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Primary Care Connection

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Healthcare is transforming, and Primary Care involvement and leadership is critical to the success of this change.

The Cambridge North Dumfries Primary Care Network has been developed to facilitate the engagement of primary care clinicians (physicians and nurse practitioners) in healthcare transformation. Primary care is the foundation of the health care system and has a unique perspective on existing challenges and pain points that must be addressed to enable transformation and integration of care. Additionally, the Primary Care Network will support the organization of primary care to optimize resources and support collective advocacy.

The CND OHT Primary Care Connection is a virtual space with two functions:

  1. Provide an ongoing forum for primary care clinicians to meaningfully engage with the Primary Care Network on areas of work that are most relevant. This space is meant as a "self serve" model of engagement, where you can participate as little or as much as you would like, at times that are convenient to you.
  2. Create a virtual space for primary care to connect and self-organize.

This page includes several forum discussions, quick polls and Q&A . These tools will:

  • Gather your questions and directly respond to you
  • Collect your perspectives and ideas
  • Help us to better understand your needs



Healthcare is transforming, and Primary Care involvement and leadership is critical to the success of this change.

The Cambridge North Dumfries Primary Care Network has been developed to facilitate the engagement of primary care clinicians (physicians and nurse practitioners) in healthcare transformation. Primary care is the foundation of the health care system and has a unique perspective on existing challenges and pain points that must be addressed to enable transformation and integration of care. Additionally, the Primary Care Network will support the organization of primary care to optimize resources and support collective advocacy.

The CND OHT Primary Care Connection is a virtual space with two functions:

  1. Provide an ongoing forum for primary care clinicians to meaningfully engage with the Primary Care Network on areas of work that are most relevant. This space is meant as a "self serve" model of engagement, where you can participate as little or as much as you would like, at times that are convenient to you.
  2. Create a virtual space for primary care to connect and self-organize.

This page includes several forum discussions, quick polls and Q&A . These tools will:

  • Gather your questions and directly respond to you
  • Collect your perspectives and ideas
  • Help us to better understand your needs



  • Mycoplasma Resistance Patterns

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    Mycoplasma Resistance Patterns

    Sent on behalf of the Office of the Chief Medical Officer of Health, Public Health

    Ontario is experiencing increased Mycoplasma pneumoniae activity, especially in young and school aged children. M. pneumoniae tends to occur in late summer and early fall, with cyclical increases every three to seven years. Total specimens tested, total positive specimens, and percent positivity have increased compared to same period last year. Activity has remained high since August.

    Common symptoms of M. pneumoniae infection are fever, headache, and a slowly worsening cough. Activity is highest in those aged 10-19 years, and they may present with prolonged fever and cough, progressive shortness of breath and fatigue, and oxygen desaturation. Kids 9 and younger may present with milder symptoms including prolonged dry cough for weeks; worse at night and difficulty sleeping. If they also present with wheezing or work of breathing, please consider managing co-morbidities including asthma. Those with pre-existing lung conditions may be at higher risk of more severe disease.

    Key messages

    • Most patients with a mild M. pneumoniae infection will recover without antibiotics
    • Amoxicillin is the first-line antibiotic in this age group to treat bacterial pneumonia. However, M. pneumoniae is treated with a macrolide. If your patient has worsening symptoms (excluding isolated cough) after 72 hours of amoxicillin or is not getting better in 5-7 days, consider testing and/or switching antibiotics.
      • For patients with suspected or confirmed M. pneumoniae infection who aren't improving on macrolides, consider using a second-line antibiotic regimen, such as doxycycline or levofloxacin.
    • Be aware of how to test for M. pneumoniae, using PHO’s testing kit or their local / institutional laboratory practice.
    • While there is no vaccine for M. pneumoniae, continue to promote the recommended vaccines for other respiratory pathogens for all patients, based on age and health status, including the annual influenza vaccine, an updated COVID-19 vaccine, an RSV vaccine (if eligible), and a pneumococcal vaccine (at age 65)

    Kindly note that there will be additional guidance information coming in the upcoming weeks from Ontario College of Family Physicians and Sick Kids.

