Activities

Update

1. Support the continued realization of a Patient’s Medical Home for all Albertans:

• Launch a continuity campaign with clinics built around the implementation of the Central Patient Attachment Registry (CPAR) to encourage attachment of patients to their identified medical home.
• Continue supporting good management and governance of PCNs to enable investment of resources in the medical home.
• Improve integration of AMA change management programs and collaboration with AH and AHS partners.

• The continuity campaign is poised for launch in fall 2018 to clinics, patients and PCNs via a series of posters and a CPG (clinical practice guideline). CPAR, an enabler for continuity, has merged with a larger AH campaign Community Information Integration (CII) and there has been agreement with AH and AHS on high level continuity messaging.
• With the creation of PCN zone committees, the integrated programs are shifting to enable support of individual PCNs through capacity building to the zone in areas such as business planning, annual reporting and evaluation process.
• Integration of the programs is nearing finalization. Staff restructuring, role refinement and program rebranding is underway.
• Team Partnerships with AHS and AH exist across all the current PCN supports and development projects.

2. Support activities that integrate care across the system:

• Work with AHS through SCNs and PHCIN to develop and test initiatives to improve integration of care between physicians and AHS services.
• Work with interested physician sections and groups to develop and test initiatives to improve transitions of care between physician practices.
• Work with interested sections to create an alliance/forum to forward system improvement initiatives.
• Seek modification of the mandate of programs to enable change management services to all specialist physicians.

• Integrated programs are part of the PHCIN and have worked closely with AHS partners in this network to define and launch a specific initiative to improve hospital to home transitions.
• The SCA (Specialty Care Alliance) has been formed and is meeting on a regular basis working towards defining a project on improved referrals as well as partnering with the PCA (Primary Care Alliance) to define areas of collaboration for improved integrated care.
• Block funding and anticipated agreement with AH to officially merge the three programs is nearing finalization. Grant deliverables are being defined and do allow for a wider mandate.

  3. Support the governance structure created under the PCN Framework:

• Support the setup of the new operating committees at the provincial and zonal levels.
• Support the work under the new PCN Framework towards improved integration of care between clinics, PCNs, AHS and other partners.
• Support the work under the new PCN Framework to continue to grow PCN capacity to assist clinics in the transition to medical home.

• The formation of five new PCN zonal committees was achieved Feb 14, 2018. The AMA change management team is working closely with AH with in restructuring other PCN provincial committees
• PCN Zonal committees are in the process of defining zone priorities that align with the newly endorsed PCN provincial committee priorities. The change management support team collaborates on committees with AH and AHS partners at provincial and zonal levels defining and supporting integration opportunities such as hospital to home and the opioid response initiatives.
• Capacity building at PCNs to support clinics in their journey to PMH is an essential base of what the integrated programs build into the development of PCN services and products. Networks of practice in improvement, communication, finance, governance, and physician leadership are supported by the integrated programs to improve and expand capacity.

Activities

Update

1. Alignment of physician compensation activities and funding with system objectives:

• Working with sections, develop an Average Net Daily Income (ANDI) model in support of income equity.
• Work with partners to align provincial Academic ARP structures towards system objectives.
• Work with AH and AHS to implement ARP’s and other alternate funding arrangements that improve the quality of care Albertans receive.

• Update on ANDI model provided under Financial Health item.
• The AMA has formal representation on the Academic ARP Provincial Strategy and Operation Committees. See additional information under Financial Health.
• The AMA is advocating for a joint AMA/AH/AHS review of ARP rates at the Physician Compensation Committee. This rate review will include consideration of workload requirements (FTE definitions).
• The AMA has been participating in the development of the Blended Capitation Model ARP for primary care. A joint planning (SPRINT) session with AMA, AH and AHS representatives was undertaken in February 2018 to identify model deficiencies and other barriers to physician uptake is schedule for approval at management committee September 2018. Once approved a re-launch and targeted approach can be taken to improve clinic uptake.

2. Support initiatives that integrate health information including enhanced information exchange and data analytics:

• Work with others to enable the flow of high value health information from community-based physicians to Netcare and AH data repository.

