2022-23 Mid-Year Update on KRA 3, System partnership and leadership

Priority activities

Update

1. Continue to strengthen the Patient’s Medical Home for all Albertans: 

• Support members, clinics and their PCNs to implement change with best practice, this year’s improvement projects include: CII/CPAR, BCM, ASI, H2H2H. 
• Meet the following targets this year:
  • 1.5 M Albertans on CII/CPAR
  • Four new BCM clinics 
  • ASI Central Access and Triage implementation (implement FAST in each zone)
  • H2H2H – Change Package launched
• Supporting physician leadership and co-design on committees such as PPCNC, ASI working groups, COVID consultation table, I-ZICC, PCN zones and others as required. 
• Launch a collaborative focused on clinic viability through leveraging PMH practices.

• ACTT Target Updates:
  • CII/CPAR currently at 1,264,019 Albertans.
  • Blended Capitation Clinic (BCM) - Currently have one new clinic committed, two clinics in financial evaluation and two in orientation.
  • ASI – see ASI section.
  • H2H2H – Change Package was launched in January with supplemental online training in progress.
• ACTT continues to support physician leaders, including PCN physician leads executive, I-ZICC table, PCN zonal physician groups, ASI working groups, physician champion network, Specialty Care Alliance and Primary Care Alliance in their work towards Patient Medical home and Medical Neighbourhood.

2. Support activities that integrate care across the system and support the health neighborhood:

• Support physician leaders in improving care transitions leveraging co-design of ASI projects between specialty and primary care. 
• Support physician leaders in shaping the PCN governance structure for future sustainability.
  • Supporting PLE in advocating for PCN funding model changes and increases, and establishing appropriate zone level corporate/legal structures.
• Continue work with PCA and SCA on leading integration projects like Alberta Surgical Initiative and Implementation of CII/CPAR.

• See report on ASI, MAPS and PCN Funding model in the New Activities section.

3. Support members on pandemic related issues as the situation evolves through the Community Physician Consultation Table. 

• This activity has ended. 

4. Represent the interests of the profession on collaborative working group and committees to influence positive change across the system including the Choosing Wisely Alberta Steering Committee, the Continuing Professional Development Network Steering Committee, the Infection Prevention and Control Advisory Committee, the Influenza Immunization Program Coordinating Committee and the Tracked Prescription Program Steering Committee.

• Members are representing the AMA and the interests of members on a number of working groups and committees.

Priority activities

Update

1. Advance the AMA’s physician compensation strategy that provides value to patients and is fair to physicians:

• Advance the income equity measure.
  • Operationalize the interim measure as directed by the RF.
  • Prepare the preliminary full IEI measure for review by the section panel.
  • Present the final measure to the RF.
  • Ratify the IEI with membership.
  • Seek government support for the initiative.
• Align payment models with other initiatives in the system that improve delivery including primary care reform.
• Working with other stakeholders, build a shared strategy to improve our measurement of the health workforce.

• AMACC continues to develop the Full Income Equity Measure for Fall 2023 RF. Work includes expanding the Interim Model to incorporate additional compensation elements and the Hours of Work study results as well as ensuring that the compensation, overhead, hours of work and training and career length factors are aligned. AMACC will continue to engage with the Section Panel as the proposed measure is completed. Proposed timelines for dispute resolution and member ratification will also be presented at Fall 2023 RF.

2. Support strategic and tactical initiatives that improve informational continuity and enhance information integration:

• Advocate for health system changes that reflect member needs through the eHealth Modernization Project.
• Work with provincial stakeholders on the development of virtual care policies and standards through the CPSA-led Alberta Virtual Care Coordinating Body.
• Work with AHS through the Non-AHS Community Provider Advisory Group, other committees and informal channels to ensure Connect Care impacts on community physicians and the delivery of care are recognized and addressed as Connect Care rolls out.
• Influence the implementation of the Alberta Surgical Initiative/Electronic Referral Solution to meet physician needs.
• Develop a dashboard for tracking and reporting informatics priorities.
• Leverage informatics committee physician leaders to monitor and adjust informatics priorities to ensure informatics priorities are flexible to reflect the current landscape.
• Facilitate member awareness, engagement and consultation as additional clinical data is moved into MyHealth Records.

