cii-cpar - pcnpmo.ca · clinic willing to assign a cii/cpar site liaison to: o manage readiness...
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Technology for Integration and ContinuityOctober 4, 2018
CII-CPARCommunity Information Integration
Central Patient Attachment Registry
PCN Strategic Leadership Forum 2019 - Workshop
Presenter Disclosure
• Faculty:
– Barbra McCaffrey
– Chris Diamant
– Sheena George
• Relationships with financial sponsors:
– No relationships to declare.
3
Partners
Why Technology for
Continuity & Integration?
4
Current Patient Journey
Patient is paneled
Recorded in EMR
Refer to Specialist
Referred to another Specialist
Patient ends up in hospital or ER
No reliable notification to Family
Physician
ER docs have limited access to information
Patient follow-up may fall through
the cracks
Rationale/Benefits
• Evidence shows that when a patient has a continuous relationship with a family physician/nurse practitioner and care team, the overall result is better than when care is disjointed or broken
• Higher continuity is associated with improved health, quality of life, and reduced mortality
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CII/CPAR Alignment with PCN Initiatives
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Transitions
of Care
Opioid
Response
Patient’s
Medical
Home
Continuity
Of
Care
What are CII and CPAR?
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• A provincial system that captures the
confirmed relationship of a primary
provider and their paneled patients.
• Receives information automatically
from clinic EMRs on a monthly basis
• Next logical step for practices that
have invested in panel management
• Foundational for future enhancements
of informational continuity
Central Patient Attachment Registry (CPAR)
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CII is a system that collects select patient information
from community Electronic Medical Records (EMRs) and
shares it with other members of the patient’s care team
through Alberta Netcare.
Community Information Integration (CII)
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Community Physician Office
EMRs
CII Data Hub
Alberta Netcare
Healthcare DataRepository
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CII/CPAR in Primary Care
CommunityPhysician Office
EMR
1.Encounter Data
2. Panel Lists
CII Data Hub
Alberta Netcare
Central Patient Attachment Registry
CED Report
Panel Conflict Report
Demographic Mismatch Report
Consult Report
3.Consult Reports
What is the Role of the PCN?
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PCN Journey and AMA/AH Supports
Knowledge
Resource Determination Training
Member Engagement
Guidance,
Support &
Facilitation
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AMA/ AH teamPlanning Tactical support
Engagement toolsPresentationsHandouts and FAQs
Team Toolkit for PCNs and Clinics
PCN Resource Training EMR Guides, CPAR Application
Guide & Videos Privacy Seminar Privacy Questionnaire Privacy Guidance
Clinic Journey
Engagement and Interest
Registration and Participation
Onboarding
Go-Live
Panel Management& Process Improvement
Post Implementation Evaluation
PCN Facilitation
AMA Support
Alberta Health&
EMR Vendors
PCN Facilitation
AMA Support
Alberta Health
PCN Support
How do PCNs and Members
get Ready?
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Criteria for CII/CPAR Participation
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Prerequisites Commitment Compliance
CII PIA endorsement signed by custodian(s)
Clinic PIA is accepted by the Office of the Information and Privacy Commissioner (OIPC) and reflects current environment
Custodians have a Health Information Act (HIA) compliant Information Management Agreement (IMA) with their EMR Vendor
Clinic willing to assign a CII/CPAR site liaison to:
o manage readiness requirements
o assist with CII/CPAR data quality testing
o coordinate awareness and training
o support issue management
Participate in evaluation activities
Sign participation agreement
Clinic Live on Alberta Netcare
Clinic PIA is up-to-date
EMR
o Vendor is conformed to CII/CPAR
o Use latest version of MQ EMR
Panel Readiness
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they are obligated to place a Health Collection Notice poster within a patient’s view.
A customizable template is provided to the clinic.
If patients have further questions, CII Patient Brochures are also provided.
A Custodian Script for Patients is provided which outlines how to discuss patient’s expressed wishes
and the use of confidential flags as well as masking in Alberta Netcare.
The Patient Frequently Asked Question (FAQ) document explains the CII/CPAR initiative and its
implications to patients of CII/CPAR clinics. It also provide patients with contact details if they have more questions.
