Greetings from the BC-PHCRN. Undoubtedly it’s been a unique and challenging year for all of us in BC – and around the globe! Here at BC-PHCRN we have continued to move forward with timely and relevant research and knowledge translation initiatives to contribute to our overall mission of improving primary care in BC. In this update we would like to share some highlights from this past spring and summer. Please enjoy this newsletter and share with your colleagues and friends.
In this Update
SPOR-PIHCI Network 2020 Summer Learning Series and New Fall Learning Series
Between June and August 2020, the PIHCI Network Coordinating Office launched the first PIHCI Network Summer Learning Series. This included seven different sessions hosted by various provincial or territorial PIHCI Networks. Expert presentations were followed by a panel discussion (including at least one patient partner) with open Q & A from the audience. Topics ranged from the current state of primary care research to early COVID-19 research results in Canada and the United States.
BC-PHCRN hosted session 4 featuring Dr. Rebecca Etz from The Larry A. Green Center and Virginia Commonwealth University, who shared the Quick COVID-19 Primary Care surveys – highlighting both clinician and patient experiences in the pandemic, a project that has evolved to include multiple international collaborations. Recordings from all of the sessions and power point slides are available here.
After the success of the Summer Learning Series, SPOR-PICHI will soon be launching a Fall Learning Series. Keep an eye on the SPOR-PIHCIN national website for details.
Canadian Quick COVID-19 Primary Care Surveys
In April 2020 the SPOR PIHCI Network, in partnership with the Larry A. Green Center, launched the Canadian Quick COVID-19 Primary Care Survey. This survey has now had 11 cycles and the results are being used to inform policy makers and medical associations in BC and across Canada. In Cycle 11, we asked primary care providers what they needed to prepare for the fall within the context of the ongoing pandemic. They replied: a reliable supply of PPE, continuation of virtual care codes, and guidance and direction on what primary care ought to be doing as Canada heads into its flu season. We shred this information with provincial medical associations and policy makers across BC and Canada.
The current 4-minute survey is open September 18-21. Please click here to fill out the survey. We want to hear from you on what is needed to support your work during COVID-19.
BC-PHCRN Website Updates
This past spring we added some new sections to the BC-PHCRN website to highlight our researcher and organizational partners. Please take a look and read about the exciting work these BC-PHCRN stakeholders are currently working on to improve the health of British Columbians!
BC-PHCRN and ISU Collaboration
An online session held on April 8, 2020 aimed to contribute to the Innovation Support Unit’s (ISU) work on Primary Care Network (PCN) evaluation, specifically to help determine the scope of PCN evaluation, including what should be measured in the short term (6-12 months) and medium to long term (2-5 years) to enable evaluation if PCNs are working effectively. Using an active link, participants completed the online prioritization exercise by looking at a 28 diverse ‘buckets’ or concepts and prioritizing these according to what they thought were most important for PCN evaluation. Examples of concepts included: access to care, provider experience, patient experience, care coordination, and equitable services. Real time graphs were created that showed how certain buckets were prioritized by this group. This session with the BC-PHCRN Advisory Committee and Patient Advisory contributed to the ISU’s overall findings from Learning Cycle 5 and was combined with input other stakeholder sessions and provided to the BC Ministry of Health to inform PCN evaluation framework. The ISU and BC-PHCRN continue to support evaluation planning in the BC Ministry of Health.
Working Together to Build a Learning Health System in Kootenay Boundary
A collaboration led by the Kootenay Boundary Division of Family Practice and Interior Health Authority with the BC-PHCRN and Population Data BC aims to advance Primary Care Network (PCN) analysis and evaluation. The purpose is to build a foundational piece of a learning health system for the Kootenay Boundary Division of Family Practice and PCN. The project is proceeding in three phases:
Phase one: In moving towards a learning health system, primary care providers in Kootenay Boundary are accessing technology developed by the BC arm of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), which is housed with BC-PHCRN. This technology uses the “extract-transform-load” processes with electronic medical record (EMR) data and then presents it to clinicians in a secure web-based form known as the Data Presentation Tool (DPT). The DPT facilitates in-depth visualization of physicians’ own patient panels allowing them to be able to conduct practice level quality improvement initiatives. Examples of DPT capabilities include: creating validated chronic disease registries, examination of practice patterns (i.e. medication prescription), and characterizing complex patients (e.g. multi-morbidity). The DPT can display data at the individual clinician, practice, and Kootenay Boundary levels.
Currently BC-PHCRN is onboarding all primary care clinics situated within Kootenay Boundary PCN. This has involved conducting a Privacy Impact Assessment (PIA) with Interior Health, regular meetings with Kootenay Boundary Division leadership, and numerous teleconferences with Kootenay Boundary physicians and other clinicians. Participation of clinicians is voluntary. Patients allowing their data to be part of this project is also voluntary. All clinics post project information posters and distribute information letters to patients. BC-PHCRN provides support to office mangers/lead clinicians at each clinic to ensure smooth uptake.
Phase two: In phase two, EMR data (primary care and specialist) in the Kootenay Boundary community will be linked to Health Authority and Ministry data to examine patients’ journeys across the healthcare system. Physicians will be able to answer questions such as, “what was the impact of adding a chronic disease management clinic in my practice on total health system resource utilization?” or “did changes to how we collaborate with specialist and health authority services impact patients’ wait times for specialist appointments?” To enable this process, Kootenay Boundary family physicians will be asked if they would like to link their data to Interior Health data. This will require the signing of appropriate information sharing agreements and extraction of an identifying file for the purposes of linking.
Phase three: In phase three, family physicians will be asked if they wish to allow a copy of their de-identified data to become part of the larger pan-Canadian CPCSSN repository to provide additional comparative data for clinicians across Canada and enable robust research and communicable/non-communicable disease surveillance (e.g. COVID-19; antimicrobial resistance to antibiotics among those diagnosed with a urinary tract infection in the community).
For CPCSSN Sentinels: New Data Presentation Tool (DPT) Instructional Video Clips
The CPCSSN team has been hard at work creating new short, targeted video clips to orient clinicians to the various quality improvement features of the DPT. This rigorous tool allows visualization of patient information and clinician practice patterns. It has integrated algorithms for 13 chronic diseases (e.g. depression, diabetes, osteoarthritis, Parkinson’s) which can assist in creating disease registries and other aspects of panel management and optimization.
The DPT videos range from 2 to 5 minutes and are aimed at maximizing clinicians’ use of the DPT. Shorter videos provide a general overview of components including the DPT Dashboard, and the Search and Reports pages. Longer video provide step-by-step guides to help clinicians utilize more advanced DPT features including Re-identification and Custom Searches.
These videos can found on the CPCSSN websiteand the CPCSSN YouTube channel.
Study Recruiting Primary Care Providers to Better Understand Lyme Disease in Canada
A new study aiming to better understand the perspectives, experiences, beliefs, and knowledge of health practitioners on the prevention, diagnosis, and treatment of Lyme disease in Canada is seeking primary care providers to participate in 30-45 minute interviews. For further information please contact Madison Robertson or Dr. Rylan Egan.
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 in order to improve BC’s health care delivery system. The 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.
The BC arm of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is housed within BC-PHCRN, where we specifically reach out and work with primary care clinicians (e.g., family physicians, nurse practitioners, etc.) to provide analytic support of electronic medical record data for purposes of practice quality improvement, disease surveillance and research. BC CPCSSN is supported by the General Practice Service Committee.
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