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Third Edition - January 2015
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FAMILY DOCTOR EDUCATION AND NETWORKING
The Vancouver Division of Family Practice (VDoFP) IT (Information Technology) Committee continues to provide Vancouver Family Doctors with the best value and greatest return on investment (ROI) for their Electronic Medical Records (EMRs). We continue to coordinate a number of initiatives that will assist and support the use of EMRs. The Committee recently planned a workshop on improving patient outcomes through enhanced mining of accurate data and how it relates to data quality and standards. The workshop, titled "How to Practice Better/Faster with your EMR", to be held on January 28, 2015, will allow individualized EMR mentors to set members up for e-prescribing, e-referral and more. To register, click here.
Additional Committee initiatives include:
- Train the Trainer: Using data collected through our recent Medical Office Assistant (MOA) survey, a program proposal will be developed to provide support for MOAs through EMR-specific user groups.
- EMR Communications: Improving communication materials to provide additional information about EMRs to members, while working collaboratively with other Committees at the VDoFP.
- Pathways: Supporting the Pathways project (for additional info on Pathways, click here).
- IT Forms: Developing a few common forms for specific EMRs (Profile, Med Access, Wolf and Oscar) to share with members.
In collaboration with UBC's Continuing Professional Development (CPD) department, the Maternity Committee is applying for ethics approval to provide data from Perinatal Services BC (PSBC) to doctors participating in the October CME on genetic screening. This data would include the number and type of genetic screening tests ordered in comparison to industry benchmarks.
WE NEED YOUR INPUT: MOA SURVEY
Through recent surveys, our members have made us aware of the different aspects of interaction between MOAs and Family Doctors in practices that can increase efficiency. To better gauge MOA needs and appropriately craft our learning sessions, the IT Committee/Attachment Team has developed a survey and your input would be invaluable. Please share this with your MOAs. For information to share with your MOA about participating in this survey, click here.
EMR USER GROUPS
The EMR User Groups are now in full swing. We have four regular User Groups set up that include Med Access, Profile, Oscar and Wolf. We had record attendance at the second meeting of the Oscar User group on Dec 11th. More than 30 attendees, including physicians and MOAs, worked through a fun-packed agenda. We ask participants to complete evaluations at the end of each session, so we know what works and what needs improvement. We are also in the planning stages of incorporating Continuing Medical Education (CME) accreditation into these User Group sessions. As a reminder, we need a minimum of eight members in attendance to continue to hold these sessions. Please send any feedback to Satnam Sekhon, so we can enhance these EMR sessions. We are also looking to recruit Oscar User Group Leads (a doctor who can lead the development and facilitation of the Oscar EMR user group sessions with the support of VDoFP staff who will be remunerated for his/her time). To express your interest or to register for our next group, contact Marcel Bosio. If you are passionate about IT, we want you on our Committee. Contact Satnam Sekhon.
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MEMBERSHIP PROJECTS
Word is getting out about Pathways! JTJ Consulting Inc., hired by the VDoFP to manage the implementat
ion of this valuable online resource, has been providing regular demons
trations and answering memb
ers' questions at VDoFP events
such as the AGM, Doctor's Lounge series, and Committee meetings.
 Members should watch for Pathways at upcoming events and look for regular updates in FastFacts and on the Pathways page here. Pathways is a proven, effective online referral tool. It is also a comprehensive information resource that incorporates best practices, decision tools, patient education materials, practice pearls, red flags and Specialist referral forms. Six VDoFP Continuity of Care Committee members were recently welcomed to the Pathways Implementation Team to ensure that the tool's resources are up-to-date and relevant to Vancouver Family Doctors, and that the greatest number of Specialists and clinics are included in the database. Doctors Nardia Strydom, Rita McCracken, Jessica Otte, Joy Russell, Joanne Yang and Dan Pare will be working with Dr. Fiona Duncan to develop guidelines for the selection of resources and to provide expert advice and outreach support for the introduction of Pathways. We are extremely grateful for the dedication, expertise and generosity of these Pathways advisors. Pathways data collection and entry is proceeding well. 860 Vancouver Specialists have returned their surveys to date. The team is now enrolling Vancouver Division members to use the system when it launches in March 2015. Our Division members can become Pathways users at no cost through funding from the GPSC. JTJ Consulting will invite members via email and fax, within the next four weeks, to obtain and activate their Pathways access keys. Members should watch for an invitation, and should encourage their colleagues, who are not yet members, to join the Vancouver Division so they can take advantage of Pathways. Stephen Torrence, Pathways Implementation Lead, welcomes all enquiries. Please contact him at
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All Residential Care Committee Programs, though at different stages, are providing excellent learning opportunities. The Mentorship Pilot Program was completed and the initial learning document was submitted to the Board in late 2014. Through this pilot, four new Family Doctors have extended their practice to include residential care and 82 Residents (new to residential care) have been assigned to experienced physicians. All mentors who participated in the project said that they would be interested in mentoring other physicians in the future. This pilot program has been approved by the Board as an ongoing program. Funding has been provided for three more mentorship pairs.
