2015 Annual Report - Divisions of Family Practice

Annual Report
Board and Committee reporting period
November 2014 to October 2015
Fiscal Year reporting period
April 2014 to March 2015
Vancouver
Acronyms
Chronic Disease Management (CDM)
Continuing Medical Education (CME)
Electronic Medical Record (EMR)
First Nations Health Authority (FNHA)
General Practice Services Committee (GPSC)
Medical Office Assistant (MOA)
Physicians Data Collaborative (PDC)
Practice Support Program (PSP)
Providence Health Care (PHC)
Society of General Practitioners (SGP)
The College of Family Physicians of Canada (CFPC)
University of British Columbia (UBC)
Vancouver Coastal Health (VCH)
Tel: 604.569.2010
Fax:604.321.5878
[email protected]
www.divisionsbc.ca/vancouver
Vancouver
Vancouver Division of Family Practice
Membership
Committee
Residential
Care
Initiative
Information
Technology
Committee
Mental
Health and
Addictions
Committee
Continuity
of Care
Committee
Pathways
Leadership
Team
Evaluation
Committee
Primary
Maternity
Care Network
Committee
Attachment
(A GP for Me)
Residential
Care
Committee
MISSION
The Vancouver Division of Family Practice will improve the primary care system in
Vancouver for the benefit of Vancouver citizens, patients and Family Doctors.
GOALS
Our commitment to Vancouver Family Practice patients – We will address gaps
in care and improve the primary health care system.
Our commitment to Vancouver Family Doctors – We will engage Family Doctors
and support them in improving ways in which they practice primary care in
Vancouver and enhance their professional satisfaction.
Our commitment to Vancouver Community – We will increase Family Doctors’
influence on health care delivery and policy to bring about improved care and
health for all segments of our community.
S T R AT E G I C P R I O R I T I E S
1.Improve and increase communication between acute care providers, primary
care providers and other specialists.
2.Improve the system of care, including timely access, gap identification, reduction
in duplication of services and tests.
3.Increase member satisfaction, collegiality, and knowledge.
4.Enhance the relationship between Family Doctors and patients.
The Vancouver Division of Family
Practice began serving local Family
Doctors on June 24, 2010. It is a
not-for-profit society led by and for
Vancouver area Family Doctors, funded
by the General Practice Services
Committee (GPSC), a joint committee
of the BC Ministry of Health and
Doctors of BC.
All local community-based Family
Doctors are welcome to become
Division members. Currently the
Vancouver Division has 945 members
in the city of Vancouver. Membership
is voluntary and open to any Family
Doctor and Family Medicine Resident,
with or without hospital ­privileges,
using various payment models and
providing specialty care (obstetrical,
emergency room, ­hospitalists and
walk-ins).
Our mission is to improve the primary
care system in Vancouver for the
benefit of citizens, patients and Family
Doctors. We pursue these goals in
­partnership with Vancouver Coastal
Health (VCH), Providence Health Care
(PHC), the BC Ministry of Health and
other community partners.
5.Improve the relationship between the Vancouver Division and stakeholders,
including Vancouver Coastal Health, Ministry of Health, Providence Health Care,
Provincial Health Services, Divisions BC, and other community partners.
6.Provide accountability and evaluation of the Vancouver Division of Family
Practice Board, committees and staff activities.
Vancouver Division of Family Practice
Annual Report 2014/2015
1
Message from the Board Chair
This year has been a time of
­tremendous growth, development
and deep involvement for our
Vancouver Division of Family Practice
members and staff. Our Division is
seen as the vibrant, grassroots voice
of Family Practice, involved in the
complex redesign and renewal of
primary care medicine in Vancouver.
I am humbled by the passion and dedication of our members as
they give their time, extensive knowledge and insight to the many
committees and working groups that represent their fellow members
and our role within primary health care.
I have personally seen the powerful relationships between our
Division and our partners VCH, PHC, GPSC, Doctors of BC and Ministry
of Health, as those relationships have grown and matured. We are
increasingly asked to engage as ­partners in a deeper and more
collaborative dynamic than ever before. Through our c­ ommittees,
we provide expertise and contribute p
­ articipants to the many
new requests we receive from GPSC, Ministry of Health and other
­organizations. I would encourage you to take the time to read the
reports from each committee’s chair to get a sense of the depth and
breadth of ­incredible work we are doing on behalf of our members.
THE KNOWLEDGE
we have gathered
will change how we practice medicine
IN THE FUTURE.
This annual report chronicles the wide range of activities the Division
has engaged in: from maternity care, to seniors and residential care,
from networking and support for our newer physicians, to office
optimization and practice enhancement. We assist in transitioning
new-to-practice and more established physicians through different
phases of their careers. Finally, we will continue to foster improved
relationships with specialists. The Pathways referral database is the
result of one such engagement.
This year Attachment (A GP for Me) and Seniors Care Initiative
represent two of our largest and most resource intensive portfolios.
Attachment was a directive from the GPSC, while the Seniors Care
Model was a Ministry of Health initiative that forged a deep and
respectful relationship between VCH, PHC, regional health ­authorities
and your Division. Through these initiatives we have taken great
care to engage our members. The knowledge we have gathered will
change how we practice medicine in the future.
There is a special sense of satisfaction from working with other Family
Doctors in the service of our patients and colleagues. I thank all of
you for this opportunity and I invite others to join us. Think about
what inspires you and call us to get involved, everyone has a role to
play in improving primary care medicine.
Yours respectfully,
Dr. Terence Chang, MD
Board Chair, Vancouver Division of Family Practice
2
Vancouver Division of Family Practice
Annual Report 2014/2015
Message from the Executive Director
TRANSFORMING HEALTHCARE
In Vancouver, we are committed to
transforming the status quo and
creating the ultimate health care
experience. We do this by placing
emphasis on engagement, action
research and what we do best:
helping to find innovative s­ olutions
to address the Triple Aim
of ­healthcare.
With Our Doctors,
Our People, Our Partners.
We are committed to transforming healthcare relationships by
working with our health authority partners and our other interfacing
stakeholders. Together we endeavor to establish a patient’s medical
home and to create a system of integrated healthcare that is effective
and responsive to the needs of patients and for every member of
their healthcare team.
As a not-for-profit society, we have a responsibility to operate within
our means and to effectively steward our resources. To this effect,
our board of directors has established a proven track record of fiscal
responsibility. This is no small achievement when you consider the
imperative to aggressively address our mission and show value for
investment, while simultaneously incorporating the government’s
new healthcare policy directions.
While this work continues at breakneck speed, we face challenges
promoting the achievements that occur within our existing community initiatives. To overcome this challenge we have established a
dedicated communication function designed specifically to get our
messaging out. Throughout the year you will see the Vancouver
Division of Family Practice communicating with its members and the
public in new ways and with clear messaging about our impact.
For example, in this report you will see a series of icons that reflect
the areas our committees’ work touches.
I would like to formally acknowledge the Board of Directors, and
specifically our chair Dr. Terence Chang, who have been a driving
force behind the Division’s ongoing development. I thank Terry for his
strong leadership and dedication over the last five years of his term.
