PCR - Primary Care Reform

1. PCR - Primary Care Reform “From theory to practice”

2. What is PrimaCare • The Paris Primary Care Network • Signed agreement with Ministry of Health in February 1999, making us the first primary care network

3. From the Beginning • A complex environment, controversy, political changes • Reduced satisfaction with access to care • Reduced physician satisfaction • Changing fiscal environment

4. The Process • Phase I -Developing a rostered population • Phase II - IT [choices,implentation,network activation] • Phase III - Telephone Health Advisory Service • Phase IV- Evaluation [provincial&participants]

5. Phase II Informatics & IT -ongoing • Core Data Set • Data connectivity (lab,ODB,drug interaction checking facility….others?) • Confidential messaging • electronic records[prescription writing etc] • FUTURE VISION tba

6. Phase II Informatics & IT-core data set • patient demographics • registration/enrollment data • medical information section - problem list, co-morbidity ,medication history, family history, allergies, risk factors and ALERTS

8. Phase III Telephone Health Advices • “ ON- CALL HEALTHLINE “ • toll free 1-866-553-7205 5:00 PM to 9:00 AM weekdays & 24hours weekends and holidays

9. PrimaCare Now • 7 physicians - 5 sites • over 10,500 rostered (over 1,500 new patients) • Over 70% signed consent forms • NP on site since February 1999 • THAS began October 1, 2000 • IT - implementation started • New payment methods with targets and incentives active since December 1999

10. Natural Linking • Hospitals • Public health • CCAC • others

11. Focus on Public Health & PrimaCare • actions developed together [based on the health status report] • specific joint initiatives -tobacco cessation ,sexual health etc • using the data of the PrimaCare roster-applied epidemiology • joint program initiation [Falls program] • evaluation of initiatives • IT interfaces in the future

12. Keep this in mind • PCN is a voluntary arrangement of 3 years • Heavy administrative component to the process so far • IT in very early stage (core data set? to come) • THAS - October 1, 2000 • Significant evaluation results coming shortly

13. Success Factors • All active physicians involved • Strong doctor/patient relationships • Supportive community and stakeholders [Health Unit / Health Council] • Supportive hospital (The Willett and the BCHS) • Infrastructure support MOHLTC /OMA • Strong information resources

14. Thankyou • John W McDonald MD • 238 Grand River St North • 519-442-3609 • whjohnm@worldchat.ca • web site: primacare.ca

15. Goals and Objectives • Increase patient and provider satisfaction • broader range of health services • enrollment / rostering • Increased efficiency through • reduced duplication • better use of information • patient and provider accountability

16. Goals and Objectives • Improved access to primary health care • stability of the network • extended office hours • 24 hour response system • telephone health advisory service • Improved quality and continuity of care • prevention • information technology

17. Services PCN Provides • The basket of services include: • Service coordination • Episodic care • Access to hospital care and coordination • Patient education and preventive health care • Appropriate periodic health assessments

18. Basket of Services (continued) • Health assessment • Diagnosis and treatment • Primary reproductive care • Primary palliative care • Primary mental health care • Access to obstetrical care and newborn care