Priority Activities

Year-end update

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.

• ACTT developed and supported g change packages and tools to support provincial initiatives (example: CII/CPAR)
  • 6 Patient's Medical Home change packages available on the ACTT website.
  • Key messaging and communications plans developed.
  • A total of 7 EMR vendors were supported to enable CII/CPAR.
  • Ongoing support was provided to the following 5 vendors who are enabled for CII/CPAR: TELUS Wolf, TELUS PS Suite, TELUS Med Access, QHR Accuro, and Microquest Healthquest.
  • Support was provided to the following 2 EMR vendors as they work towards becoming enabled for CII/CPAR: TELUS Collaborative Health Record (CHR) and EPIC/ Ava   8 change packages are currently available on the ACTT website (Panel Processes, Continuity, Screening & Prevention, ASaP+, Opioid Processes, Care Planning, H2H2H and RIFS).
• ACTT has supported PCN zones in implementing provincial targets for CII/CPAR. Progress as of August 2022:

• ACTT has offered a number of training sessions and opportunities for network connections (combination as required across Physician champions, practice facilitators, panel managers or EMR supports):
  • 20 EMR Network sessions with 594 participants
  • Physician Champion Network sessions with 203 participants
  • 9 CII/CPAR Open Space for Practice Facilitators webinars with 542 participants
  • 8 Practice Facilitator Monthly webinars with 767 participants
  • 2 Core Practice Facilitator Training cohorts with 52 participants representing 29/40 PCNs.
  • (21/40) of PCNs have used ACTT support at strategic board planning sessions
• ACTT supported clinics in transitioning clinic practice changes in a blended capitation model:
  • 8 clinics interested
  • 5 clinics live
  • A total of 9 clinics attended the 6 BCM community of practice meetings
• ACTT Continues to support PCN leads executive leadership in monthly meetings, strategic sessions, and work on task groups and committees.

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.

• ACTT partnered with Alberta Health Services (AHS) in developing tools for Hospital to Home transitions improvement:
  • H2H2H Transitions Change Package: 1.  testing plan as developed in Q3. 2. Facilitated physician champion feedback on Change Package.
  • Co-facilitated information sessions with AHS on H2H2H IT Enablers Map; My Next Steps (patient tool).
  • Supporting zone Transitions of Care Committees to operationalize H2H2H Transitions Guideline elements as capacity exists in each zone.
  • Development of change management practice level tools for H2H2H.
  • A PIN (Provincial Implementation Network) structure under the I-ZICC (Inter-Zone Implementation Coordination Committee) has been co-developed with AHS.
• ACTT has partnered with AHS (PHCIN), Physician leaders, and the Province on the Alberta Surgical Initiative:
  • PCN Zones have recruited primary care physician representatives for the working groups addressing orthopedics, urology, and ophthalmology.
  • New PCN Physician lead executive representative was onboarded to ASI sponsorship role.
  • A Physician Community of Practice was created to support the primary care physicians on ASI zone and provincial working groups.
  • A Provincial Specialty Advice Model, a Provincial Pathways Unit Operation Model and Repository have been endorsed for development.
  • ASI Governance 2.0 has been populated with physician representation at the Executive Oversight Committee and the four Sub-Tables.
  • 6 ASI Physician Leads (Primary Care) are in recruitment phase.
• Support development of PCN zone service planning through support PCN Physician leaders in the zone and being part of zone support team.
  • 5/5 Zones have a zone service plan that aligns with the provincial priorities.
• ACTT Team supports PCN physician advisory committees in all 5 zones.
• ACTT supports physician leadership groups and committees such as PCN Physician Leads Executive, Primary Care Alliance, Provincial Primary Care Networks Committee, the Specialty Care Alliance, the Inter-Zone Implementation Coordination Committee, PCN zone Committees, and others as required. Support includes strategy development, improving the sustainability of governance and visioning the future in areas such as Rural Sustainability, Measurement and Evaluation, and the Future of Primary Healthcare.

Support members on pandemic related issues as the situation evolves (e.g., care deficit, return to schools) including income stabilization, virtual care and personal protective equipment.

• ACTT has supported physicians across the province and PCNs in responding to the COVID pandemic.  ACTT has delivered educational webinars and has been supporting members and partners with PPE distribution, Rapid Antigen Testing, new treatments, managing restrictions and advice, virtual care support tools and others as required.

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.

• The AMA, RMA, AUMA group continues to meet periodically. The last meeting occurred on March 22.  

Priority Activities

Year-end update

• Complete the remaining Income Equity Initiative studies:
  • 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
    • ​​​​​​​Complete phase 2 of the Market Impact Study
  • ​​​​​​​Physician Compensation Study
    • ​​​​​​​Align claims data with the various components of the study
    • Ratify the IEI with membership
  • ​​​​​​​Seek government support for the initiative

