
  • Provider Name
  • Source (clinic)

Possible Allergy

  • Encounter Date
  • Possible Allergy
  • Provider Name
  • Source (clinic)

Measured Observations

  • Encounter Date
  • BP, Height, Weight, Waist

Circumference

  • Source (clinic)

Referrals

  • Type
  • Request date
  • Occurrence date
  • Source (clinic)

Immunizations

slide-64
SLIDE 64

64

If we could only do one thing…

“Having a family doctor, being able to access the family doctor, and most importantly, continuity of care with a family doctor, is probably the single most important thing a health care system can provide to its population. ”

  • Dr. Richard Lewanczuk,

Senior Medical Director, Primary Health Care, AHS

High Continuity Low Mortality

slide-65
SLIDE 65

65

  • Take steps to identify your panel of unique,

unduplicated patients

  • Review and actively manage your panel size.
  • Identify and focus on sub populations who may benefit

most from continuity (e.g., elderly patients, vulnerable populations,

and those with complex needs or multiple chronic conditions).

Relational Continuity CPG – 3 of 9 Recommendations

EMR

slide-66
SLIDE 66

66

Panel Conflict Management - Considerations

Rights of Albertans Approaches to Panel Conflict Management Physician Choices

05

slide-67
SLIDE 67

67

Panel Conflict Management – Albertan Rights

Rights of Albertans

05

  • Right to seek care wherever they choose
  • Choose to seek care from multiple providers, even if it is

not in their best interest

  • Some patients have legitimate reasons for seeking primary

care from multiple providers

  • Acknowledge and offer coordination
  • The message is not that Albertans have to choose one

physician – rather they should:

  • Have a trusting, ongoing therapeutic relationship
  • See that provider and team as the “quarterback” of

their care.

  • Always try to see that provider and team first.
  • When they see other providers make sure their

primary provider and team is aware

slide-68
SLIDE 68

68

Panel Conflict Management – Physician Choices

05

  • Right to establish a panel relationship
  • Right to have a closed or open practice
  • Accepting or not accepting new patients
  • Manage their panel size
  • This new information does not absolve a

physician of their responsibilities when it comes to ending a patient relationship. Physician Choices

slide-69
SLIDE 69

69

Panel Change Notification

Visit: actt.albertadoctors.org