I wish to thank and express my gratitude to every member of our
staff team. Your strength and commitment to our doctors and this
organization has helped our Division achieve much of its success.
This is both an exciting and a challenging time in healthcare and I
cannot imagine a more able and ready team with which to meet
these ­c­­hallenges head on.
Finally, I wish to acknowledge the dedication of all of our doctors,
the more than 945 Family Doctors and Family Practice Residents in
the Vancouver area that are making a tremendous difference every
day in the health and wellbeing of our citizens. It is a great privilege
to interact with professionals who share a fundamental belief that
health care can be changed and, by extension, improve the lives of
those that live in Vancouver.
Together we have built a highly reliable organization that is
­undoubtedly helping to shape the future of healthcare in
this province.
Respectfully,
Dr. Dave Baspaly
Executive Director, Vancouver Division of Family Practice
TRIPLE AIM
Improved
Community
Health
VANCOUVER DIVISION OF FAMILY PRACTICE WORK
Healthcare
Cost Savings
Better
Patient Care
Improved
Physician
Experience
System
Change
Innovation
Knowledge
Transfer
Vancouver Division of Family Practice
Clinic
Support
Network
Building
Annual Report 2014/2015
3
Our Team
Board of Directors & Roles
Dr. Terence A. Chang – Board Chair
Dr. Fiona Duncan – Vice-Chair
Dr. Patricia Mirwaldt – Physician Lead
Dr. Jim Thorsteinson – Treasurer
Dr. Kaiyo Nedd
Dr. Terence A. Chang
Dr. Fiona Duncan
Dr. Patricia Mirwaldt
Dr. Renee Fernandez
Dr. James Lai
Dr. Margaret McGregor
Dr. Daniel Ngui
Dr. Nardia Strydom
Dr. Jennifer Leavitt
Dr. Jim Thorsteinson
Dr. Kaiyo Nedd
Dr. Renee Fernandez
Dr. James Lai
Dr. Margaret McGregor
Dr. Daniel Ngui
Dr. Nardia Strydom
Dr. Jennifer Leavitt
Operation Leads
Dr. Dave Baspaly – Executive Director
Ms. Cheryl Hogg – Chief Operating Officer
Ms. Martina Nova – Office Administrator
Dr. Dave Baspaly
4
Ms. Cheryl Hogg
Vancouver Division of Family Practice
Ms. Martina Nova
Annual Report 2014/2015
Major Events 2014 – 2015
2014
OCTOBER
NOVEMBER
Clinic Visits and Interviews with GPs and practices
CME: But I don’t do maternity care!: “Hot Topics in the First Year of Life”
DECEMBER
CME: Doctor’s Lounge Tech Tips
JANUARY
FEBRUARY
MARCH
2015
Oscar: Top 10 Problems that Annoy Oscar Users
Call Out to GPs to participate in Practice Optimization Work
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
Committee colour legend
Information Technology
Committee
Dropbox Lunch and Learn Session Pilot
CME: Insulin Initiation PSP Collaboration CME
IntraHealth: Open Mic Session
Oscar: ODD
Wolf: Billing Part 2
Dinner Meeting: It Takes Two to Tango: Using PIECES to understand physically
and verbally responsive behaviors during care
Membership Committee
Residential Care Initiative
Continuity of Care
Committee
CME: Doctor’s Lounge CDM Management
CME: Workshop at Post Grad Review in Family Medicine: “Postpartum Care”
Clinic selection and Development of Scope of Work for Individual Practices
New to Practice Networking Event
MedAccess: Getting the ODD in 10 Steps
IntraHealth: ODD II
Oscar: Last Call for ODD
Wolf: Updating Medical Summary
Attachment Initiative
Primary Maternity Care
Network Committee
Pathways Leadership Team
Dropbox Program Launch
Speaker Series: Fixing Primary Care
CME: But I don’t do maternity care!: “Prenatal Genetic Screening”
Focus Group: Referral and Attachment process
Oscar: Open Mic
IntraHealth: Last Call ODD III
Launch of Pathways
Seniors Care Initiative
CME: Doctor’s Lounge CDM Management
Oral presentation: 2015 Canadian Conference on Medical Education
Implementation of Practice Optimization Work by Business Analysts and Practice Management Consultants
Wolf: CDM
Resident and New Doc Social
CME: But I don’t do maternity care!: “Postpartum Care”
Billing Workshop attended by GPs and MOAs
MedAccess: Macros and Templates
Intrahealth: CDM
Oscar: Templates and Setting up Measurements
Dinner Meeting: GPSC Residential Care Funding Program Overview, Eligibility Criteria & Planning Session
Resident Focus Group – (2 sessions)
CME: Dine and Learn – Community Resources for the Frail
Wolf: Referral Management
Oscar: Optimizing E Forms
Seniors Care Initiative: Primary and Community Care Forum – From Strategy to Execution * 2 days
Open House
CME: Doctor’s Lounge Physician Mindfulness
CME: GPSC Visioning Event (2 sessions)
CME: GPSC Visioning Event
Speaker Series
Launch of PregnancyVancouver.ca
MedAccess: How to Find the Data You Need
Oscar: Back To Basics: Proper Charting
Intrahealth: Finding Groups and Objects
Seniors Care Initiative: Primary and Community Care: Seniors Model Discussion
Member Social & AGM
CME: But I don’t do maternity care!: “Mental Health in Perinatal Care”
New to Practice Billing Workshop (GPs Only)
Wolf: Patient Portal
IntraHealth: Billing Tips and Tricks
CME Event: Polypharmacy Risk Reduction for our Growing Frail Elder Community
Vancouver Division of Family Practice
Annual Report 2014/2015
5
(A GP FOR ME)
Better
Patient Care
ATTACHMENT STATS:
131
Number GPs Engaged
71,405
Patients Impacted
9,301
Capacity to Attach Patients Identified
4,609 Patients Attached/Remained Attached
This year the Attachment Committee brought together a
team of GP champions, health authority partners, community
partners, business analysts, practice management consultants
and other subject matter experts to implement the proposal
that was approved in September 2014 .
Our focus has been to achieve the goals set out by the
­provincial A GP for Me Initiative through three strategies:
recruitment and retention, practice optimization and patient
matching. Committees for the three strategies were tasked
with building models and consulting on our approach for
each strategy.
A robust evaluation framework has been developed to
capture physicians, patients and partners’ experiences and
measure whether the initiative has been able to:
• Confirm and strengthen the doctor-patient relationship,
with special consideration given to vulnerable patients
• Enable patients who want a Family Doctor to find one
• Increase the capacity of the primary health care system
Vancouver Division of Family Practice
Improved
Community
Health
Innovation
System
Change
Clinic
Support
PARTNERSHIPS
A GP FOR ME 2015
6
Healthcare
Cost Savings
Annual Report 2014/2015
We have continued our partnerships with VCH and PHC
and have built strong relationships with First Nations
Health Authority (FNHA), Musqueam Indian Band, City of
Vancouver, the University of British Columbia (UBC) Faculty
of Pharmaceutical Sciences and the Society of General
Practitioners (SGP). We collaborated with the City of Vancouver
and FNHA to assist Lu’ma Native Housing Society in creating
a model for their new health clinic and to recruit Family
Doctors for their facility in East Vancouver. The clinic will
provide services to both Aboriginal and non-Aboriginal
Vancouver citizens beginning this fall. Additionally, through
­consultation with the SGP and continued partnership with the
UBC Pharmaceutical Sciences, our team is actively developing
sustainable models to help integrate allied health providers
into family practices.