• Earlier this year, the AMA Compensation Committee (AMACC) developed a project plan that defined the steps required for the AMA to develop an equity-based compensation adjustment (Interim Measure), using the best available data to inform a future allocation decision. The Interim Measure was reviewed by the (all section) Physician Panel on May 3 and by RF on May 13 and 14, where it received RF approval. AMACC has advised that the interim Measure is now complete and has provided this information to the negotiating committee.
• Under the IEI Interim measure, five economic sections were identified as falling below the lower income equity threshold: Family Medicine, Psychiatry, Pediatrics, Neurology and Obstetrics & Gynecology.
• The Hours of Work Study began on March 29, 2022, with daily activities logging from April 4 to July 24. The last day of physician activity logging for the Hours of Work study was July 24. Staff are working with the study vendor (Malatest) to process the collected data and begin analysis. All (IEI related) reporting will be reviewed by AMACC and provided to the (all section) Physician Panel for feedback. The Hours of Work final report is expected to be completed in December.
• The Institute of Health Economics has provided the AMA with a draft of the Market Report and Dr. Kate Harback provided AMACC with an overview presentation of the report at its June meeting. The Market Study is designed to address RF17Sp-08: “THAT any income equity adjustment based on ANDI model or variant, factor in physician supply and patient access.” The objective of the Market Study is to provide information on the likely supply responses to potential ANDI-related rate changes. The AMA is currently reviewing the report in detail.

• 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 protocols.

• Alberta Health recently launched an eHealth Modernization project. In collaboration with other key provincial stakeholders this project will work towards a more comprehensive integrated eHealth ecosystem. This will include improving system integration and communications in support of a more comprehensive, effective system. The working group is co-chaired by the AMA Informatics Chair, and AMA physicians and staff will be involved in a series of workshops to identify physician and provincial priorities. It is expected that the AMA will be tightly involved through the lifecycle of the project.
• AMA continues to work with AH in advancing the CPAR/CII initiative through physician design and prioritization input at clinical work groups.
• AMA physician leaders and staff continue to work with the AHS Connect Care team on identifying challenges for community physicians, and minimizing negative impact to patient care by collaboratively working on resolutions through eDelivery improvements and other system enhancements. Over the past few months results routing issues were raised and discussed with the Section of Family Rural Medicine and the Section of Family Medicine, and then taken to the AMA board for consultation in February.
• Work continues on virtual care standards and policy through the CPSA led Alberta Virtual Care Coordinating Body; compensation is not in scope and is being addressed through negotiations.
• Expectations on work on the technology roadmap for immunization will fall under the eHealth Modernization project.

• Working with other stakeholders including the student associations, PARA, training institutions and communities, develop solutions to address needs-based gaps in physicians supply.
• Provide support and input to stakeholders including medical student associations, PARA, training institutions and communities on responding to government’s consultation process on its new regulations that are expected to take effect April 2022. (Note: Government has deferred implementation of the legislation and has advised that at a minimum it will not apply to physician residents who are eligible for a billing number in the next fiscal year.)

• A joint statement between government and AMA, government stated that the restriction on new billing numbers (PRAC IDs) would not begin on April 1, 2022, as provided for in 2019 legislation.
• The government has told the AMA that they have no intention of moving forward with using this legislation. The AMA and government are working on developing a Physician Resource Planning Committee and will be looking at alternative strategies for physician resource allocation within that process.
• The tentative agreement provides for the re-establishment of a Physician Resource Planning Advisory Committee (PRPAC) and also puts programs and funding in place to assist in this regard. The AMA and government will jointly develop a Terms of Reference to be recommended to the Minister for a renewed PRPAC. Medical students and physician resident’s will be included as members of the PRPAC.
• AMA will continue to work with stakeholders including medical student associations, PARA, training institutions and communities on establishing a needs-based physician resource plan for Alberta.

Priority Activities

Year-end update

• Maintain or expand the Albertapatients.ca portal community to become the preeminent patient community in Alberta and Canada currently at 15,000 members.
  • 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.
  • Albertapatients.ca will be the driver of public advocacy with respect to the COVID care deficit and what is needed for recovery through multiple surveys and reporting.
  • Improve community member experience by taking advantage of capabilities of new platform for engagement between surveys.

• albertapatients has exceeded the 15,000 mark and is climbing again with new recruiting efforts on AMA social media platforms and encouraging the PatientsFirst.ca activists to join.
• The population is more than sufficient for general statistical soundness but as (we believe) the largest patient panel of its sort in Canada, there is value in continuing to grow. This will also be helpful as we dig into more granular issues to support advocacy where the population in the panel for a certain topic may be smaller.
• albertapatients is a key support tool for the Joint Physician Advocacy Committee in its mandate to advocate toward recovery from the COVID care deficit. We have recently taken a pulse on care deficit impacts as we have measured them over the course of the pandemic. In early May we launched a full survey regarding pediatric mental health, the first issue highighted by JPAC in its Care Deficit Assessment Series. Further topics will be released regularly and physicians contributing advocacy content also have opportunity to suggest questions that can go to albertapatients to better understand patient needs and concerns. The pediatric mental health study gained local, provincial and national media attention and data is being used to develop further advocacy.
• In September we intend to survey regarding physical and mental health vs. the benchmarks we have been tracking through the pandemic. We are also exploring with JPAC how to engage the community in the need for a team approach to use of allied health professions.

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.

• The Indigenous Health Committee recently welcomed new community member representatives from Treaty 6 and the Métis Settlements General Council.
• The AMA supported and advocated for improved health care delivery for the Indigenous community. This involved outreach to Indigenous physicians and First Nations communities, participation in the Population Aboriginal Health SCN and continued activity of the AMA Indigenous Health committee.
• Planning for the AMA Board viewing and discussion of the film, The Unforgotten is ongoing.