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

Priority Activities

Year-end update

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
  • 4 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) - As of April 1, we have 5 clinics on BCM, 1 clinic committed, 3 clinics in financial evaluation and 64 clinics in orientation. ACTT has collaborated with 3 PCNs to deliver 2 zone BCM webinars (Edmonton and Calgary Zones); hosted 2 BCM Community of Practice meetings; Supported facilitation and development of Practice Agreements for 3 BCM clinics and created peer-to-peer video vignettes.
  • 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.

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 part 1.

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

• This activity has ended.

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.

• The AMA participates on many external committees and continues to review and assess the priority and value of AMA’s participation on various external committees.

Priority Activities

Year-end update

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 dir ected 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 is completing the development of the Full Income Equity Measure for presentation to the Fall 2023 RF. Work has included 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 has engaged with the Section Panel, individual sections (on request) and AMHSP Council as the proposed measure was being completed. Proposed timelines for dispute resolution and member ratification will be presented at Fall 2023 RF.
• AMA staff have worked with primary care leadership to explore issues such as delegation and supervision of services under the Schedule of Medical Benefits, assessment of the new BC primary care compensation model, and estimation of overhead costs in the Patient Medical Home. Work is ongoing in these areas.

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.
  • Requirements sessions focusing on health system opportunities have taken place over the course of 2023 across stakeholder groups including patients, physicians and other health care professionals.
  • Informatics Advisory Committee (IAC) members and other physician will continue to be tightly involved as the next steps unfold.
• AMA continues to work closely with Alberta Health on the expansion of results and information made available to patients through MyHealth Records. The release of referral information is expected in the fall.
• An IAC dashboard has been created to monitor and adjust priorities as the landscape changes.
• Informatics Advisory Committee will meet in person in September with Alberta Health Services attending to discuss short and long term digital health priorities.
• The IAC welcomed additional members to expand the expertise and breadth of experience within the committee.
• IAC members and AMA staff continue to monitor and adjust the informatics dashboard as the landscape and provincial priorities change.
• Informatics Advisory Committee members and AMA staff participated in Alberta Virtual Care Coordinating Body subcommittees to do a deep dive on all aspects of virtual care. Detailed reports and next steps are expected in the fall.
• 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.
  • Both AHS and SCA sent surveys earlier this year. A townhall to discuss the results and next steps will take place in September.
  • 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 has been established and will work with IAC to help bring key issues back to the board for guidance and support as needed.
• At the request of Physicians Lead Executive, and with the support of the IAC, AMA Informatics staff worked with ThinkHQ to develop an EMR survey for primary care physicians. This results will be used to identify opportunities and establish priorities.
• AMA staff worked with University of Calgary in support of research on access to patient records and the limitations of the HIA.

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. Members of the AMA PRP Working Group are Dr. Eric Wasylenko (Chair); Dr. Michael Auld; Dr. Scott Beach; Dr. Nicholas Monfries; Dr. Ankur Sharma; Dr. Suzanne Squires; Dr. Parker Vandermeer; Dr. Nathan Rider/Dr. Tamara Rider (PARA representatives: these residents will alternate their attendance); Mr. Gareth Jones (Medical Student Rep).
• The first meeting of the AMA PRPWG was held on May 24. The working group discussed its role and how it can assist with solutions to addressing short, mid, and long-term health resource needs for the province. Regularly scheduled meeting will be occurring to prepare the AMA for the anticipated revival of a Minister’s Physician Resource Planning Advisory Committee.

Priority Activities

Year-end update

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.
• The research strategy will be revised in 2023-24 to better complement government relations and advocacy programming with quarterly omnibus surveys through albertapatients.ca

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.

• The Care Deficit Assessment Series was the basis of the AMA’s pre-election public information program, Handle With Care. Each profile built on the existing CDAS profile and posed questions that all political parties should be prepared to answer in asking for a mandate from Albertans. The program was well received and highly viewed. See Government Relations for more information.

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.

• Infographics and a list of resources and recommended actions are being developed to make available to community physicians to support them in finding ways to recognize the 2023 National Day for Truth and Reconciliation on September 30.
• The Indigenous Health Committee will be hosting a group viewing of The Unforgotten at Representative Forum. This will be followed by an Indigenous lunch with invited Indigenous leaders from across our province. After lunch, a panel of Indigenous leaders will address questions from the audience related to the movie and the health inequities that Indigenous peoples face.