  • AI Scribe Final Report

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    The final report can be viewed here:

    https://www.ontariomd.ca/documents/ai%20scribe/ai%20scribe%20evaluation_final%20report_vf.pdf

  • Infant and High-Risk Children RSV Prevention Program

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  • Provincial Webinar: Expansion of the OBSP to People Ages 40 to 49

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    NEW: Provincial Webinar: Expansion of the OBSP to People Ages 40 to 49

    Ontario Health (Cancer Care Ontario) is pleased to announce that on October 8, 2024, the OBSP will be expanding to offer breast cancer screening to people ages 40 to 49.


    Primary care providers are invited to learn more about the OBSP expansion to people ages 40 to 49 through one of the following virtual webinars:

    · Friday, September 13, 2024 from 12:00 – 1:00 p.m.: Register here

    · Thursday, October 10, 2024 from 12:00 – 1:00 p.m.: Register here

    Invitations will be sent via email following registration.


    Another opportunity to learn about OBSP expansion will be through the Ontario College of Family Physician’s Community of Practice virtual meeting on October 18. Details on this session will be confirmed separately.


    The webinars will be hosted by the Provincial Primary Care Lead, Dr. Jonathan Isenberg, and provincial clinical and/or scientific leadership from the OBSP. The webinars will cover:

    · An overview of OBSP expansion and program recommendations

    · A walkthrough of informed decision-making discussions for people ages 40 to 49

    · Additional support resources and next steps

    · Opportunity for Q&A

    Thanks,


    Iram Munawar, M.Sc.,

    Regional Coordinator, Cancer Programs

    835 King Street West, Kitchener, ON, N2G 1G3

    Cell: (519) 584-5347

    Email: Iram.Munawar@grhosp.on.ca

  • Fall/Winter Respiratory Preparedness Primary Care Checklist

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  • Waterloo Wellington Breast Centre Direct Surgical Referrals

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    Date: August 2024

    TO:

    Dr. Neil Naik

    From:

    Waterloo Wellington Breast Centre

    Regarding:

    Direct Surgical Referrals

    Quick Details:

    •  Only Malignant pathology results will be directly referred with patient’s consent by WWBC to one of our breast surgeons

    •  All other pathology results are the responsibility of the referring provider to manage directly

      Highlighting Waterloo Wellington’s Breast Centre (WWBC) direct surgical referral process.

      With patient’s consent malignant pathology results will be directly referred by WWBC to one of WWBC’s breast surgeons.

      All other cases/results are the responsibility of the referring provider to

      manage. For example if the Referring provider feels a surgical referral is required and WWBC has indicated they have not sent one, the referring provider will refer directly to a surgeon in our community (not to WWBC).

      If you have any questions or concerns please feel free to reach out to Jennifer Campbell or Linda Kennedy.

      Jennifer Campbell – Team Lead Mammography, 519-749-4300 ext 7389 Linda Kennedy – Medical Imaging Manager, 519-749-4300 ext 2875

  • OBSP Expansion

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    Sent on behalf of Dr. Samantha Fienberg, Dr. Anna Chiarelli, Dr. Jonathan Isenberg, Judy Linton and Dr. Chris Simpson


    Dear colleagues,

    Ontario Health (Cancer Care Ontario) is pleased to announce that on October 8, 2024, the Ontario Breast

    Screening Program (OBSP) will be expanding to offer breast cancer screening to people ages 40 to 49. As

    part of expansion, people ages 40 to 49 will be able to self-refer to the program.

    Regular screening can find cancer early when treatment has a better chance of working. This expansion

    will provide people ages 40 to 49 with access to high quality breast cancer screening and the benefits of

    participating in an organized screening program (e.g., mailed normal result letters). In addition, eligible

    Ontarians ages 40 to 49 will be able to self-refer to any OBSP screening location, which supports access

    to screening for people without a family doctor or nurse practitioner.


    The OBSP eligibility criteria and screening recommendations for people ages 40 to 49 are the same as

    those for people ages 50 to 74. Similar to people ages 50 to 74, most people ages 40 to 49 will be screened

    with a mammogram every two years. People at increased risk of breast cancer due to their medical history

    or family history of breast or ovarian cancer will be recalled annually; people who have Breast Imaging

    Reporting and Data System (BI-RADS) breast (chest) density category D or if an earlier recall was

    recommended by a radiologist will be recalled in one year.


