HQCA Physician Panel Report IF Session 3

1. HQCA Physician Panel ReportIF Session 3

2. What is Health Quality Council of Alberta? HQCA: Mandate • To promote and improve patient safety and health service quality on a province-wide basis, primarily through the lens of the Alberta Quality Matrix for Health.

3. Responsibilities of HQCA , as set forth in the Health Quality Council of Alberta Act., many of which ASaP relates directly to: • Measure, monitor and assess patient safety and health service quality. • Identify effective practices and make recommendations for the improvement of patient safety and health service quality. • Assist in the implementation and evaluation of activities, strategies and mechanisms designed to improve patient safety and health service quality. • Survey Albertans on their experience and satisfaction with patient safety and health service quality. • Assess or study matters respecting patient safety and health service quality. • Appoint a panel and provide administrative support for public inquiries relating to the health system, as directed by the Lieutenant Governor in Council.

4. Responsibilities of HQCA Set forth in the Health Quality Council of Alberta Act Directly relate to ASaP • Measure, monitor and assess patient safety and health service quality. • Identify effective practices and make recommendations for the improvement of patient safety and health service quality. • Assist in the implementation and evaluation of activities, strategies and mechanisms designed to improve patient safety and health service quality. • Survey Albertans on their experience and satisfaction with patient safety and health service quality. • Assess or study matters respecting patient safety and health service quality. • Appoint a panel and provide administrative support for public inquiries relating to the health system, as directed by the Lieutenant Governor in Council.

5. ASaP Partnership for Panel Reports • TOP and HQCA partnership • Provide panel reports based on 6 cut proxy panel, or based on panel list provided by the physician • Evaluation support • Pilot project support linking screening offers to uptake and to results • Long term vision • Support providers with patient specific data as well as profiles of health service utilization

6. Objectives • Describe the benefits to physicians of receiving the HQCA Physician Panel Report • Be familiar with the contents of the report and its basic interpretation. • Outline the steps for a provider to receive their HQCA report

7. Proxy Panel Attachment Algorithm • Based off of 6-criteria algorithm with tie-breakers: • Sole visits • Frequency of procedure codes* • Frequency of diagnostic codes* • Frequency of visits, excluding certain codes* • Frequency of visits • Most recent visit * HQCA modifications making list more sensitive than Alberta Health 4 cut method.

8. Validated Patient Lists • A list of patients that are attached to the provider. The attachment was validated through an intentional process by the clinic. • Specific process for submitting the list is expected to be ready by August 2013.

9. Data Sources • Physician Claims Database • Alberta Health and Wellness • Inpatient ; Ambulatory Care Coding System (ACCS) • Emergency and Urgent Care ; Discharge Abstract Database (DAD)

10. HQCA Physician Panel Report ConsentUpdate • Phase I • Proxy Patient List requests • End of July 2013 • Phase II • Validated Patient List request • End of September 2013 Primary Care Organizations are asked to collect the consent forms and submit them monthly to HQCA.

11. Considerations for initiating a screening, prevention and disease management program at a clinic Elements from the HQCA reports: • Demographics • Gender • Age • Physician Continuity • Sicker patients and continuity • Clinical Risk Grouper (CRG) • GP visit numbers • # patients, # visits, average # of visits per patient

12. Report shows utilization of the panel: GP Visits Specialist Visits Emergency Department Visits GP Sensitive Condition Visits Inpatient Length of Stay

13. Gender Distribution

14. What is the largest age group, and what percentage of patients are in this age category. (page 2)

15. Age Distribution

16. What percentage of patients see only this provider? (page 15)

17. Physician (GP) Continuity

18. What the report can tell you. • What does your perusal of the report tell you about the screening or prevention programs that could support this panel?

19. Considerations for chronic disease, acute care and specialty care clinic program decisions Elements from the HQCA reports: • Specialists visit #s • ED visits • GP Sensitive Conditions (CPSC) Visits • Inpatient Length of Stay • Chronic Diseases A • Hypertension, Diabetes, COPD, Asthma, CHF, Angina and IHD • Chronic Diseases B • Alzheimer's/Dementia, ADHD, Bi-polar, Schizophrenia, Depressive and other psychoses, acute stress and anxiety • Frequency of Diagnosis

20. Summary • HQCA draws from information that would not otherwise be readily available to a provider or clinic. • Understanding the profile of the patients on a panel can help a clinic plan services to best address their needs.

21. Clinical Risk Grouper Distribution

22. CRG Distribution Continued

23. GP Visits

24. GP Visits Continued

25. Specialist Visits

26. Specialist Visits Continued

27. Emergency Department Visits

28. ED Visits Continued

29. GP Sensitive Condition Visits

30. GPSC Visits Continued

31. Sicker Patients

32. Chronic Diseases and Frequency of Diagnosis Group A complex care plan conditions Mental health conditions based off of Group B complex care plan conditions Frequency of diagnosed conditions (top 10)

33. Chronic Conditions

34. Mental Health Conditions

35. Top 10 Most Frequent Diagnoses

36. Frequency of Diagnoses Continued