PALLIATIVE CARE PSP MODULES
The Residential Care Committee has been working closely with PSP, VCH's Home Hospice program, and UBC Community Geriatrics to develop a PSP-type module on
 palliative care in residential care facilities. Both learning sessions have been completed and facility improvement project work is ongoing. Project impact data will be collected over the next six months.
ENHANCED HOUSE PHYSICIAN NETWORK The Residential Care Committee's Enhanced House Physician Network Pilot includes five participating physicians and has been underway since December. Preliminary program feedback has been positive.
DINNER MEETING
Initial planning has been completed for the next Residential Care Committee dinner meeting, which will be held on January 27th. Dr. Liz Drance will be speaking about the management of challenging behaviour related to dementia in residential care. For more information about this Committee, please contact Jaimie Ashton.
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The Membership Committee's objectives are determined by our member needs. Each project and program begins with a single member idea. Throughout the implementation process, members are involved and take ownership of initiatives to ensure they are practical and sustainable for medical practice. Out of these ideas, the Membership Committee recently formed two new subCommittees: "The Doctor's Lounge Advisory Committee" and the "Resident and New to Practice Committee." These Committees focus on developing sustainable and impactful resources and tools for members. Continue reading to find out more about these Committees, what they do, and how you can get involved. Read more below to check out what projects we are working on.
New Family Doctor Casual Social Event
The VDoFP strives to support Family Doctors in Vancouver to improve various aspects of Family Practice. Dr. Simon Moore a VDoFP member and planning leader for this event, told us that Family Doctors can feel isolated at the beginning of their careers.
Hospital Doctor's Lounges used to be social hubs for Family Doctors, but now there are limited opportunities to connect and share ideas. We hosted the first social networking event in November to improve collegiality among new Family Doctors and Residents in Vancouver. More than 30 Family Doctors, Residents and VDoFP staff attended the event to network, share ideas, exchange information and learn about resources available to them through the VDoFP. Based on the success of this event, the Membership Committee is looking into planning regular events like this for our members. If you have any novel ideas on how we can make events like this even better, contact Halla Elmobayad.
DOCTOR'S DEN
If you haven't already heard, the VDoFP can provide small project funding through our Doctor's Den program (click here for more info). Below is a list of all our ongoing member projects. More information on these projects, including clinical resources and tools, will be available through our VDoFP Clinical Dropbox tool in the weeks to come. Colleen Kirkham: "Sexual Health Education Lunches: a pilot project to create a liaison between community Family Doctors and their local high school(s)" Daniel Ngui: "The Vancouver Division of Family Practice FP Clinical Dropbox. The Quintessential Family Practice Tool for the Next Century" Daniel Ngui: "Supporting & Enhancing Patient Attachment and Quality of Doctor/Patient Attachment by Optimizing Chronic Disease Management in Family Medicine using an EMR Dashboard" Ellen Wiebe Telemed: "Telemedicine for city doctors: Seeing family practice patients by Skype (A pilot project)" Eric Cadeksy: "MeKeeper: the accurate, secure and mobile patient health record"
Doctor's Lounge Advisory Committee (subCommittee of Membership Committee)
Another significant component of the Membership Committee's directive is to create, enhance, and master the art of Family Doctor networking, mentorship and knowledge exchange. The Doctor's Lounge CME Series, which aims to connect Family Doctors through interactive learning and informal mentorship, aligns with the Committee's directives and the sessions are run BY Family Doctors FOR Family Doctors. Based on high levels of interest from our members, our second Doctor's Lounge series will focus on chronic disease management (CDM),  expanded services and billing. This 2.5 hour, Mainpro-C interactive workshop will be delivered in an interactive and informal environment on February 5 th, 2015. The five topics that will be addressed include: 1) Chronic Disease Management, 2) Complex care, 3) Mental health, 4) Attachment - A GP for Me, and 5) Phone consults and home visits. Contact
Dropbox Editorial Board (subCommittee of Membership Committee)
During October 2014, the Editorial Board met to do a mass review of over 250 member submissions to determine what tools and resources should be included in the November tool update. Vancouver Division members, who sit on the Committee, collaboratively reviewed each submission to ensure that only relevant, reliable and appropriate materials would be made available to members. In November, the Committee released its update, which members now have full access to. If you haven't already signed up for the tool, you can do so by contacting Halla Elmobayad, it only takes a few seconds to send an email and sign-up for this at-your-fingertips tool!