    Family doctors and nurse practitioners play a key role in supporting their patients to make an informed

    decision-making about breast cancer screening. Having conversations with patients about breast cancer

    screening is important because people ages 40 to 49 have a lower chance of getting breast cancer and the

    balance of potential benefits to potential harms of breast cancer screening may be different than for

    people ages 50 to 74. Therefore, the OBSP encourages people ages 40 to 49 to make an informed decision

    about whether breast cancer screening is right for them based on their individual risk for breast cancer,

    the potential benefits and potential harms of breast cancer screening, and what matters most to them in

    taking care of their health.


    The following resources have been developed to support family doctors and nurse practitioners to

    prepare for the upcoming changes to the OBSP:

    • Provider conversation guide (available in English and French): To support breast cancer

    screening conversations with people ages 40 to 49, this includes information on a breast cancer

    risk assessment tool (My CancerIQ), the potential benefits and potential harms of breast cancer

    screening, and reminders to consider what matters most to them in taking care of their health.

    This tool is currently available as a PDF and will be available online on the Screening Resources for

    Healthcare Providers | Cancer Care Ontario webpage in time for program launch on October 8,

    2024.

    • Frequently Asked Questions (available in English and French): Frequently asked questions to

    support questions from patients about the OBSP expansion to people ages 40 to 49.


    If you have any questions, please contact Ontario Health toll free at 1.866.662.9233 from 8:30 a.m. to 5

    p.m. Monday to Friday or email us at cancerinfo@ontariohealth.ca.


    Thank you for supporting the successful expansion of the Ontario Breast Screening Program.


    Sincerely,

    Samantha Fienberg MD FRCPC MBAClinical Lead, Ontario Breast Screening Program, Ontario Health (Cancer Care Ontario)


    Anna Chiarelli MHSc PhD Scientific Lead, Ontario Breast Screening Program, Ontario Health (Cancer Care Ontario)


    Jonathan Isenberg MD CCFP Provincial Primary Care Lead, Cancer Screening, Ontario Health (Cancer Care Ontario)


    Judy Linton RN BScN MHSc Executive Vice-President, Chief Nursing Executive, Ontario Health


    Chris Simpson MD FRCPC Executive Vice-President, Chief Medical Executive, Ontario

  • eCE West Deployment Team Quarterly Newsletter

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    Dear Ontario Health West Community:


    Welcome to the fourth eCE West Deployment Team Newsletter for health care professionals in the West Region.


    The West Deployment Team (DT) at the eHealth Centre of Excellence supports the deployment of eConsult in South West and Waterloo Wellington, and eReferral across South West, Waterloo Wellington and Hamilton Niagara Haldimand Brant, partnering with Ontario Health West for change management support in Erie St. Clair.

    In this Issue:


    • eReferral Onboarding Update
    • Ocean Update – Expanded Filtering Options
    • eReferral Helpful Tips:
    • Enhancing the Patient Experience Through eReferral Emails
    • Anticipated Time to Appointment Feature
    • Extending the Amount of Time eReferrals are Retained
    • Discover newly added services and programs accepting eReferrals
    • Discover new specialists available to respond to your eConsults
    • Updated destination lists for both eReferral and eConsult
    • West Region Highlights
    • Quarterly Spotlight – Erie St. Clair and South West Cataract Central Intake
    • Contact Information
     
     

    eReferral Onboarding Update

     

    There is currently a pause on onboarding new eReferral senders and receivers while Ontario Health is undergoing a public procurement through a Request for Proposal for Vendor(s) of Record to provide eReferral Management Solution(s).

    If you are already set up with eReferral and need support or additional training, please reach out to your Change Management Specialist, or email eReferral@ehealthce.ca.

    Please fill out the following form to be added to our onboarding queue: eReferral Onboarding Queue Form

     

    Ocean Update - Enhanced Filtering

     

    Some recent updates to Ocean's filtering functionality were made at the end of July 2024. These enhancements were made to ensure a more flexible and efficient experience when managing your eReferrals in Ocean. Filters are applied and saved on a user-specific basis, adding efficiency for each user to suit their preferences.