The CII/CPAR Privacy & Security FAQ further details the sharing of health information.
Health Collection
Poster
Patient Brochure
? Custodian & Team Script
Patient FAQ
Privacy & Security FAQ
CII/CPAR falls under the Alberta Netcare umbrella, which is covered by the Health Information Act.
Providers are not required to have directconversations with their patients, however… About Privacy…
PCN CII/CPAR ReadinessPCN *Clinic
CountLive On AlbertaNetcare
Conformed EMR vendorsMQ + TELUS
**Non-Conformed
PIALast 5yrs
PIA>5 yrs
***No PIA found Panel Readiness (Y/N)
ICE 20 100% 80% 20% 0 13 7 TBD
FIRE 20 70% 40% 60% 0 20 0 TBD
*From PCN website** Unknown EMR or paper based*** 3 data sources (OIPC, AH, POSP)
Things for the PCN to consider:
• Are there PCN Change Agents (Improvement Facilitators) to facilitate CII/CPAR implementation?
• Can the Change Agent offer the privacy self-assessment to the clinic to formulate a response to eHealth Support Services?
• Is the Change Agent in a position to assess panel readiness?
Westeros PCN CII/CPAR ReadinessFamily Clinics Lords/
LadiesLive On Netcare
ConformedEMR Vendors
% MQ + TELUS
**Non-Conformed
PIALast 5yrs
PIA>5 yrs
***No PIA found
Panel Readiness (Y/N)
HouseBaratheon
6 0
HouseLannister
20
0
House Stark 5
Yes
HouseTargaryen
10 0
HouseGreyjoy
1 No
0
*From PCN website** Unknown EMR or paper based*** 3 data sources (OIPC, AH, POSP)
Are there Tools to Support
PCN Implementation?
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Tools ( www.topalbertadoctors.org/CII-CPAR)
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CII/CPAR Guide for:
• PCN Change Agents
• Participating clinic teams
Team Toolkit
• Process Guide– Responsibilities of various groups:
• PCN, AMA, eHealth Support Services, EMR
Vendor, Clinic Team
• Content guide
– Improvement Facilitation related to
CII/CPAR and Continuity of Care
Team Toolkit – A Guide for PCN Change Agents
• Background
• Prerequisites
• Privacy and
Security
• Teamwork
• Clinic Journey
• CPAR Web Portal
Guides
• Conflict and
Mismatch Report
Management
• Scripting
• Glossary
• Roles and
Responsibilities
• FAQ
Team Toolkit - Contents
Why Invest in Change Agents?
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Change Agents – Enablers for Improvement
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Accelerates the Rate
Augments Effectiveness
Builds Capacity for Improvement
Practice
Change
Improvement Facilitator Physician Champion
Panel Manager
• Require
– Training
– Sponsorship for the initiative from leadership
• Transfer learnings from one practice to another in
the PCN
• Networks of Practice support the change agents and
the transfer of better practices across the province
Lessons from Early Adopters – Change
Agents:
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• PCN Investments
– Proactive preventive screening care (ASaP, ASaP+)
– Chronic disease management
– Care planning for patients with complex health needs
(PaCT)
– Transitions of care
– Opioid Response
CII/CPAR – Next Logical Step in Proactive,
Panel-based Care Delivery
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• Patient’s primary provider (MRP) is identified
– Care is coordinated and services are not duplicated• In the PCN or in the province
• Gaps in transitions in care are closed with e-
notifications
• Attached and unattached populations can be
identified
CII/CPAR – A Direct Fit with PCN
Investments to Ensure
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Short Term
Medium Term
Long Term
More Information and Resources
30www.topalbertadoctors.org
Questions
& Next
Steps
Information
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• Contact: Chris Diamant, EMR Advisor
[email protected] or (780) 266-4147
• Contact: Barbra McCaffrey, EMR Lead
[email protected] or (780) 231-0254
http://www.albertanetcare.ca/learningcentre/CII.htm
http://www.topalbertadoctors.org/CII-CPAR/