SUCCESS
We are successfully matching new-to-practice Family Doctors
to retiring doctors. We have been able to address the goals
and objectives of our project plan within our practice
­optimization strategy and we continue to attach patients
through our Patient Matching Mechanism.
Our success has been the result of strong relationships built
with our members, based on a level of mutual trust and
respect for each others’ unique skills and on ­understanding
the need to work collaboratively to achieve our goals.
The partnerships between our attachment team and our
members, and the development of tools to assist us in
our work, have allowed us to engage with each clinic and
­accommodate their particular needs, creating capacity and
engendering change across the system.
STRATEGIES
RECRUITMENT & RETENTION
Guided by our GP champions, our team developed two
approaches to assess, document and categorize the needs of
retiring Family Doctors and new-to-practice Family Doctors
seeking support. Our team’s interactions with Family Doctors has
been valuable as we were able to experience and learn how to
­practically address the needs of our Family Doctors who are in the
­transition phases of their careers.
We have engaged 28 Family Doctors at various stages of
­retirement. For some, we have placed locums into short and long
term positions, with the potential for taking on their practice. For
imminently retiring Family Doctors, we have created a process for
connecting patients from closing practices to new doctors with
capacity through patient education materials and a file transfer
process. We have also provided practice-improvement support to
prepare practices for new-to-practice Family Doctors to join.
As a result of our research and our experience assisting retiring
Family Doctors, our team has prepared a resource guide to
help doctors plan their retirement more strategically. The “How
to Retire” guide will help Family Doctors map out their plans
to ­transition out of practice, whether through a high-level
­assessment several years before a retirement date, or a granular
step-by-step guide on closing a practice.
Our team’s callout to all Division members to participate in
this strategy was met with overwhelming enthusiasm. Using
a rigorous method of scoring a clinic’s potential to meet the
­initiative’s goals, our team prioritized 12 out of 32 clinics to
provide support to in practice optimization.
We signed memorandums of understanding with the selected
clinics, identified clinic leads and, under the leadership of
our ­business analysts, began developing and implementing
­respective scopes of work for each clinic.
In other clinics we are assisting with the development of
­procedures and resources necessary to improve clinic ­efficiency.
This includes assisting with various human resource issues;
creating policies, procedure manuals and clinic manuals;
developing financial models; implementing payroll systems;
supporting billing optimization and financial forecasting;
business and strategic planning; building networks for shared
resources; and training Family Doctors on best business practices.
PATIENT MATCHING MECHANISM
Through engagement events and peer referrals, our team has
engaged 26 new-to-practice Family Doctors. These new doctors
will take on locum positions to gain a better idea of whether they
would like to take over, join, or start a practice of their own.
To guide these doctors through the process of taking on
their own panels, our team has developed models that help
Family Doctors navigate the financial commitments of joining
a practice or starting their own, compiled resources to help
in the ­negotiations and connected Family Doctors to locum
­opportunities. Additional resources to assist these doctors are
currently in development, including a financial model that
compares the fiscal gains of taking on a panel with those of
locuming. Our efforts to date have facilitated the transition of a
retiring Family Doctor’s practice to a younger doctor, preserving
the attachment of 1100 patients. Additionally, we have transferred
patients from three retiring ­practices into the capacity created
through recruitment and practice optimization. We have placed
eight Family Doctors into locum positions and identified capacity
for more than 4,000 patients to be transferred.
PRACTICE OPTIMIZATION
With guidance from our business analysts, our practice
­management consultants have been working with clinics to
provide Electronic Medical Record (EMR) optimization, workflow
assessments and processes, billing and Medical Office Assistant
(MOA) training. With our assistance, participating clinics are also
implementing e-booking systems, developing new websites and
utilizing technology to provide more timely care to their patients.
File scanning is being provided at a low cost to offices with
paper charts to help utilize additional space and increase EMR
­operability. Recruitment of staff and allied health professionals,
such as office managers, pharmacists, scribes, etc., has been
­integral to developing clinics that can act as the patient’s
medical home.
We are working closely with our GP champions and partners at
VCH and PHC to develop a streamlined approach for transferring
unattached patients to available and appropriate providers in
Vancouver. Prioritizing more medically complex patients, our
team has focused on building patient referral streams coming
from retiring Family Doctors, maternity providers, outpatient
units and acute wards at St. Paul’s Hospital and VCH community
health centres and public health teams. Teams from each referral
source and Family Doctors helped develop materials used for
these transfers, with feedback and contributions from all levels
of stakeholders.
By creating capacity through recruitment and retention and
practice optimization for new patients, the response from Family
Doctors to taking on new patients through the Patient Matching
Mechanism has been tremendous. To date, 33 Family Doctors
have registered, equaling over 1,300 potential patients attached.
The attachment facilitator (a registered nurse) helps ensure that
those appropriate for care by Family Doctors in the community
have made an appropriate match. The attachment facilitator is
allowed direct access to patient information and contact, which
helps the attachment facilitator match patients to a Family
Doctor with the appropriate skillset, as evident in the following
patient’s experience:
“This service is the best. I was matched with a GP who is
­specialized in addiction. I am so happy to have such an
­understanding, amazing and compassionate Dr. I feel that he
is a good fit for me. So far he has been seeing me weekly for
double the usual length of time. As a result, we have made a plan
together and will ­reassess in 15 weeks’ time as to whether I need
to go to rehab or not. I am feeling really good.”
Vancouver Division of Family Practice
Annual Report 2014/2015
7
Better
Patient Care
Network
Building
GOALS
SUCCESS
The Continuity of Care Committee’s goals for this year were
to further increase connections between our Family Doctor
members and the numerous specialist, health authorities and
hospital partners. We built on prior successes to increase our
participation in health authorities and hospital-led initiatives
and to connect with more specialists and specialist groups to
improve care as patients move between different parts of the
healthcare system.
The Committee is proud to have advanced in all three of its
areas of focus. We are proud of the strategic support it has
offered to the Division’s Pathways initiative. Pathways is a
simple-to-use tool for Family Doctors that greatly improves
the process of identifying the most appropriate specialist
and understanding the referral process. Facing a very tight
project implementation timeline, the Committee worked
closely with the Division executive and the highly capable
project consultants to plan the project and follow its ­progress.
The Committee prioritized the specialist groups to bring
onto Pathways, leveraged relationships with specialists to
encourage their participation and set standards for the use
of Pathways as part of a provincial Steering Committee.
ACHIEVEMENTS
The Committee has focused on three areas to reach its goals
this year: to strategically support Division initiatives, to host
events that connect members with specialists and educate
members on available community resources, and participate
in health authority and hospital initiatives that ensure the
Family Doctor point of view is embedded into those initiatives
and ensure more successful outcomes.
This year, the Committee provided strategic leadership
and oversight to the Division’s successful Pathways launch.
