Monthly Bulletin of the Alliance's Learning Health System |
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OHDC: Use Data to Drive Learning & Make Health More Equitable |
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Get a Big-Picture View of Primary Care in your OHT |
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Get Involved: Research & Sharing |
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Learning Events & Programs |
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Ontario Health Data Council's Call to Action:
Build a Learning Health System to Advance Equity
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Late last year, the Ontario Health Data Council (OHDC) released its first report, A Vision for Ontario’s Health Data Ecosystem. This report calls on health system planners and decision-makers at the Ministry of Health, Ontario Health, and Public Health Ontario to transform the governance, stewardship, and use of health data to drive improvements in care and advance health equity. EPIC News spoke with Jane Philpott, Chair of the OHDC, about the Council’s work, their vision, and the contents of the report.
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Gathering insights from diverse perspectives |
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Dr. Philpott notes that the report comes from nearly two years of work by a diverse group of contributors across the province. They bring a wide range of perspectives including front-line health care, policy, public service, law, and cybersecurity. Partnering organizations include the Office of the Ontario Privacy Commissioner, ICES, Ontario Health, Ontario Public Health, and the Chiefs of Ontario. Collectively, they have a strong interest in equity, public engagement, primary health care, and developing a learning health system. In particular, Dr. Philpott is excited that the Chiefs of Ontario are participating. Their guidance led the Council to emphasize in their report the importance of Indigenous data sovereignty and the urgent need to recognize the rights of Indigenous people and address the health inequities they experience.
To tackle the broad range of issues surrounding health data, the Council broke into working groups dedicated to governance, stewardship, equity & engagement, and electronic health records. While the groups completed the bulk of their work independently, the Council convened monthly to endorse each one’s recommendations and ensure alignment and integration. At times, this was challenging, as each group had different priorities, but Dr. Philpott sees this as a strength. “Processes that have a bit of tension involved often get you to a better place,” she says. As an example, she credits the equity working group for the OHDC’s decision to adopt a broad definition of health data that includes sociodemographic and determinants-of-health data.
Although the OHDC was convened to provide guidance to the Health Minister, the Minister chose to release the report to the public. Dr. Philpott is pleased with this choice to be transparent, as it creates a foundation for trust – not only that our health information is secure, but also that it will be used to improve health and public policy. So far, however, public uptake of the report has been modest. As Dr. Philpott notes, “public discourse is a busy place,” and there are a lot of ongoing conversations about health systems. To advance public engagement, the Council has convened a group of health care clients, families, and community members who will provide guidance and help ensure recommendations resonate with the public. The next phase of the OHDC’s work will be dedicated to making their recommendations more concrete and pragmatic.
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The vision: A multi-sector learning health system |
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This report lays out a vision for a health system where data enables continual learning, person-centered care, population-based planning, and equity. Asked whether she thinks this vision is attainable, Dr. Philpott is cautiously optimistic. She says there is a long list of potential steps to be taken: building the public’s trust in the security of their data, implementing regulatory and technological changes to support better data integration and interoperability, and finding ways to make data and analyses accessible to people where they receive care.
At the same time, she sees increasingly powerful examples of the potential of learning health systems and machine learning. She also points out that the province continues to encourage and support the Council in its work, and that people and organizations who work in health policy and learning health systems have been expressing interest and support. She also points to collaboration at the pan-Canadian level, where a national counterpart to the OHDC is providing similar guidance to the federal government. The provincial and national bodies are collaborating to ensure that their principles are aligned, leading to better data integration among jurisdictions.
Of all the things she has learned through the OHDC’s work, Dr. Philpott says the most exciting was realizing that there is a broad range of people who are enthusiastic about the work and willing to give their personal time to it. “An enormous number of smart, dedicated people want to make our health systems work better.”
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Who are the primary care clients in your OHT?
Data reports from INSPIRE-PHC provide answers.
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Imagine if you and your OHT partners could get a big-picture view of your attributed population. Who are they? Where do they live? How do they access the health system? The Primary Care Data Report (PCDR) from INSPIRE-PHC is a toolkit developed for each OHT that can give you this picture now. EPIC News spoke with Dr. Michael Green and Eliot Frymire, two members of the Attachment Working Group that assembled the data.
A PCDR is available for each of Ontario’s 54 OHTs, with a wealth of data about its attributed population. Numeric datasets examine the characteristics of six priority populations: Those who had an ED visit within the previous 2 years, who were hospitalized within the previous two years, who are experiencing frailty, who receive long-term home care, who have mental health issues, and who received palliative care within the previous year. Each of these groups is categorized according to primary care attachment (whether they are attached, and to which model) and described by 30 different indicators of socioeconomic status, marginalization, health complexity, health system use, and demographics. These datasets are accompanied by maps showing how many people in the attributed population live outside of the OHT’s boundaries and how many are uncertainly attached to primary care providers. Together, these tools helps OHTs and providers coordinate programs and services within and across OHT boundaries, making care more accessible and tailoring it to local needs.
