Update on KRA 3, System partnership and leadership
The AMA supports members in their role as leaders within the health care system. This includes supporting physician leadership in developing innovations in care delivery and integration of primary and specialty care. Other activities include the AMA’s key role, with Alberta Health (AH) through the AMA Agreement, in developing and implementing the physician payment strategy for the province; several programs aimed at quality improvement; activities related to eHealth; and supporting the development of physician leadership skills.
Goal 1 - Working with Alberta Health, Alberta Health Services and other partners, lead and influence positive change in the delivery of services
Activities
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Year-end update
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Continue to strengthen the Patient’s Medical Home for all Albertans:
- Support members, clinics and their PCNs to improving relationship continuity to patients using the central patient attachment registry / community information integration (CPAR/CII) as an enabling tool and leverage the functionality in other areas including immunization, eReferral and Alberta Surgical Initiative.
- Support PCNs in operationalizing new standardized, sustainable and shared services prioritized by the PCN Provincial Committee and PCN Zonal Committees.
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- AMA’s ACTT service is continuing to support primary care members and leadership in the continuing journey towards PMH for all Albertans. Progress is occurring in all identified priority areas as well as assisting with emerging needs created by the pandemic.
- AMA’s ACTT Service has been supporting physician leaders, PCNs and PCN zones to respond to the pandemic. PCN physician leads executive have been partnering with AH and AHS since the beginning of the pandemic on issues such as PPE distribution, COVID + test results to family physicians including establishing data hubs in Calgary and Edmonton, population panel management for at risk patients and the work continues with immunization and support for physicians on vaccination roll out and hesitancy.
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Support activities that integrate care across the system and support the health neighborhood:
- Support physician leaders in PCN zones to achieve functional partnerships with AHS zones to enable new ways of sharing care using sustainable approaches.
- Work with PCA and SCA as well as AHS Primary Health Care Integration Network to promote virtual care capabilities including secure communication, eReferral and integration with community EMRs.
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- AMA reps have been afforded the opportunity to provide input into many AH and AHS initiatives and that input appears to be influencing plan development.
- Ernst and Young have recently been awarded the contract to develop an e Health Strategy for AH. The AMA was identified as a key informant. Several meetings have been scheduled to garner input from key stakeholders including AMA physician leaders and staff.
- A Virtual Care discussion paper was recently prepared and endorsed by the board. AMA reps are also participating on a multi-stakeholder virtual care advisory group chaired by a senior physician from the CPSA. A virtual care discussion paper dealing primarily with economic challenges and associated solutions was developed and highlighted at a recent Physician Compensation Advisory Committee and is being considered by AH.
- Immunization advocacy efforts continued through the winter. In February a joint Alberta Health/AMA statement was released indicating that the parties would collaborate toward the massive vaccine rollout initiative. AMA sits now on the Alberta Covid Immunization Coordinating Committee and the role of physicians to administer vaccine and priority to receive it in the community is being identified.
- AMA’s ACTT service is continuing to support both community specialists and primary care (and working with AHS partners) in the continuing journey towards improved integration of the health neighborhood Progress is occurring in all identified priority areas as well as assisting with emerging needs created by the pandemic.
- AMA’s ACTT program, in partnership with other AMA branches, have supported physician leaders in creating an AMA virtual care strategy.
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Support members on pandemic related issues as the situation evolves (e.g., second wave, return to schools) including income stabilization, virtual care and personal protective equipment.
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- A multi-branch response from the AMA is helping members with the practical issues of continuing to practice in a pandemic. Progress is being achieved in some operational issues, but financial advocacy is encountering on-going resistance by government.
- AMA has provided proposals to government in relation to: Income stabilization; quarantine and illness; virtual care strategies; and competitive rates associated with COVID19 treatment.
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In collaboration with others including the Rural Municipalities Association and Alberta Urban Municipalities Association, advocate for an implementation plan to the AHS Ernst and Young report that provides value for patients and is fair to physicians.
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- Monthly meetings occur at a staff level.
- The implementation plan was released October 13, 2020.
- Recommendations 8-13 largely being worked on with JTF and Health Economics staff.
- Additional recommendations for focus have been identified for further Board discussion.
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Goal 2 - Key incentives and supports for physicians are aligned with the delivery of care and toward overall system objectives of timely access for patients to quality care
Activities
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Year-end update
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Complete all approved Income Equity Initiative studies:
- Physician office overhead
- Complete field work including office visits.
- Present preliminary results for validation by the panel.
- Hours of Work Study
- Deploy survey instrument when necessary conditions are achieved (e.g. reasonable level of return to work is established during COVID relaunch).
- Present preliminary results for validation by the panel.
- Market Impact Study
- Present preliminary report to sections for review.
- Approve final report.
- Seek government support for the initiative
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- AMA has contracted with a number of consultants to complete the various studies associated with the Income Equity Initiative.
- The AMA Overhead report was completed and presented to the Spring RF. Overhead cost estimates for all types of physician practices were presented to RF but additional work is required to ensure appropriate office type weighting for section results.
- The hours of work study is ready to launch. The AMACC is closely monitoring criteria and feedback received from a panel of section representatives regarding stability of practice activity that would allow for reasonable hours of work estimates.