Committee members supported the Division executive and
project consultants with the strategy and tactics necessary to
bring the hundreds of specialists and Family Doctor members
onto the Pathways platform.
As well, the Committee hosted its first Dine and Learn in
­partnership with VCH Home is Best Program. The evening
event, Community Resources for the Frail, brought together
Family Doctors, VCH front-line staff and department directors
to discuss VCH programs to assist Family Doctors in caring
for frail patients in the community. The Family Doctors met in
small groups with the different program leads in 20-minute
rotations. This small group format allowed Family Doctors to
learn more about specific resources, share their experiences
and provide suggestions for improving services.
Also, over the year, many health authority project leads and
department chairs asked for Division member participation
on their projects. The Committee evaluated the requests and
matched the project with a Division member. The member,
supported closely by the Committee, served as the official
representative of the Division on the project team to ensure
that the project incorporates the recommendations of
Family Doctors.
8
System
Change
Vancouver Division of Family Practice
Annual Report 2014/2015
WHAT IS AHEAD FOR 2016?
The Committee will continue to advance its three focus areas.
We will provide strategic support to Division and external
initiatives, such as VCH’s Regional Public Health Program.
The scope of the program encompasses all strategic and
operational decision-making that is regional in nature and
involves public health services throughout VCH, including:
Prevention Services, Communicable Disease Control, Health
Protection, Population Health, Aboriginal Health and Public
Health Surveillance.
The Committee is already planning its second Dine and Learn
this autumn, in partnership with the BC Paediatric Society,
and a third Dine and Learn will take place in the first quarter
of 2016.
As the positive impact of having Division representation on
health authority and hospital initiatives grows, we expect
to have more requests for participation from more project
leads and department heads. We will continue to encourage
requests for project participation and identify interested
Division members for these initiatives.
Better
Patient Care
Healthcare
Cost Savings
System
Change
Knowledge
Transfer
GOALS
SUCCESS
The IT Committee’s focus this year was to improve the quality
of patient care and the clinic experience for both patients and
physicians through the proper use of EMRs by addressing the
adoption, use and interoperability of EMRs in the Vancouver
practice region. In particular, the Committee’s work focused on
physician to physician communication, acute to community
communication and sharing of pertinent patient information
among practitioners.
The EMR user groups have consistently proved invaluable
to our physician community. Our feedback process has
captured topics relevant and timely to our Family Doctors’
needs. It’s also a place where peers meet and learn from each
others experiences.
Information Technology is at the heart of healthcare reform.
The Committee has been focusing on sharpening the skills of
our individual members to use our technology, such as EMRs,
to help in practicing better medicine. This improvement has
spanned the entire spectrum, from new-to-practice to longer
established physicians and their practices.
We held a special, sold out EMR event in September titled:
“How to Safeguard against an Audit”. It highlighted the real
life audit consequences of insufficient documentation. Family
Doctors learned how to effectively document and bill Chronic
Disease Management (CDM) e­ ncounters in their specific EMRs,
which fully satisfy GPSC and Medical Service Commission
(MSC) audit requirements. The sessions also covered how to
use the EMR as a search tool and underscored the importance
of correct and accurate coding of patient information.
The Committee is looking forward, searching out o
­ pportunities
and projects that help shape and model a new and
more efficient ways to deliver healthcare using advanced
­communication and technology tools.
WHAT IS AHEAD FOR 2016?
ACHIEVEMENTS
The Committee has developed a common curriculum to
help facilitate the educational objectives and standards of
­user-group learning sessions for OSCAR, Wolf, MedAccess and
Profile EMR systems. We are working with VCH and the PSP to
make these user groups a­ ccredited for Continuing Medical
Education (CME).
Projects underway to improve proper use of EMRs include:
The Committee’s goals and objectives are dependent on the
proper adoption and development of healthcare technology
from the EMR vendors and the Ministry of Health Provincial
systems. We will continue to deliver learning sessions to
our members, initiative projects that are relevant to gaining
interoperability with other clinical systems and registries, and
provide better patient access to information where practical
and feasible.
In our EMR small-group learning sessions, we want to teach
and inspire our Family Doctors to more fully utilize the full
functionality of their EMR.
• Common EMR forms were developed for OSCAR, Wolf,
MedAccess and Profile and uploaded to Dropbox for easy
access to members
• In collaboration with the PSP Technology Group, the
Committee focused on learning sessions to ensure accurate
data entry into the EMR system and qualify for PSP funding.
• Developed OSCAR report templates and GreaseMonkey
scripts to helps physicians use the EMR.
• A locum training program is underway, with cheat sheets
developed for MedAccess, Wolf and Profile systems. A video
has been collated for OSCAR.
• We have initiated an MOA training program to support our
doctor’s clinics and bring trainers on site to provide EMR
support and training. This is on track and scheduled to finish
in November 2015.
Vancouver Division of Family Practice
Annual Report 2014/2015
9
Knowledge
Transfer
MEMBERSHIP STATS:
945
Total Number of Members
592
Total Number of Members Reached Through Events
54%
Average % of Newly Engaged Members Per Event
Our goal was to continue to recruit and retain members and
provide the best possible services and benefits to Family
Doctors in Vancouver. The Vancouver Division of Family
Practice membership has increased substantially over the last
few years, taking us from approximately 350 members to 945
as of August 2015.
Given our vast membership, our focus for 2014–15 has been
member engagement. Through a series of needs ­assessments
and surveys conducted over the last two years, we identified
core areas that our members are interested in and offered
programming and events to addresses these needs. We
created three subcommittees to better engage membership
and serve their needs: Dropbox Editorial Board, Doctor’s
Lounge Advisory Committee and Resident and New to
Practice Committee.
SUCCESS
We have held a series of Doctor’s Lounge events through
which we have reached over 250 different Family Doctors
since the program was implemented in August 2014. These
quality educational sessions have empowered doctors with
knowledge and expertise in business-related areas, such as
technology and CDM management. Also this year, we have
provided 17 in-clinic Dropbox Lunch and Learn sessions,
where Division staff members provide a customized learning
session with a general practice office. A new set of sessions
will be offered later this fall or early this winter.
Vancouver Division of Family Practice
Network
Building
ACHIEVEMENTS
GOALS
10
Improved
Physician
Experience
Annual Report 2014/2015
Our team has been focused on understanding our members’
needs and creating events and resources that support
them as a more connected and engaged network of
local Family Doctors. Information gathered from several
needs ­assessments and surveys served as the foundation
for all programs and events offered by the Membership
Committee and its three subcommittees. Main topics that
members i­dentified as wanting or needing more support are:
­programming and knowledge transfer in technology support
(non-EMR tools such as mobile apps, digital dictation and
Dropbox), support transitioning into practice, in-clinic support
for the clinical Dropbox tool, billing and CDM support,
­opportunities for networking and informal ­mentorship (across
and among different practice years), and opportunities for
formal and informal knowledge sharing.
In order to enhance the delivery and reach of current activities
and to ensure proper representation on the Committee –
which ultimately enables the Committee to have a deeper
understanding of the diversity of our members – we opened
two new seats on the Membership Committee to better serve
our members, including our growing new-to-practice and
resident cohorts.
WHAT IS AHEAD FOR 2016?
