1 PCR - Primary Care Reform “From theory to practice”

2 What is PrimaCare The Paris Primary Care Network Signed agreement with Ministry of Health in February 1999, making us the first primary care network

3 From the Beginning A complex environment, controversy, political changes Reduced satisfaction with access to care Reduced physician satisfaction Changing fiscal environment

4 The Process Phase I -Developing a rostered population Phase II - IT [choices,implentation,network activation] Phase III - Telephone Health Advisory Service Phase IV- Evaluation [provincial&participants]

5 Phase II Informatics & IT - ongoing Core Data Set Data connectivity (lab,ODB,drug interaction checking facility….others?) Confidential messaging electronic records[prescription writing etc] FUTURE VISION tba

6 Phase II Informatics & IT-core data set patient demographics registration/enrollment data medical information section - problem list, co-morbidity,medication history, family history, allergies, risk factors and ALERTS

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8 Phase III Telephone Health Advices “ ON- CALL HEALTHLINE “ toll free :00 PM to 9:00 AM weekdays & 24hours weekends and holidays

9 PrimaCare Now 7 physicians - 5 sites over 10,500 rostered (over 1,500 new patients) Over 70% signed consent forms NP on site since February 1999 THAS began October 1, 2000 IT - implementation started New payment methods with targets and incentives active since December 1999

10 Natural Linking Hospitals Public health CCAC others

11 Focus on Public Health & PrimaCare actions developed together [based on the health status report] specific joint initiatives -tobacco cessation,sexual health etc using the data of the PrimaCare roster- applied epidemiology joint program initiation [Falls program] evaluation of initiatives IT interfaces in the future

12 Keep this in mind PCN is a voluntary arrangement of 3 years Heavy administrative component to the process so far IT in very early stage (core data set? to come) THAS - October 1, 2000 Significant evaluation results coming shortly

13 Success Factors All active physicians involved Strong doctor/patient relationships Supportive community and stakeholders [Health Unit / Health Council] Supportive hospital (The Willett and the BCHS) Infrastructure support MOHLTC /OMA Strong information resources

14 Thankyou John W McDonald MD 238 Grand River St North web site: primacare.ca

15 Goals and Objectives Increase patient and provider satisfaction – broader range of health services – enrollment / rostering Increased efficiency through – reduced duplication – better use of information – patient and provider accountability

16 Goals and Objectives Improved access to primary health care – stability of the network – extended office hours – 24 hour response system – telephone health advisory service Improved quality and continuity of care – prevention – information technology

17 Services PCN Provides The basket of services include: Service coordination Episodic care Access to hospital care and coordination Patient education and preventive health care Appropriate periodic health assessments

18 Basket of Services (continued)  Health assessment Diagnosis and treatment Primary reproductive care Primary palliative care Primary mental health care Access to obstetrical care and newborn care