• The Central Patient Attachment Registry (CPAR) will be combined with CII to provide automatic upload capability of patient panel information from primary care offices.
• Community-based specialist practices will be able to send consult reports to Alberta Netcare from your electronic medical records.
• We’re optimistic that beginning in 2019, CII-enabled notifications about patient events (emergency room visits and hospital admissions and discharges) will be sent to the patient’s medical home.
• Also (hopefully in 2019), community EMRs will generate a standardized patient summary to Alberta Netcare, allowing other physicians to see a pertinent summary of the patient’s medical history.

• Implement the provincial AHS clinical information system information sharing framework.
• Champion the adoption of a common secure messaging standard for Alberta.

• The new AHS Clinical Information Sharing Approach has been implemented. AMA reps have been named to the new governance committees.
• Discussions between vendors, AH and AHS will be reinitiated in light of planned developments (e.g., deployment of the AHS provider portal in late 2019).

3. Participate in the development of a needs based physician resource plan:

• Ensure that physician supply is reasonable to meet Alberta population health needs including needs by specialty and by geographic location.
• Ensure that physician’s professional and economic interests are identified and represented.

• AMA has two representatives on the PRPAC who will continue to identify possible implications for patients, physicians and the health system as physician resource needs are determined. As well, the AMA has formal representation on the PRPAC Technical Working Group and the Operational Working Group. The technical working group is tasked to provide the PRPAC with analysis and data collection to support the recommendation for physician resources. The mandate of the operational working group covers identifying potential levers for physician distribution and supply and develop methods to implement, review and evaluate progress.
• The Physician Resource Planning Advisory Committee (PRPAC) sent a report to the Minister defining a range of physician needs for the year.
• The AMA has undertaken consultation sessions with the Section of General Practice (SGP); Primary Care Alliance (PCA); the Specialty Care Alliance (SCA) and the AMA PRP Advisory Group. Purpose of the sessions were to obtain perspectives from the leaders on important characteristics, principles, new control mechanisms, potential relationship to negotiations and what roles and responsibilities should the AMA take on related to a physician supply strategy.

Activities

Update

1. Assess the value of the Albertapatients.ca portal to the board and patients and identify opportunities to enhance that value.

• At the end of the business year, the AMA’s albertapatients.ca community had passed the 7,000 member mark and continues to grow. It continues to be the most recognized (statistically significant) patient research portal in Alberta and was a highlighted service at the 2018 Canadian Medical Association Grand Central exhibitor event during the Innovation Summit. The community continues to grow and identify issues that are on the minds of Alberta patients.
• Surveys have been conducted in partnership with AH, AHS and HQCA, all of whom recognize the value of this community and the perspective it can bring.
• Surveys are shared with the AMA Board of Directors to help inform AMA participation in provincial activities. A research agenda is being developed to support the 2018-19 Business Plan to inform advocacy and policy setting work.
• A primary care tracking survey is being conducted to assess opinions of the primary care system, patient expectations of their relationships with family medicine, etc.
• Specialty groups are being assisted through researching Albertans’ awareness of the role and importance of the specialty in the wider health care system.
• We’re exploring patient experience with obtaining prescriptions for opioids and cannabis and further research will be conducted in the next year to provide particular data requests coming from the Section of Rheumatology.

2. Support physician leadership:

• Provide skill development opportunities to AMA physician leaders.

The AMA has provided 6 courses for leadership development this year: The Difficult Conversation in Healthcare, Resolving Conflict in the Healthcare Workplace, The Spectrum of Behavior in Healthcare and Team Dynamics and Communications for Healthcare Professionals.

• Develop a leadership framework to create physician capacity to leading system change that improves care for Albertans.

The AMA is participating in the Advancing Professional Behavior in the Workplace project with the CPSA, AHS and the HQCA which has a focus on leadership development.

3. Support and advocacy for improved access and quality of care to Indigenous communities through implementation and actions to support the AMA Indigenous Health policy. This will involve establishment of an Indigenous Health committee and engagement of Indigenous leadership and other stakeholders.

• The AMA Indigenous Health Committee has begun its work towards prioritizing and implementation of the AMA Indigenous Health policy.
• The AMA board participated in Indigenous Cultural Safety Training in February.
• AMA Staff are being offered training in Indigenous Cultural Safety