Membership engagement and quality programming will
continue to be the focus of the Membership Committee and
its subcommittees. Given we have the largest number of
Family Doctors and resident members across British Columbia,
it is important for us to continue talking with members to
understand their varying needs. The Dropbox Editorial Board
will continue to focus on ensuring that relevant and recent
information is included in the tool and will explore several
pilot sharing-projects with our sister Divisions. The Doctor’s
Lounge Advisory Committee is interested in physician
­wellness, stress reduction and business management and will
continue to explore programming and tools related to this.
The Resident and New to Practice Committee will continue to
develop resources and events that will address gaps for this
demographic of Family Doctors.
Goals for the year included:
1.Improve the skills of clinicians
and teams using Dropbox and increase the number of
MOAs using Dropbox to support their physicians
This was achieved through the delivery of the in-clinic
Dropbox lunch and learn sessions. During these sessions
members and their MOAs were offered an opportunity
to meet our staff during the lunch hour and to learn how
to effectively use the Clinical Dropbox Tool. Post-session
­evaluation results reported high levels of satisfaction.
On average, users reported a confidence level of 4.0 in
using the tool after being trained (on a scale of 1–5; average
­confidence level before session was 2.1) and rated the
session as 4.6 for its informative, educational and ­interactive
nature (scale of 1–5).
2.Share our Dropbox learnings with other divisions
through a pilot sharing program
The Powell River Division of Family Practice and the Kootenay
Boundary Division of Family practice signed on to our
six-month pilot sharing program. During this pilot share,
Vancouver Division staff trained other Division staff and
board members on how to administer and deploy the tool
in their community. Through training, the other Divisions
were then able to offer the tool to their members and
improve efficiencies in their clinic. Combined, these two
sister Divisions reach over 160 family physicians outside of
the Vancouver Division who are now accessing our clinic
Dropbox tool.
3.Work with Practice Support Program (PSP) to ensure
common resources were ­available to all physicians
Division staff and the PSP worked together over the past year
to review current PSP resources in order to determine which
would be most useful to include in the Clinical Dropbox
tool for member access. After reviewing PSP modules and
tools, the Clinical Dropbox tool has included a litany of
­documents and algorithms from PSP for topics including
chronic obstructive pulmonary disease management, insulin
­initiation management, advanced care access and mental
health resources. Additionally, PSP staff received basic
training on the Dropbox tool to help ­physicians access the
resources when needed.
DROPBOX COMMITTEE STATS:
476
Total Number of Dropbox Users
(Doctor and MOAs)
316
Total number of tool users
(within Vancouver)
RESIDENT AND
NEW TO PRACTICE
COMMITTEE
The Vancouver Divisions’ Resident
and New to Practice Committee
was created in March 2015 to understand the needs, increase
the engagement and give a voice to those members still in
training or their first 5-years of practice. Since its creation,
the committee has conducted a needs assessment to help
guide our activities going forward. This included reviewing
the Division’s data and supplementing it through a dedicated
section of the membership survey and two focus groups of
Residents in all stages of training. We have connected with
the RACE Line to share focus group feedback and explore
forums for mentorship. In May we hosted a mentorship and
networking event to connect with Residents to introduce them
to the Division and collaborated with internal committees to
provide the Resident and New to Practice perspective event
which received excellent feedback – “Lots of useful insight.”
“Great support from the VDoFP.” – reaffirming the need for
connection among these members.
Our vision for the coming year has been shaped by our needs
assessment. Highlights include providing educational seminars
and creating a curated webpage to address common issues for
New to Practice doctors.
The Doctor’s Lounge Advisory
Committee offered a series of
events and workshops where Family Doctors participated in
knowledge sharing through mentorship on popular practice
management topics. Goals for the year include:
1.Create novel opportunities to engage physicians who have
not attended our previous sessions.
2.Create quality sessions, based on needs assessments, to
increase sense of connectedness and collegiality.
3.Provide opportunities to address unmet needs in the areas of
mentorship, business management and physician wellness.
In partnership with UBC, each session offered is preceded by a
needs assessment that identifies what specific elements within
a topic (e.g. Technology Tips) need to be addressed during
the session. Using this tactic, we address specific questions
and needs for our members, making each session unique
and customized. For example, during our technology tips
sessions, we offered members interactive round-table learning
opportunities with their peers on digital dictation, medical
mobile apps, the Division’s Clinical Dropbox tool, Patient
Portal and ­e-scheduling and electronic privacy and security
when emailing or texting patients. Evaluations of these events
revealed high levels of member satisfaction (4.52 on a scale of
1–5). As one member put it: “Thank you – I am naive and feel
more comfortable/informed than previously about medical
technology.” The different topics we offered include
technology tips, CDM, billing, p
­ hysician wellness and
models for practice success.
Vancouver Division of Family Practice
Annual Report 2014/2015
11
Better
Patient Care
GOALS
This year the Primary Maternity Care Network Committee
continued its work building a learning network of Family
Doctors that provide maternity care while also laying the
ground work for an outreach and awareness campaign to
increase the number of referrals to Family Doctors for primary
maternity care. The Committee continued to deliver, and also
expanded, the number of modules available in the CME series:
But I Don’t Do Maternity Care! Workshops for Family Physicians
Who Don’t’ Do Deliveries.
ACHIEVEMENTS
Knowledge
Transfer
Network
Building
Find a family doctor for your
pregnancy and beyond...
PregnancyVancouver.ca
This year the Committee redesigned and relaunched the
website at pregnancyvancouver.ca under the Vancouver
Division’s brand and colours. The new site features an
­interactive, map-based directory of Family Doctors and
an updated library of resources. Our outreach campaign
is underway at this time and runs until the end of 2015.
The outreach campaign features a series of blog posts
about maternity care and pregnancy. This content is being
shared through social media channels and via websites like
­babycentre.com.
In addition, we are offering two new modules in the CME
series this year: Beyond the Blues: Mental Health in Perinatal
Care and The 5 As of Healthy Pregnancy Weight Gain. The
latter is offered in collaboration with Perinatal Services BC
(PSBC). With support from PSBC, we have invited all Divisions
to participate in a train-the-trainer workshop to facilitate the
delivery of the CME series in other communities around BC.
We have engaged doctors and clinic staff in a process-­
mapping exercise to better understand the patient journey
through maternity care, to learn about and improve the
process for the benefit of all involved. Our Committee
members have vetted and organized an extensive library
of maternity care and perinatal care resources as part of
the Division’s Clinical Dropbox tool – the resources are now
­organized by theme and by gestational age.
Vancouver
SUCCESS
The College of Family Physicians of Canada (CFPC) selected
us to receive the 2015 CFPC Continuing Professional
Development Program Award for our CME program entitled:
But I Don’t Do Maternity Care! Workshops for Family Physicians
Who Don’t Do Deliveries.
The workshop series has attracted a lot of positive attention
from Division members as well as from outside the city.
We delivered an oral presentation at the 2015 Canadian
Conference on Medical Education in April and a workshop at
Post Grad Review in Family Medicine in February that were
both very well received. The Committee has also submitted an
abstract to present at the GPSC Quality Forum next year along
with a new poster.