- AMA has assembled a panel composed of physician representatives from each economic section. Early survey enrollment/familiarization opportunity and subsequent Q&A meeting is planned for section panel representatives.
- Phase 2 of the Market Study is proceeding, and results are expected by year end.
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Support strategic and tactical initiatives that improve informational continuity and enhance information integration:
- Provide input into the operationalization of key provincial health information-related initiatives, including but not limited to the CPAR/CII initiative, eDelivery of results and the AHS Connect Care provider portal.
- Represent community physicians and physicians in AHS facilities moving from community EMRs to Connect Care in areas such as: eDelivery, data migration, provider and patient portals.
- Provide input into the design and development of a provincial virtual care strategy.
- Advocate for an integrated and efficient rollout of systems needed to support new immunization regulations expected in January 2021.
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- AMA reps have been afforded the opportunity to provide input to AH and AHS and that input appears to be influencing plan development.
- AMA’s ACTT program is supporting physician leaders at tables with AH and AHS on CPAR/CII Rollout and supporting PCNs in implementation and change management.
- AMA’s ACTT program with funding through a privacy and security grant opportunity are rolling out basic privacy training and working with community specialists on implementing CII.
- A Virtual Care discussion paper was recently prepared are tabled with the board. Advancement opportunities are being pursued and efforts are being made to align with other virtual care related initiatives.
- Immunization advocacy efforts continued through the winter. In February a joint Alberta Health/AMA statement was released indicating that the parties would collaborate toward the massive vaccine rollout initiative. AMA sits now on the Alberta Covid Immunization Coordinating Committee and the role of physicians to administer vaccine and priority to receive it in the community is being identified.
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Working with other stakeholders including the student associations, PARA, training institutions and communities, develop solutions to address needs-based gaps in physicians supply.
- Support the development of an effective needs-based assessment.
- Provide input into the development and implementation of PRAC ID regulations to ensure service gaps are filled in a way that is fair to new physicians, practicing physicians and communities.
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- The AMA’s Representative Forum passed several recent motions in this regard.
- The AMA will be working with these stakeholders on responding to government’s consultation process on its new regulations regarding restrictions on PRAC IDs, etc. NOTE: Government announced these restrictions will not be effective April 1, 2022, as planned to allow for additional consultation with stakeholders (AMA, PARA, Medical Student associations, community representatives.)
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Goal 3 - Physicians and the AMA, in partnership with patients, play a leadership role in advocating and promoting a system characterized by Patients First®
Activities
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Year-end update
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Continue to grow the Albertapatients.ca portal community to become the preeminent patient community in Alberta and Canada (Average 200 new members a month to 15,000 in the year).
- Maintaining neutral, non-partisan space for those who join on that basis.
- Migrate PatientsFirst.ca activists over to albertapatients.ca, offering a different, non-political experience helping to improve the system.
- Seek opportunities to inform or support other priority activities in the Business Plan by testing concepts and learning about the way they wish to be involved in the health system.
- Explore alternative platform provider and explore business case for making the move, including new ways to engage community members.
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- Upon first invitation, nearly 1,000 member of the activist panel joined albertapatients.ca. Invitations will be extended regularly. The albertapatients community is now over 14,500
- A major albertapatients survey on the mental and physical and care aspects of the pandemic was conducted in May, tracking against an earlier survey November 2020. As noted elsewhere, the concerning results will be the focus of the AMA’s care deficit campaign
- A new hub platform was launched allowing for more interaction with albertapatients community and more flexibility to deliver information. While licensing costs remained flat there are savings to be made because of greatly increased ability to update the platform and post information without going through the platform provider.
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Provide advice to government on any proposed changes to the Health Professions Act following the white paper consultation process.
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- No proposed changes came forward following the white paper consultation process.
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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.
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- Two letters were sent – one each to AHS and NZMSA – requesting collaboration to address recommendations to improve access to primary care for patients in the North Zone.
- In an ongoing effort to continue the conversation around Indigenous Health and Wellness, systemic racism issues faced by Indigenous people and how to improve health care for Indigenous patients, the Mar /Apr special issue Alberta Doctors Digest focused on the Indigenous experience of Racism in Health Care. This issue included a variety of articles, stories and a video that brought an awareness to aspects of Indigenous Health Care in Alberta and Canada. In addition to being shared with AMA members, the issue was promoted on AMA social media. The issue was completed with the help of Indigenous contributors, editors and photography.
- Following the publication of the Mar/Apr ADD, a presentation on Racism in Health Care was delivered at the Spring RF. The presentation was well-received by RF delegates and they expressed appreciation for the continued conversation around this important topic.
- In June, AHS confirmed that Alberta physicians can access online Indigenous awareness learning resources that the AHS Indigenous Health and Cultural Competence teams have created. AHS Medical Staff members can access these modules via MyLearningLink.ahs.ca and searching for Indigenous Awareness. Non-AHS Medical Staff members can create an account at Create Account | Primary Health Care Learning Portal (absorbtraining.ca) and then search for Indigenous Awareness to access the same resources. This information was promoted to AMA members in the June 24 MD Scope.
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