Every OHT uses the reports differently, responding to local goals and priorities. Dr. Green offers an example: An OHT is working on increasing primary care attachment with a focus on people who have a chronic condition and have been hospitalized in the last year. They use their OHT data report to determine the scope of the issue and learn that while there are thousands of unattached people in their attributed population, only about 100 are in this priority group. The primary care providers agree that this would be a manageable increase in their case load. A working group then gathers data from other sources, such as hospital records. They use it to identify these clients, reach out to them, and connect them to primary care.
There has been considerable uptake of the toolkit since it was first released in December 2021. It is being used by OHTs, Family Health Teams, CHCs, Hospitals, primary care teams, Ontario Health, the Ontario College of Family Physicians, the Ministry of Health, and the John Howard society. As the data was taken from ICES administrative databases on March 31, 2020, there is also considerable demand for a data refresh, which is currently underway.
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To access the PCDR, visit this page. Select an OHT from the map or the list below it, and then choose the tool(s) you want to access.
For each OHT, you’ll find:
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A summary/overview report that lists and describes the measures.
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Maps showing where all people attributed to that OHT reside, both within and outside of its boundaries; where those who are uncertainly attached to primary care reside; and where uncertainly attached people from other OHTs reside within the OHT.
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A spreadsheet with data about the population attributed to the OHT and one with corresponding data for all of Ontario.
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Answers to frequently asked questions.
For a walkthrough of the reports and some examples of how your OHT can use them, check out this recorded webinar from December 2021. Dr. Michael Green and Dr. Rick Glazier provide an orientation to the Primary Care Data Reports and share practical examples of how to use it.
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Funding Available
$400 million in funding available for community-based COVID-19 recovery work! The federal government has created the Community Services Recovery Fund to help health service providers and community partners adapt their people, structures, and programs for COVID-19 recovery. Non-profits, registered charities, and Indigenous governing bodies are invited to apply. Learn more here, find application resources here, or reach out to CSRFgrants@redcross.ca with your questions. Deadline to apply is February 21.
News for Clients
Health Connect Ontario is now Health811. This service, which replaced Telehealth Ontario, enables people to access information about non-urgent health issues around the clock at Ontario.ca/Health811 (in French at Ontario.ca/Sante811) or by phoning 811. The website is available in English and French, and the telephone service is available in over 200 languages, including Cree, Ojibwe, and Inuktitut. Health professionals locate health services and find information for callers. An AI-powered symptom assessment tool helps users identify possible causes of their symptoms as well as treatment options. Please update your records and any client-facing materials you have about this service.
Tools for Improvement and Highest-Quality Care
New Quality Standard from Ontario Health for Sickle Cell Disease (SCD): The new Quality Standard, Quality Standard Placemat and related resources provide guidance so you can deliver the highest quality of care for your clients and community members with SCD. The Patient Guide can help people living with SCD know what to ask for in their care. These tools were developed with input from an advisory council that included people with lived experience of SCD.
Data Resources from Ontario Health (Cancer Care Ontario): Ontario Cancer Statistics 2022 and Ontario Cancer Profiles. Reporting on over 30 years of data, Ontario Cancer Statistics 2022 is the fourth in a series of reports which provide comprehensive information on the burden of cancer in Ontario, organized around 4 main types of indicators: incidence, mortality, survival and prevalence. Ontario Cancer Profiles is a self-serve, interactive set of dashboards. It gives you the ability to export data and create custom graphs, maps and tables that show recent provincial and regional statistics on cancer burden, cancer screening, risk factors, and socio-demographic factors.
Knowledge resources to support home and community care: ELEVATE Impact Hub is an online repository of research, webinars, and other tools curated by the Ontario Community Support Association to support evidence-informed decision-making about how to help people age well in their communities. Check out their website or sign up here for their newsletter.
Recent Publications
Health Care Use and System Costs among Pediatric Refugees in Canada examines health system utilization, costs, and illness burden among child refugees. Overall, additional demand on the health system from this population is low, with some differences among resettlement models. Written by Alliance staff and research partners and published in Pediatrics.
Webinars and Podcasts: In Case You Missed It (or Want to Revisit It)
Recorded Lunch ‘n’ Learn Webinar: Support for your 2023/24 Quality Improvement Plans. This webinar from January 26 provides an overview of the 2023/24 Quality Improvement Plan (QIP) program, including resources and priority indicators from Ontario Health, the Alliance, and the Indigenous Primary Health Care Council. Find the recording, slide deck, and links to resources here.
