Beruflich Dokumente
Kultur Dokumente
Outline
Introduction
(PCNs) Brief Overview of Trilateral Committee Structure Implementation Research & Evaluation Questions
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Wednesday October 27, 2010
of the Strategic Physician Advisory Committees Mandate Broad responsibilities in planning, implementation and evaluation Equal representation of AHW, AHS and AMA
Trilateral Governance
Primary
Trilateral agreement between Alberta Health and Wellness, the Alberta Medical Association and Albertas Regional Health Authorities
A reem nt S g e tructure
M te C m itte as r o m e
The
S creta e riat
New way to deliver primary health care Local initiatives within provincial framework Formal arrangements between AHS and groups of physicians Defined roles and responsibilities AHS representatives and physicians in PCN jointly
PCN Governance
PCN
partnership is formed through a joint venture agreement between AHS and a not for profit corporation (NPC) formed by the physicians Partnership forms a governance committee to provide oversight for the network
Increase access to primary care 24/7 management of access to appropriate primary care services Emphasis on: health promotion, disease and injury prevention, care of medically complex and chronically ill patients Improve coordination and integration of primary health services Greater use of multi-disciplinary teams
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Basic ambulatory care Care of complex problems Psychological counselling Screening/chronic disease prevention Family planning and pregnancy counselling Well-child care Obstetrical care Palliative Care
Geriatric care Care of chronically ill Minor surgery Minor emergency care Primary in-patient care including hospitals and long term care institutions Rehabilitative care Information management Population Health
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PCN funding
PCNs operate within a mixed payment environment, receiving a per-capita payment of $50 per patient per year from Alberta Health and Wellness. Physicians continue to be compensated for insured medical services using either fee-for-service or existing alternate payment arrangements. In the past some PCNs also received funding from Capacity Building, Specialist Linkages and Pharmacy Grants.
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services or service enhancements (e.g. other health care providers and incentives to expand comprehensiveness of existing services) Physician services not covered under the Physician Services Budget (PSB) or AHS.
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What is a panel
Panels identify the patient population for which a provider is responsible. Panels are based on historical fee-for-service and shadow billing information for the last 3 years. The actual size of the panel determines per-capita funding for each PCN.
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Evaluation (August 2008), assessed how PCNs increased access Comprehensive evaluation of PCI and PCNs to be completed in March 2011.
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New service provider roles Expanded service New locations Education and screening programs Multidisciplinary teams New access strategies
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PCN Impacts on
Improving
Access
Reducing wait times Reducing patient backlog waits Providing after-hours care Avoiding/limiting inappropriate ER use Linking unattached patients to primary care providers
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PCN Impacts on
Health
Improved identification of population health needs Improved integration between primary care providers Improved satisfaction with health promotion and disease and injury prevention
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PCN Impacts on
Care
Enhances the role of family practice nurses Patient registries ensure more comprehensive care Integrating patients and providers with the right services
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PCN Impacts on
Coordination
and Integration
Use of multidisciplinary teams Development of service responsibility agreements Patient referral/feedback mechanism Joint agency/program collaboration
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PCN Impacts on
Multidisciplinary
teams
Co-location and centralized service delivery Effective teams with diverse skills Delegation of responsibility Enhanced information sharing among providers More comprehensive and coordinated care
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Evaluation Conclusions
The
Aim for comprehensiveness Provide clinically effective services Build on the social capital in their community Focus on high need and high priority program areas
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New and expanded roles for health care providers. Chronic disease prevention and management Change management and access and process improvements (AIM) Research and evaluation
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Two Audits by the Office of the Internal Corporate Auditor (OCIA) Evaluation of Access through primary care networks Evaluation of the Primary Care Networks and Pharmacists Integration Project (completed) Evaluation of Primary Care Initiative Health Quality Council PCN Pilot (currently underway) Research: The Impact of Primary Care Networks on the Care and Outcomes of Patients with Diabetes
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Audit of the PCI Program by the Office of the Auditor General (OAG) CIHI EMR Standards Pilot Primary Health Care Strategy released by AHW
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PCNs
In the past year the number of PCN has grown to 38 Approximately 2202 family physicians are in a PCN Other health care providers including nurses, dieticians, social workers and pharmacists are currently part of a PCN. More than 2.5 million patients are informally enrolled with PCNs. An additional four PCNs are in various stages of development
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What is Next
Development
and release of a Primary Health Care Strategy by government Continued Support for PCNs and related Initiatives Work on an Evolved PCN model with an examination of existing policies Data - New Initiatives supported by grants
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Questions?
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