In this Update

• Strategy for Patient-Oriented Research (SPOR) Summit 2016
• Taking the Pulse of Primary Care Reform Conference
• 2016 Quick Strike Grants Funded in BC
1. A comparative analysis of centralized waiting lists for patients without a primary care provider implemented in six Canadian provinces
2. Validation of administrative and primary care electronic medical record derived frailty algorithms
• Canadian Primary Care Sentinel Surveillance Network

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Strategy for Patient-Oriented Research (SPOR) Summit 2016

The Canadian Institutes for Health Research hosted the SPOR Summit last week, October 25-27, in Ottawa, to bring together SPOR stakeholders, including patients, federal/provincial/territorial ministry representatives, partners, researchers, and clinicians. Several BC-PHCRN leads and staff attended the event, and were inspired by the story of Tal Golesworthy, a patient who worked with surgeons to develop a new medical device. Learn more about Golesworthy here and about the SPOR Summit here.

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Taking the Pulse of Primary Care Reform Conference

On March 10, 2017, at the Pinnacle Hotel Vancouver Harbourfront, clinicians, policy makers, health authority representatives, researchers, and patients will gather to explore the promise, potential, and (real) progress on primary health care reform in BC and Canada. A call for research poster abstracts is open for this event, hosted by the UBC Centre for Health Services and Policy Research, and registration will open in November. More details

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2016 Quick Strike Grants Funded in BC

In the spring of 2016 two BC-PHCRN-supported Strategy for Patient-Orient Research (SPOR) Pan-Canadian Network in Primary and Integrated Health Care Innovations (PIHCI) Quick Strike operating grants were awarded funding for one year. Six months in, how are these projects going?

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1. A Comparative Analysis of Centralized Waiting Lists for Patients without a Primary Care Provider Implemented in Six Canadian Provinces

Principal Investigators: Mylaine Breton, Université de Sherbrooke; Michael Green, Queen’s University; Jalila Jbilou, Université de Moncton; Sara Kreindler, Winnipeg Regional Health Authority; Jason Sutherland, University of BC

4.6 million Canadians, approximately 15% of the population, do not have a regular primary care provider (i.e. family physician or nurse practitioner), although being attached to such a provider is widely considered to be a prerequisite for obtaining health care that is timely, accessible, continuous, comprehensive, and well-coordinated. To address the need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists. These waiting lists centralize unattached patients’ requests for a primary care provider in a given territory and match patients with providers.

Study objective

• Compare the different centralized waiting list models implemented in the six provinces to each other and to available scientific knowledge to make recommendations on ways to improve their design

Activities to date

• A grey literature analysis is complete and a summary written for each province
• The provinces are in various stages of the key stakeholder interview process (potential participants being identified, contacted, and interviewed)
• A realistic review has been initiated:
• The first part of the review is in the initial search step (research question: What are unattached patients’ characteristics and primary care needs?)
• The second part of the review is in the data extraction step (research question: What are the best ways to manage centralized waiting lists?)
• The third part of the review is currently under title and abstract review (research question: What are the most effective incentives (financial or other) to increase the number of new patients attached to primary care providers?)

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2. Validation of Administrative and Primary Care Electronic Medical Record Derived Frailty Algorithms

Principal Investigators: Sabrina Wong, University of BC; Tyler Williamson, University of Calgary; Alan Katz, University of Manitoba

Frailty is a medical syndrome that is predictive of adverse health events and increased health spending. The ability to identify frailty in the population will allow for appropriate resource planning and better meet the health care needs of a vulnerable population.

Study objectives

1. Identify administrative- and electronic medical record (EMR) data-derived algorithms of frailty in community dwelling seniors (aged 65 years and older)
2. Conduct content, face, and predictive validation of the administrative and EMR frailty algorithms by engaging primary care clinicians and patients
3. Identify natural ranges of frailty associated with differential risks of experiencing a hospital-related event

Activities to date

• UBC ethics approval has been obtained and a data access request has been submitted to obtain and link administrative health data
• The data access request in Manitoba has been approved and administrative and EMR data have been linked
• A data access request is being submitted in Alberta
• An information sharing agreement has been developed to document how information will be exchanged between participating sites and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), the source of EMR data for this project
• An EMR-derived algorithm has been developed using lab and clinical data based on indicators identified in the literature and input from clinical team members
• Administrative-data derived frailty algorithms developed by the BC Ministry of Health and Dalhousie University have been adapted and tested using BC data
• An administrative-data derived algorithm has been developed that can be used to identify frailty in any province

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Canadian Primary Care Sentinel Surveillance Network (CPCSSN)

CPCSSN is a pan-Canadian electronic medical record (EMR) surveillance system. The BC regional network, BC-CPCSSN, is now embedded within the BC-PHCRN. In March 2015 the founding five-year CPCSSN study ended, but given the successes achieved, each of the 10 networks, like BC, found homes and funding to continue the project.

Since then BC-CPCSSN has added six new sites to its network of primary care providers. The network is working with additional EMR vendors and building tools to assist sentinel providers with quality improvement efforts. INQUIRE, a secure online tool under development in BC, allows physicians and nurse practitioners to easily access patient demographics and information about the prevalence and management of chronic conditions in their practice.

CPCSSN is also a novel source of research data. A UBC study published in 2016 (Singian et al, 2016) analysed the associations between Parkinson’s disease, depression, and related medications, finding that depression in patients with Parkinson’s disease is primarily treated with SSRI drugs, counter to guidelines – guidelines which may need to be revised. Researchers are finding new uses for the data and several more studies are now underway in BC, including the frailty study described above.

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About the BC-PHCRN

The BC Primary Health Care Research Network (BC-PHCRN) is one of 11 Strategy for Patient-Oriented Research (SPOR) Primary and Integrated Health Care Innovations (PIHCI) networks in Canadian jurisdictions designed to support evidence-informed transformation of the delivery of primary and integrated health care.

The goal of the BC-PHCRN is to encourage, facilitate, and support collaborations between government, health authorities, health professionals, patients and researchers. The BC-PHCRN aims to seek out, develop, and facilitate adoption of health care innovations to improve BC’s health care delivery system.

The BC-PHCRN is funded by the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research.

BC-PHCRN is an open network and welcomes individuals from all sectors involved in primary health care – researchers, patients, health care providers and policy makers. To join, visit our website.

Follow us on Twitter @BC_PHCRN.