WHAT IS AHEAD FOR 2016?
We will evaluate the outreach campaign in December
and determine whether social media is an effective way
of building awareness of, and referrals to, Family Doctors
for maternity care. We may or may not invest more in this
campaign, depending on the interim results.
Next year we will support PSBC in their collaborative project
to share the CME event series to other Divisions.
We will also continue to develop our understanding of the
“value stream” in the process of providing maternity care and
finding new opportunities for improvement.
12
Vancouver Division of Family Practice
Annual Report 2014/2015
Better
Patient Care
Knowledge
Transfer
Network
Building
System
Change
GOALS
ACHIEVEMENTS
The Residential Care Committee’s goals this year were to
increase recruitment and retention of physicians with a
portion of their practice dedicated to residential care work,
encourage the development of a consistent standard of
medical care within the residential care community of practice
and to ­advocate change in the residential care system that
would promote stable care coverage and address Vancouver’s
increasing residential care needs.
The Residential Care Committee continues to provide regular
opportunities to discuss best practices and tactics for improving
patient care to physicians working in residential care. The
Committee held three dinner meetings that brought together
residential care physicians, representatives from VCH, residential
care leadership and directors of care and allied staff from
care facilities.
SUCCESS
The Committee was instrumental in putting together
the GPSC Residential Care Initiative Program plan which
was approved as developed and is now in the initial
­implementation phase. The speed with which the division
was able to pull this project plan together is the result of
the ongoing work being done by the passionate, driven and
highly invested Residential Care Committee members.
The projects that we have been working on over the last
two years directly support the overarching best practice
expectations that have been set out for residential care in the
province. We are fortunate that Vancouver has been moving in
this direction for some time. This alignment has increased the
efficiency and effectiveness of our community engagement
and work in residential care.
WHAT IS AHEAD FOR 2016?
The Committee will continue to work towards meeting our
committee goals next year. As the projects we are working
on directly support the larger goals and best practice
expectations set out for residential care within Vancouver, we
will continue to move forward with these proven projects.
We will continue to leverage the deep knowledge of best
practices in frail elderly care that the residential care physician
community has to support Family Doctors new to residential
care and those who are currently providing frail elder care in
the community. We will work to build their confidence and
capacity to work with this population and ensure that there
are physicians who are able to fill this need within growing
frail elderly population.
We have also worked on four projects this year. Each one
­specifically supports the achievement of our overarching
Committee goals. They are the Residential Care Mentorship
project, the Residential Care CME project, the Residential Care
Polypharmacy Risk Reduction project and the Palliative Care in
Residential Care project.
Over the last year, the Residential Care Mentorship project
provided mentorship opportunities for five more physicians
new to residential care. This program attached approximately
100 residents in Vancouver residential care facilities to engaged
physicians, new to residential care. In addition, the project helps
provides an option for proactive succession planning for retiring
residential care physicians.
With the Residential Care CME Project, we developed a
Mainpro-C accredited CME course focused on polypharmacy.
This event was developed for health practitioners who wish to
gain practical skills, increased competence and confidence in
dealing with the issue of polypharmacy within their frail elderly
patient population.
In the Residential Care Polypharmacy Risk Reduction Project,
we are working with physicians and facilities to increase
­awareness and address the issue of polypharmacy. We are
­facilitating collaborative medication reviews with Family Doctors
working in residential care facilities as well as facilitating quality
improvement projects within facilities who show interest.
Funding for this initiative was provided for by the Shared Care
Committee, a joint collaborative committee of the Doctors of BC
and the BC Ministry of Health.
With our Palliative Care in Residential Care Project, we’ve
partnered with VCH Home Hospice, the Government of BC and
Doctors of BCs PSP and the UBC Division of Geriatric Medicine
to roll out a second iteration to our initial Palliative Care in
Residential Care (PCRC) project. This project educates Family
Doctors and allied health clinicians about the trajectories of
end stage illness with a focus on frailty and dementia. Clinicians
become confident in initiating goals-of-care conversations
with residents and families and improves clinical knowledge of
symptom palliation. Ultimately, it improves end of life care in
residential care.
Vancouver Division of Family Practice
Annual Report 2014/2015
13
RESIDENTIAL CARE
INITIATIVE
Better
Patient Care
Healthcare
Cost Savings
System
Change
GOALS
The Residential Care Initiative was initially mobilized by the
Ministry of Health in 2011 and became an initiative of the
GPSC in April 2014. Divisions were able to access funding as
of April 1, 2015 and the Vancouver Division of Family Practice,
having already started to work on identifying issues within
residential care and potential solutions, was ready to put this
funding to use as soon as it was available.
The Division put together a GPSC Residential Care Funding
Steering Committee which, working closely with the
Residential Care Committee, developed a program ­document
for submission prior to the program funding start date of
July 1, 2015. This program document and the associated
­memorandum of understanding were signed by VCH and
approved by GPSC in June 2015 and we launched the
program July 1, 2015. The program outlines the following
five best practices and three system level outcomes put
forward by GPSC:
Five best practice expectations
•
•
•
•
•
24/7 availability and on-site attendance, when required
Proactive visits to residents
Meaningful medication reviews
Completed documentation
Attendance at care conferences
Three system-level outcomes
• Reduced unnecessary or inappropriate hospital transfers
• Improved patient-provider experience
• Reduced cost per patient as a result of a higher
quality of care
Within the first quarter of the Residential Care Initiative
program, 61% of residential care facilities have signed on.
14
Vancouver Division of Family Practice
Annual Report 2014/2015
PARTNERSHIPS
We worked closely with VCH’s Residential Care leadership to
make sure that we were aligned, and working collectively
towards, providing a structure that fosters best practice
primary care within residential facilities. Dr. Marla Gordon,
VCH Medical Director of Residential Care, sits on our Steering
Committee and has been integral in ensuring collaborative,
efficient communication between our two organizations.
GPSC has been and continues to be extremely supportive.
Their efforts to remove roadblocks and barriers within the
process has allowed us to focus on efficiently and effectively
putting together a program that will meet the needs of our
residential care community.
With the support of VCH we were able to attend and provide
an overview of our draft program plan to their Residential
Care Leadership Advisory Group, VCH’s administrators council
and to their Residential Directors of Care group. These groups
provided feedback which helped us to assess program facility
impacts and supports. We also held a meeting for Family
Doctors to provide input into, and ask questions about, the
initiative during our planning and development phase.
Each of these engagements helped to focused our program
priorities and refine our plan. We will continue to engage with
our stakeholders as we move though the implementation of
this program.
Improved
Community
Health
Better
Patient Care
System
Change
GOALS
ACHIEVEMENTS
Our goal this year was to work with our partners, VCH and
PHC, to streamline the referral process and allow quicker access
to out-patient psychiatry. In the second half of the fiscal year,
the Committee members engaged in re-envisioning how the
Committee and Division members approach mental health
and addiction and support Vancouver patients and
community interests.
The Mental Health and Addictions Committee has reinvented
itself with a broader mandate and scope. Our new purpose
is to enhance the patient experience and care through the
primary mental health and addictions health care systems
and will be achieved through diverse channels and ­partners.