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Looking for more?
Consider subscribing to these newsletters to receive regular updates from Alliance system partners:
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Research & Sharing Opportunities |
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Research Partners Needed
Deaths and Diseases of Despair (DDoD) Study: DDoDs include substance-use disorders, diseases, and overdose/drug-poisoning deaths, which are believed to have common social causes, including social exclusion, poverty, and an inadequate social safety net. A team of researchers from York University is seeking partners who work in social policy and social protection spaces providing harm reduction approaches to partner in a study. Partners will have opportunities to contribute to all aspects of the study design and implementation as well as dissemination. The research team is asking prospective partners to add their name to a SSHRC grant application and contribute a letter of support. A template will be provided. For more information, reach out to Chungah Kim by email or by phone at 365-888-1871.
Primary care clinicians needed: Help guide comparative research about the care and outcomes in different PC models for people living with dementia. A research team from Arizona State University and Dalla Lana school of Public Health want to understand what enables effective communication and diagnoses with primary care clients who have mild cognitive impairment (MCI) or early-stage Alzheimer disease or related dementia (ADRD). They're comparing different models in Ontario, Arizona, and New York State. Interested? Consider joining the project's steering committee. For more information, please email Allie Peckham email Allie Peckham at Arizona State University.
Clinical Trials and Participatory Research
Recruitment in Ontario is now open for the CanTreatCOVID Adaptive Platform Trial. Adults aged 18-49 with one or more chronic conditions and all adults aged 50+ years are eligible to participate if they have had a positive diagnosis of COVID in the past five days. Learn more here or contact the study team to sign up. This pan-Canadian study is based at MAP Centre for Urban Health Solutions, Unity Health Toronto and funded by the Canadian Institutes of Health Research, Health Canada, and the Public Health Agency of Canada. Dr. Jennifer Rayner, the Alliance’s Director of Research and Evaluation, is one of the co-investigators.
Research opportunity for Alliance member organizations: Goal-oriented care in Community Health Centres. A research team at the Lunenfeld-Tanenbaum Research Institute is recruiting primary health care teams (6-8 clinicians and interprofessional providers) from four CHCs to participate in this study. If you are familiar with goal-oriented care and have either used this approach or are willing to try it, you can help them understand how it’s implemented in a real-world setting. They’ll use what they learn to make the model more accessible and feasible. Participants will be asked to reflect on their experiences with goal-oriented care in interviews. Check out the infosheet or email Carolyn Steele Gray or Dagje Boeykens for more information.
Do you have older adult clients who are experiencing loneliness? A research team at Baycrest is studying the use of a virtual, at-home program aimed at promoting brain health. Participants will engage in either mindfulness meditation or brain training for 8 weeks and complete online sessions and surveys to assess the impact of the interventions. Compensation will be provided. To be eligible, participants must be over 60, live in Ontario, and have access to a mobile device or computer with an internet connection. Full details and contact information here. Register here.
Need help with client engagement and communication? Get access to the Canadian Primary Care Information Network (CPIN), tailored messages for your vaccine-hesitant clients, and up to three additional communications and survey campaigns on topics of your choice. Family physicians at the University of Ottawa and Monfort Hospital are studying how automated patient engagement systems like CPIN can improve communications with clients about COVID-19 vaccines. Get more information here or email the study team.
Interviews and Focus Groups
Social workers in primary health care: Your insights are needed. Researchers at the U of T are inviting you to help inform recommendations on how best to organize social work practice in interprofessional primary care settings. In this phase of a mixed-methods study, social workers from primary health care teams across Ontario will participate in semi-structured, 60-minute group conversations about their daily practice during the pandemic. All data collected will be kept confidential, and you will not be identified in study results. Dr. Rachelle Ashcroft, an Associate Professor of Social Work at the University of Toronto, is leading this study. For more information or to get involved, email Simon Lam, Research Coordinator.
Primary Care Providers: Is at least 60% of your practice made up of clients who experience marginalization in some way? Do you have high (70%+) cancer screening rates for these clients? Consider sharing your insights and approach through a 1/2-to-1-hour interview with researchers from Women's College Hospital. Learnings will be used to develop targeted cancer-screening interventions. Remuneration will be provided. For info, see this flyer and email Arlinda Ruco at WCH.
Surveys
Evaluation survey: Phase 1 Guidance for Clinically Appropriate Use of Virtual Care for Primary Care. The Evidence Network is conducting an evaluation of these virtual care guidance tools on behalf of Ontario Health. The tools were developed for primary health care providers by OH in collaboration with an expert panel of clients and providers. Please complete this five- to ten-minute survey by February 28.