Because of its high utility in the clinic setting, its practicality and its ease of access, other regional Divisions have shown interest in accessing the Clinical Dropbox tool and have approached us. Discussions and negotiations are currently in progress. Watch our Communiqué and FastFacts for ongoing updates.
Resident and New to Practice Committee (subCommittee of Membership Committee)
The Membership Committee has formed a Resident and New to Practice Committee for the New Year to address the growing needs of Resident and new to practice (0-5 years) members. The Committee will support local Residents and new-to-practice Family Doctors and address their needs as they transition to practice in Vancouver. The Committee's activities will range from social and networking events to mentoring and educational activities, involvement in the Doctor's Lounge and the creation of resources. We are excited about the ideas that this new Committee will bring to the VDoFP. Committee members will consist of individuals who are Vancouver Residents and Family Doctor members in the first five years of practice. The VDoFP sent out a call in FastFacts and asked applicants to submit expressions of interest by Jan 14th, 2015. The Committee received many applicants and is now in the process of reviewing applications. An announcement will be made in an upcoming FastFacts. If you're interested in what the Membership Committee and any of its subCommittees do, and have ideas to share, email Halla Elmobayad.
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"There's always gonna be those who are resistant to change. And there's gonna be people that are pushing change forward, like our committee."
Dr. Damon Ramsey,
IT Committee
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The Continuity of Care Committee (CCC) is focused on building better relationships with Specialists, health authorities and hospitals to improve the patient's journey through the healthcare system.
SUPPORT FOR PATHWAYS
The CCC has been working closely with the Pathways Implementation Team to ensure that, upon launch, the quality and quantity of information in Pathways makes the tool immediately valuable to Family Doctors. Committee members are choosing the resources available to Vancouver Family Doctors on the Pathways home page, providing  guidance on how to present Specialist and clinic data and convincing reluctant Specialists to participate in this important project. There will be ongoing opportunities for members to be involved with Pathways, so stay tuned for more information as the launch date approaches.
TELEMEDICINE WHITE PAPER
The CCC has completed its white paper on Telemedicine, which explores the current research and literature around the use of Telemedicine in Family Practice and its impact on the Triple Aim. Given the growing importance of this topic within BC, the CCC is creating its second Telemedicine white paper, with a focus on best practices around video conferencing and family medicine. Evidence suggests that telemedicine can improve the patient experience of care by increasing access to healthcare, maintaining the patient's proximity to their social network, reducing travel time and costs, increasing timeliness of care, increasing communication and coordination of care, and educating both patients and care providers. Understanding the current uses, benefits, challenges, barriers, opportunities and risks of Telemedicine is a key concern to those seeking to access and provide primary healthcare To read the full white paper, click here. The executive summary is also available here.
CURRENT PROJECTS TO IMPROVE FAMILY DOCTOR-SPECIALIST COLLABORATION The CCC continues to participate in many important projects that strengthen relationships between Family Doctors and other healthcare providers, including a single Cardiology referral form, restoring Family Doctor phone access to VGH ER physicians, RACE line expansion and identifying solutions to the current difficulty with referrals to Vancouver area gastroenterologists.
2015 STRATEGY SETTING
The CCC is creating its 2015 strategy, which will include ideas such as Family Doctor-Specialist forums, ongoing participation in health authority and hospital projects to provide a family doctor perspective, and research on topics that impact our members and their relationships with Specialists.
Given the above, 2015 is set to be a very impactful year for the CCC. We encourage members with a passion for our mission (and the above initiatives in particular) to contact Brian Rowland.
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The Attachment Team submitted the
"Attachment (A GP for Me)" Implementation Proposal to the GPSC's "A GP for Me" Working Group on August 27th, 2014 and it was approved on September 17th, 2014. In summary, the plan focuses on three strategies:
- Strategy 1 - Family Doctor Recruitment and Retention aims to maintain continuity of care for patients whose Family Doctors will be retiring in the next two to five years. The Attachment Team will help retiring doctors transition their practices to new doctors, optimize their practice and encourage them to mentor and coach potential replacement doctors. New or incoming doctors interested in taking over a Family Practice will be matched with retiring doctors, whose practice model is in line with the new physicians' professional interests.
- Strategy 2 - Practice Modelling will focus on improving models of practice to increase patient access to primary care. The Attachment Team will assist doctors and their clinics to increase practice efficiencies and clinic optimization, develop a model to better integrate interdisciplinary care teams into clinics, and improve after-hours patient access.
- Strategy 3 - Connecting Patients will address challenges in finding a Family Doctor and help citizens and patients connect with appropriate, available healthcare providers in Vancouver. The Attachment Team will work in partnership with VCH and PHC to develop a coordinated, streamlined process to accomplish this.