The efforts of our historic Mental Health Collaborative Services
Committee (a collaboration with our health authority partners)
will continue but will be one initiative within the Committee.
The Committee is working towards improving child and youth
mental health and addiction, resource sharing and clinical
learning opportunities for members, and a­ dvocating and
piloting the use of mental health and/or addiction
professionals in primary care settings.
SUCCESS
This year, the Committee participated in creating value-stream
maps that focus on the inpatient and outpatient journeys in
current and future states.
In addition, we were involved in an outpatient collaboration
with Shared Care, a pilot project of the behavioral health
consultant at Broadway Family Practice and at Three Bridges
one day each week. This has been a successful project that
helped patients in primary care have timely access to brief
psychological interventions.
We also advised on an e-mental health interactive website
and continue to provide clinical input to support St. Paul’s
development of the mental health hub.
WHAT IS AHEAD FOR 2016?
Next year the Committee will work to enhance primary
mental health care for children and youth, to enhance primary
care for individuals with substance abuse and addictions
issues, to enhance primary care for individuals with common
mental health issues, to collaborate with key stakeholders to
offer seamless care for mental health issues and addictions,
and to further enable Division members to strengthen the
therapeutic doctor/patient relationship and their personal
and professional capacity in primary mental health care.
This year, the Committee has worked to improve access to
Vancouver General Hospital adult mental health services
through a more responsive process, which includes access to an
emergency support group while patients are waiting for specific
treatments. Members should find increased c­ ommunication
with psychiatry through telephone calls and quicker access to
assessment done in hospital. We provided clinical input into
the planning process for a diversion unit at St. Paul’s Hospital to
manage patients with urgent mental health concerns in a way
that is more effective than an emergency room. This planning
process will continue over the next year.
The Committee is excited to welcome Drs. Cynthia Chan,
Dipinder Keer, Damon Ramsey, Lisa Miller, Steven Yau, and Tania
Culham and Kali Gartner as members of the Committee to join
Drs. Patricia Mirwaldt and Angela Nguan.
The Committee would like to acknowledge the departures of
Drs. Bob Bluman, Jim Thorsteinson and Veerle Willaeys from the
Committee and thank them for their contribution.
Other emerging areas we’ll focus on include: clinician
education and resource distribution, improved
communication between Family Doctors and other
Committee providers and increasing affordable access
to mental health and addiction services.
Vancouver Division of Family Practice
Annual Report 2014/2015
15
PATHWAYS
LEADERSHIP TEAM
Better
Patient Care
Improved
Physician
Experience
GOALS
WHAT IS AHEAD FOR 2016?
Through the fall of 2014 and early 2015, the Pathways team
has worked hard to collect data on the approximately 1700
­specialists practicing in Vancouver and to invite Division
members to enroll in Pathways as users. This culminated in
the successful launch of Pathways Vancouver in March of 2015.
To date approximately 71 per cent of Vancouver specialists
have profiles on Pathways, providing detailed and up-to-date
practice information, and we are continuing to survey
new specialists.
We will continue to reach out to Family Doctors and
encourage them to enroll in Pathways and provide support
to all users who require assistance using the site. We will
assist in improving how Pathways data is displayed, gathered
and updated. New specialists and clinics will be profiled on
Pathways and data for all specialty areas will be constantly
updated. We will continue to respond quickly to enquiries
from physicians and other health care professionals about
Pathways and advise the User Group on feedback we receive
from Division members.
As well, we have provided access to Pathways for over 430
Division members, with more enrollments every week. In July
we began collecting information from Family Doctors who
are interested in being listed on Pathways in the new Family
Practice specialty. The specialty area profiles Family Doctors
who offer specialized services on a referral basis for patients of
their Family Doctor colleagues. So far about 80 Family Doctors
in Vancouver have provided information to our team about
the specialized services they provide in practice areas, such as
primary obstetrics and sports medicine. We welcome enquiries
from Family Doctors who wish to have a searchable profile in
Family Practice on Pathways.
Early evaluations of the effectiveness and value of Pathways
have revealed that members are finding Pathways to be a
valuable tool for streamlining referrals. Family Doctors use it to
locate up-to-date and breaking news about specialists who
have opened a new office, who have moved or retired, or for
locating practice tips, forms and printable patient information
from the large library of Pathways resources.
ACHIEVEMENTS
We have worked extensively with VCH, Providence Health,
the Fraser Northwest Division of Family Practice, Vancouver
Division staff and committees and our own leadership
team of Drs. Terry Chang, Fiona Duncan and Joanne Yang.
We participate in the Pathways User Group, which includes
­representatives from all Divisions in the province who are
using Pathways. The user group meets monthly and works
diligently to improve Pathways.
16
Vancouver Division of Family Practice
Annual Report 2014/2015
Message from the Treasurer
The Division’s activities and funding
have increased and continue to
grow substantially, in the service
of our goals and as a result of the
successes of our Board, our
programs and the support from
our members. With increased
­l­­eadership in the primary care
community, we are challenged
to responsibly manage the
increasing resources available for our ­organization.
As we each know in our own sphere, careful financial m
­ anagement
is key to achieving our multiple goals. Your review of our ­financial
­statements will only provide a glimpse into the scope of our
­organization’s activities. The landscape changes as the year
progresses, requiring constant adjustments. Fortunately, we
have a very experienced and professional staff supporting our
­financial “back end.”
REVENUE 2014/2015
Attachment (A GP for Me) – $492,079
Pathways – $430,000
Interest – $22,403
Infrastructure Grant – $1,770,435
EXPENSES 2014/2015
Committee Support - Pathways – $426,246
Human Resources – $393,555
Committee Support – $213,945
I am grateful to have had the opportunity to serve with the Vancouver
Division of Family Practice. As you review this year’s financial activities,
we can all be proud of the leadership provided by the Board and the
professionalism of our management team.
Meeting Costs and Events – $212,526
Administrative Costs – $139,635
Physicians Data Collaborative – $70,455
Evaluation Costs – $69,903
Grants and Other Project Costs – $68,278
Marketing and Communications – $66,527
Dr. Jim Thorsteinson MD
Treasurer, Vancouver Division of Family Practice
Committee Support - Attachment – $537,103
Physician Payments – $494,341
YEAR OVER YEAR REVENUE GROWTH
ASSETS 2014/2015
Interest
6,000,000
Term Deposits – $1,178,055
Shared Care Initiative - Polypharmacy
Cash – $107,756
Residential Care Initiative
GST Receivable – $42,543
Property and Equipment – $32,750
Prepaids – $19,850
EMR2EMR Special Project
5,000,000
Communities of Practice (PITO)
Attachment (A GP for Me)
4,000,000
Carryforward funding
Infrastructure
3,000,000
*Complete audited financial statements are available upon request.
2,000,000
1,000,000
0
2011
2012
2013
2014
2015
2016 Budget
Vancouver Division of Family Practice
Annual Report 2014/2015
17
Initiatives in Focus
Better
Patient Care
Healthcare
Cost Savings
Improved
Community
Health
COLLABORATIVE SERVICES COMMITTEE
The Collaborative Services Committee is a forum for discussing
issues concerning patient care outcomes, determining priorities
and co-­designing solutions with partners in the Vancouver health
care system.