Do you have clients who are currently breast/chest feeding, pregnant, or planning a pregnancy? Encourage them to complete this survey by February 3, 2023, to share how they feel about receiving COVID-19 vaccines while breast/chest feeding. It’s part of the Confidence Project, a initiative by McMaster University and Health Nexus to support vaccine confidence and uptake.
Survey for your older adult clients: A graduate student at the University of Toronto is surveying older adults about how they use the Internet for health information, and how they would like to learn new information for their health maintenance and improvement. Anyone aged 55+ is welcome to participate, especially those who are Indigenous, racialized, 2SLGBTQ+; have disabilities; or live in rural/remote areas. Consent form and survey here. For further information, please reach out to Mary Hynes by email or at (416) 597-3422 ext. 7775.
Does your organization provide health care or other supports to refugees and asylum seekers? Researchers at the University of Calgary are looking for people working in clinical, public health, or settlement organizations to answer some questions via an online survey. They want to understand who provides care to refugees and asylum seekers in Canada, how this care is coordinated and delivered, how it differs among jurisdictions, and how COVID-19 has impacted it. Participate by completing this short survey. In lieu of an honorarium, the research team will donate $10 to support refugee student scholarships. See flyer (English or French) for more information.
Help shape the future of virtual health care in Ontario! Researchers at the University of Toronto and University of Ottawa are looking for primary health care clients and caregivers in Ontario to take a 15 to 20-minutes survey about their experiences and expectations with virtual care appointments as a patient or caregiver with a doctor, nurse, or another healthcare professional in a family practice. See the flyer for more information. The survey can be accessed at the links below:
Collaborative Learning
Pilot: Improving the quality and access of sexual and reproductive healthcare for 2SLGBTQ people living in Canada. Sherbourne health is offering two new courses as part of a pilot project, funded by Health Canada, aimed at building health care providers’ capacity to provide culturally safe, affirming, and accurate care to 2SLGBTQ clients. They are looking for healthcare providers across Canada who are interested in taking one or both of the following courses, which will be offered once each between February and March 2023:
- General Sexual and Reproductive Health and Wellness for 2SLGBTQ Communities
- 2SLGBTQ Fertility Care and Family Planning
SPIDER Learning Collaborative: De-prescribing dangerous medications. Can data-driven QI activities help de-prescribe potentially harmful medications, for medically complex senior clients? Help answer this question and improve health outcomes for your clients by participating in a 12-month learning collaborative. EMR queries will be provided to help participating Alliance members identify clients who would benefit. Contact Jennifer Rayner for more information.
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Learning Events & Programs |
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February
Monday, February, 6, 3:00 pm | NSS-CoP Monthly Research Spotlight Webinar: Imagine Safer Supply. Hear about a multi-provincial research project from the Canadian Drug Policy Coalition that’s exploring the attitudes and perceptions people have about safer supply. The research team will describe the project and share emerging findings. Speakers TBD. Register here.
Thursday, February 23, 12:00-1:15 pm | Social Prescribing Lunch 'n' Learn Series: Community Connection/211. Community Connection 211. has been accepting referrals from health care providers and paramedics to support their patients with social determinants of health since 2015. Their specialized community navigators use a comprehensive database to connect individuals with appropriate supports in their communities. This includes a follow-up process and report back to the referring provider for closing the loop. On February 23, they'll join us for a conversation about how they can support your social prescribing program. Bring your questions and ideas! Register here.
March
Wednesday, March 1, 1:00-2:30pm | NCCDH Webinar Series on Anti-Black Racism in Public Health, Part 2: Anti-Black Racism. The National Collaborating Centre on the Determinants of Health (NCCDH) has partnered with the Black Health Education Collaborative (BHEC) to present a 3-part webinar series on anti-Black racism and public health. This interactive series will explore how anti-Black racism impacts health and identify concrete opportunities for public health action. Learn more and register for all sessions here.
Thursday, March 9, 12:00-2:00pm. Social Needs and SDOH: Impact on Patients & Communities. Health-related social needs (HRSN) have been top of mind for health care organizations in recent years, but with new mandates ahead to screen all patients for social determinants of health (SDOH), now is the time for leaders to act. At this free webinar from the New England Journal of Medicine you will get a roadmap to building a comprehensive SDOH and HRSN care delivery model including screening programs, referral channels, associated technology needs, and how to best measure your success. Register here.
Wednesday, March 29, 1:00-2:30pm | NCCDH Webinar Series on Anti-Black Racism in Public Health, Part 3: Uprooting Anti-Black Racism. The National Collaborating Centre on the Determinants of Health (NCCDH) has partnered with the Black Health Education Collaborative (BHEC) to present a 3-part webinar series on anti-Black racism and public health. This interactive series will explore how anti-Black racism impacts health and identify concrete opportunities for public health action. Learn more and register for all sessions here.
April
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