A robust Attachment Resource Team, which includes business analysts, billing coaches, super MOAs, and PSP coaches, has been working to help with the implementation of the plan since mid-September. The Vancouver Division is now implementing the Attachment Strategy through three Committees.
The Strategy 1 and 2 Assessment and Selection Committee first met in October to finalize the process
to assess and select Family Doctor offices for participation in the Attachment Initiative. Family Doctors interested in participating
 applied by completing the Attachment Assessment Tool, which was sent to all our Division members in mid-October. The Committee reviewed the applications and shortlisted nine clinics for Strategy 1 and 19 clinics for Strategy 2. The Attachment Resource Team is currently working with each of the clinics to complete an on-site comprehensive assessment, with the expectation to select the initial clinics and develop plans for each of them by the end of January. Clinics not selected to participate will have access to the GP Toolbox, which will hold individual strategies and ideas that may be utilized by any office without the support of the Attachment Resource Team. The Attachment Resource Team also visited practice reference sites to begin collating and analyzing potential strategies and trends that will populate the GP Toolbox. This has informed the process of assessing clinics selected for Strategies 1 and 2. The Strategy 3 Committee is currently reviewing challenges within the system and identifying barriers that must be overcome to connect patients to Family Doctors. This year's goal is to work with health authority partners to develop a matching mechanism and begin identifying patient populations to connect with the appropriate and available primary care providers in Vancouver.
The Evaluation Committee, led by evaluator Marla Steinberg, is working to refine the evaluation methodology and to ensure that the GPSC overall "GP for Me" evaluation metrics are incorporated into the plan. For more information contact Rose Gidzinski.
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Mental Health Committee VDoFP members and the Vancouver Coastal Health Authority are committed to enhancing the mental health system of care in Vancouver through a variety of projects, including the Emergency Care journey from home to Family Doctor to hospital. To achieve this, we have continued to work with VCH on a pilot program that brings a behaviour specialist to two member clinics in Vancouver. This has been very successful and the Committee is looking for funding to spread this successful model to other Division members.
Both VCH and Providence have started a review of their mental health services and capacities. The Vancouver Division is asking to be included as a main stakeholder in the steering Committees and working groups for the review and recommendations. As the work unfolds, we will update our Division members as appropriate.
Please contact Ali Ledgerwood
for more information.
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"It's not just about recording information. It's about communicating information. It's about connecting things that before were not connected when they were on paper."
Dr. Damon Ramsey, IT Committee
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PHYSICAL EDUCATION
The CME events in September (Early Prenatal Care - repeat session), October (Prenatal Genetic Testing) and November (Hot Topics in the First Year of Life) were filled to capacity and received positive reviews from participating physicians.
Interest in this series of events continues to grow. A workshop on Initial Postpartum Care will be offered at the VGH Post Graduate Review for Family Medicine conference in February 2015. An abstract submitted by UBC Continuing Professional Development (CPD) describing the Maternity Care CME series, titled "Building a Maternity Care Network in Urban Family Practice Through CPD", has been accepted for an oral presentation at the 2015 Canadian Conference on Medical Education in April. Other Divisions are also interested in using the syllabi to mount their own primary care maternity CME events.
In collaboration with the UBC CPD, the Committee received ethics approval to provide test ordering data from PSBC to doctors that participated in the October CME on Genetic Screening. This data, and follow up data on the number and type of genetic screening tests ordered, compared to benchmarks, will inform a study to be published next year. Dr. Lai is the liaison for the Committee for this research study.
Collaboration with VCH Physician Support Program (PSP)
So far, 82% of the 281 participants in the CME event series have completed Commitment to Change forms. To date, 88 unique individuals have followed up and engaged with PSP for support with improving the maternity care aspects of their practices. The top five themes for support are:
- EMR Support Implementing Templates for Maternity Care
- Automation and Office Efficiencies
- References & Handouts & Websites
- Vancouver Division of Family Practice Prenatal Summary Checklist
- Latest Maternity Care Routine Guidelines:
a. EMR Prenatal Templates Flow Sheet b. Sleep & Nutrition Handout c. Counselling d. Latching e. Patterns in Sleep f. Breastfeeding
Building a Network
The Maternity Care Provider Network List now has 65 members and is
 growing. It has been circulated to participants in the CME events and made available to members via the Vancouver Divisions' Dropbox. The purpose of the list is to facilitate referrals to Family Doctors who provide maternity care. The Committee met with the Pathways implementation team and worked out a timeline for adding maternity care information for Family Doctors in the category of "GP Specialists". This feature is expected to be in place by mid-2015. The Committee is in planning discussions about a public-facing resource (e.g. website) to facilitate patients finding Family Doctors for maternity care that would complement the private Pathways resource. For more information on this Committee, please contact Mike Rowlands. |
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Check out our whiteboard video that explains everything you need to know about the VDoFP!
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