Comprised of the Vancouver Division of Family Practice, VCH, PHC and
the GPSC, this partnership is guided by the principles of the Triple Aim.
This year, the Committee’s work has primarily focused on the A GP for
Me initiative and the Seniors Care Model pilot project.
PARTNER
NAME
TITLE
Vancouver Division
of Family Practice
Dr. Terence A. Chang (Co-Chair)
Board Chair
Dr. Patricia Mirwaldt
Board Physician Lead
Dr. Fiona Duncan
Board Vice-Chair
Dr. Jim Thorsteinson
Board Treasurer
Laura Case (Co-Chair)
Chief Operating Officer, Vancouver Community
Shannon Hopkins
Director of Home Health and Transition Services, Vancouver Community
Carol Park
Director, Primary Health Integration
Dr. Patricia Daly
Vice President , Public Health Chief Medical Health Office
Dr. David Hall
Medical Director Primary Care, Vancouver Community
Nellie Hariri
Operations Director, Primary Care, Public Health, C&Y MH, HIV/AIDS,
Volunteer Resources, Vancouver Community
Dianne Doyle
President and Chief Executive Officer
David Thompson
Vice President – Seniors Care & Clinical Support Services
Margot Wilson
Director – CDM Strategy
General Practice
Services Committee
Dr. Shelly Ross
Co-Chair
Provincial Division
Susan Papadinonissiou
Executive Lead
Vancouver Coastal
Health
Providence Health
Care
PHYSICIANS DATA COLLABORATIVE
The Physicians Data Collaborative (PDC) is a not for profit society
formed through a collaboration of Divisions of Family Practice of BC,
with the assistance of UBC Family Practice and AMCARE. With an aim
to develop a system capable of ­aggregating anonymized clinical data
from EMRs in primary care clinics, this physician-led initiative provides
data to enable practice reflection and quality improvement. The
Vancouver Division of Family Practice remains the PDC’s main funder
with board member Dr. Patricia Mirwaldt sitting on the PDC board
as treasurer.
18
Vancouver Division of Family Practice
This year the PDC’s distributed physician network is transitioning
from its initial testing phase to prototyping its services with Divisions.
Starting with the Attachment (A GP for Me) Initiative, the PDC is
working with the Fraser Northwest Division to gather ­information
about attachment rates, panel size changes, demographics of
attached patients and changes in access, without the use of surveys
or direct outreach. Applications such as these will help avoid survey
fatigue and burnout on the part of physicians. Through its ­partnership
with AMCARE, the PDC has created the Health Data Coalition,
capturing 70 per cent of northern patients and 25 per cent of
the province.
Annual Report 2014/2015
Initiatives in Focus
Better
Patient Care
Healthcare
Cost Savings
Improved
Community
Health
STRATEGIC THINK TANK
The Vancouver Division of Family Practice is a part of a collective
effort to improve primary health care through the use of the Triple
Aim, healthcare cost savings, improved community health and better
patient care. Together with our sister Divisions, a Strategic Think
Tank has formed to provide a venue for discussion and collaboration
between regional divisions.
Partners are encouraged to share and discuss common issues and
obstacles that are local and applicable interdivisionally within VCH.
This open dialogue has helped to identify areas of common concern,
allowing for allied solutions to be identified and addressed.
REGIONAL DIVISION
MEMBER
TITLE WITH RESPECTIVE ORGANIZATION
Vancouver
Dr. Terence A. Chang
Board Chair
Dr. Fiona Duncan
Board Vice-Chair
Dr. Patricia Mirwaldt
Board Physician Lead
Dr. Jim Thorsteinson
Board Treasurer
Powell River
Dr. Bruce Hobson
Lead Physician
Richmond
Dr. Peter Chee
Board Chair
North Shore
Dr. Lisa Gaede
Board Chair
Provincial Division
Susan Papadinonissiou
Executive Lead
SENIORS CARE INITIATIVE
Following the release of the Ministry of Health white paper Primary
and Community Care in BC: A Strategic Policy Framework, the
Vancouver Division of Family Practice has been working intensely
with VCH since June 2, 2015 in response to the directive to offer
better care to frail elderly patients with multiple complex, chronic
conditions. The premise is that this cohort of patients often lands in
emergency and acute care beds because there are no alternative
subacute treatment options in the c­ ommunity.
In response to this need, the Division has engaged in developing
a pilot model where seniors (70 years or older) living with complex
health conditions, including frailty and palliation, will be supported
to receive most of their care in the community based on a Primary
Care Home model. The model will allow family physicians to
provide continued and coordinated care with timely access to allied
health professionals working as an integrated team. These team
members include social workers, nurses, physical and occupational
therapist, dietitians and mental health and addiction counselors,
as well as home support workers and community health workers.
Team members will have access to, and record, pertinent patient
­information into the Family Practice EMRs, where the physician
and team members can meet virtually to build, adjust and enable
­proactive and integrated care plans. There will be 24/7 support for
patients to connect with a member of the Primary Care Home team,
who will triage issues and concerns and expeditiously contact the
family physician for backup support when necessary. The underlying
principle is the ability to ramp up care and services of this patient
group in the community, rather than have them enter the acute care
system through emergency rooms.
The Vancouver Division is excited to continue working with VCH and
our members to develop opportunities, beginning with a limited
pilot, for Family Doctors to work in multidisciplinary teams providing
longitudinal, comprehensive care to seniors.
Vancouver Division of Family Practice
Annual Report 2014/2015
19
Governance and Organizational Structure
The Vancouver Division of Family Practice is
governed by a Board of Directors comprised of
local, practicing Family Doctors that represent the
ideas and opinions of its members.
AGM Task
Force
BOARD
Executive
VDoFP Staff and
Consultants
Strategic
Think Tank
Continuity
of Care
Committee
Membership
Committee
Primary Maternity
Care Network
Committee
Information
Technology
Committee
Evaluation
Committee
Attachment
(A GP for Me)
Mental Health
and Addictions
Committee
Drop Box
Editorial Board
Doctor’s Lounge
Advisory
Committee
Resident and New
to Practice GP
Committee
EMR User
Groups
Recruitment
and Retention
Committee
Practice
Modelling
Committee
Matching Mechanism
Committee
(VCH/PHC)
Committee
EMR – Electronic Medical Record
GPSC – General Practice Services Committee
PHC – Providence Health Care
VCH – Vancouver Coastal Health
VDoFP – Vancouver Division of Family Practice
VDoFP
Programming
20
Finance
Vancouver Division of Family Practice
Annual Report 2014/2015
GPSC
Residential Care
Project
Pathways
Leadership
Team
Residential Care
Committee
Pathways
Advisory Group
Our Partners
Doctors of BC
Ministry of Health
First Nations Health Authority
City of Vancouver
Vancouver Coastal Health
Providence Health Care
Collaborative Services Committee
Practice Support Program
Specialist Services Committee
University of British Columbia
Musqueam Nation
Society of General Practitioners of BC
Provincial and Regional Divisions
Vancouver Division of Family Practice
Annual Report 2014/2015
21
Tel:604.569.2010
Fax:604.321.5878
[email protected]
www.divisionsbc.ca/vancouver
Vancouver