• AMA continues to co-chair the eHealth Modernization Working Group.
• Informatics Advisory Committee (IAC) members and other physician leaders continue to be tightly involved in requirements definition.
• Discussions continue with AMA physician leaders and staff on the key components such as the EMR Vendor Model.
• Informatics Advisory Committee met in person in December with Alberta Health attending for robust discussion on the future of digital health and priorities. 
• Informatics Advisory Committee Terms of Reference was approved by the board changing its scope to be a board advisory and allowing for additional members with expanded expertise in various aspects of informatics.
• An IAC dashboard has been created to monitor and adjust priorities as the landscape changes. 
• Informatics Advisory Committee members and AMA staff are participating in Alberta Virtual Care Coordinating Body subcommittees to do a deep dive on all aspects of virtual care including interoperability, equity, access and Indigenous Data Sovereignty.
• Advocacy and relationship building continues with Alberta Health Services in support of improving the flow of information within Connect Care and between Connect Care and the community.
• Non-AHS Community Provider Advisory Group continues to be a key component to escalating and helping AHS resolve and prioritize Connect Care challenges in the community.
• A board subcommittee will work with IAC to help bring key issues back to the board for guidance and support as needed.
• AMA staff worked with University of Calgary in support of research on access to patient records and the limitations of the HIA.

3. Working with other stakeholders including the student associations, PARA, training institutions and communities, develop solutions to address needs-based gaps in physician supply. 

• The AMA Agreement provides for the re-establishment of a Physician Resource Planning Advisory Committee. The terms of reference that include the composition of this committee will be developed and recommended to the Minister. Physician supply will be part of the implementation activities of the AMA Agreement. 
• To support the work of AMA’s involvement in the multi-stakeholder PRP Advisory Committee mentioned above, as well around any other issues that deal with human health resources the AMA is in the process of forming an AMA PRP Working Group. This working group will be particularly helpful to support discussions related to human health resources as noted in the Targeted Investments (Schedule 7) of the AMA Agreement.
• In late-December, a callout for representatives was conducted. Staff are now in the process of reviewing the submissions and will provide an applicant summary for consideration by the AMA Executive Director in the coming weeks.

Priority activities

Update

1. Engage patients to understand their challenges with albertapatients.ca as a major vehicle. 

• Explore the patient perspectives on the care deficit created by the pandemic and use the results to bring the patient’s voice to our advocacy and discussions with system partners.
• Frequently (at least bi-monthly) survey on topics relating to AMA advocacy activity and share the results with the profession and the public through President’s Letters, social media and earned media.
• Maintain or grow the size of the community by monitoring usage and reaction to the updated albertapatients.ca hub.

• albertapatients.ca, holding well at about 14,000 active members, has been an important part of AMA advocacy.
• Surveys have gathered patient perspective on a range of topics including pediatric mental health, the primary care experience, patient attitudes to care provided by allied health professionals, virtual care from their own physicians vs corporate offerings and attitudes and experience in the emergency department.
• We continue to track and report on the care deficit from the pandemic and the secondary wave of backlog subsequently generated.

2. Support and advocate for an improved health care system

• Use the Care Deficit Assessment Series to explore different areas of medicine, different communities and their specific experience. 
• Provide an assessment of the situation, an overview of how doctors have been managing in the environment and then the long-term solutions that they see to the problems we face. Include available resources and information for patients.

• We have continued to develop care deficit information but also to mine what we have learned from the earlier issues to inform advocacy and respond to daily news coverage and commentary. 
• News outlets report our input from physicians and data from albertapatietns.ca and our PatientsFirst.ca community of activists.

3. Support and advocate for improved health care delivery for the Indigenous community. This will involve outreach to Indigenous physicians and First Nations communities, participation in the Population Aboriginal Health SCN and continued activity of the AMA Indigenous Health committee. 

• Support physician practices in recognizing the National Day for Truth and Reconciliation.
• Organize an event centered around a collective viewing of The Unforgotten.

• The AMA Indigenous Health committee continues to build relationships and share ideas and information with external partners on issues pertinent to Indigenous Health, including improved health care delivery. Collaborative opportunities are being investigated.
• Representatives from the AMA Indigenous Health committee will pilot and provide feedback on the educational joint project with AMA, CPSA and AHS, “Micro-aggression training for Physicians”. The anticipated launch date for this course is spring. 
• The AMA Indigenous Health committee will discuss potential actions to recognize the National Day for Truth and Reconciliation on Saturday, September 30, 2023. One action being considered is a collective viewing of the film, The Unforgotten, followed by an opportunity for discussion.