    Group-level filters are available across all status folders:

    

    • Listing Filter: This allows you to filter received eReferrals by the Directory Listing to which they were sent
    • Service Filter: This allows you to filter received eReferrals by the requested Health Service Category (e.g. Orthopedics: Hip, Ultrasound, etc.)
    • Referring Clinicians Filter: This allows you to filter your sent eReferrals by the user who sent them

    Folder-specific filters are located on the right. Each status folder will contain specific filters depending on the filtering criteria required in that folder.

     

    eReferral Email to Enhance Patient Experience


    The patient experience is greatly improved with the use of eReferral email notifications. Patients whose email addresses were included on the sent eReferral will receive email notifications throughout the referral cycle from receiving sites that have email notifications enabled. These emails are automatically sent when certain changes (listed below) are made to their eReferral.

    How this Helps the Patient: Being informed about the various stages of a referral can help ease patient anxiety and improve their referral experience. Email notifications are automatically sent from a ‘no-reply’ email address to keep the patient informed throughout the referral process, beginning when the referral has been sent right up until the final reminder that arrives prior to their scheduled appointment.

    

    How this Helps Your Practice: When patients are kept informed, your staff will receive less phone calls inquiring about referral statuses, and your patients will have an improved experience. These emails are sent automatically with no extra work from you or your staff. No-show rates are also reduced due to the appointment reminder emails.

    Examples of automatic emails that will be sent to patients if their email address is included on the referral:


    Sent Referral Notification:

    When the eReferral is first sent, the patient will receive an email informing them that their health referral has been sent and informs them that they will be notified when an appointment has been booked.



    Forwarded Referral:

    When the patient’s referral is forwarded from a site - such as a Central Intake - to another site, they will receive an email notifying them of this action.



    Referrals with Estimated Wait Times:

    When an ‘Anticipated Time to Appointment’ is provided by the referral recipient, the patient will receive an email notifying them of this wait time.



    

    Booked Referrals:

    When an appointment has been booked for the patient’s referral, or when booking information has been changed or updated, the patient will receive an email notifying them of their appointment. They can also confirm the appointment from this email.

    Appointment Reminders:

    Receiving sites are able to set up appointment reminders in their Ocean site (note that some sites utilize other reminder technology and disable this feature).


    If eReferral reminders are enabled, the patient will receive reminder notifications before their scheduled appointment which can be customized by the referral recipient (e.g., 7 days before, 1 day before).


    Redirected Referral:

    If the referral is cancelled by the referrer or declined by the recipient and is subsequently redirected to another provider, the patient will receive an email notifying them of this redirection, as well as the reason for redirection if one was provided by the referring clinician.

    

    If you’d like to expand the number of patient email addresses collected in your practice, we are here to help! Our Change Management Specialists can work with you on strategies to collect more of this information, as well as support you with consent templates, flyers for your waiting room, and more!

    Reach out to your Change Management Specialist or to our general inbox (eReferral@ehealthce.ca) at any time!


    Anticipated Time to Appointment Feature

     

    Did you know that if an appointment cannot be scheduled right away, eReferral receivers can communicate an Anticipated Time to Appointment to the patient and the referring clinician by selecting the ‘Anticipated Time to Appointment’ dropdown in the eReferral’s ‘Scheduling’ section?

    Users can also update the ‘Anticipated Time to Appointment’ field for multiple referrals at the same time by doing the following:

    (NOTE: When bulk updating wait times, the wait time email notifications will not be sent to patients)

    1. From your main Ocean portal screen, select ‘Update Wait Times’ in the bottom left corner.

    2. Enter the criteria that will be used to find and update matching not-booked referrals.

    Wait Time 1: Time from the sending of the referral to the date of the first consultation.

    Wait Time 2: Time between the first consultation and the surgery/intervention.

    3. Click ‘Update Wait Times’ when complete.

    A message will appear indicating how many eReferrals were updated with the wait time.


    Extending the Amount of Time eReferrals are Retained

    The default storage time for eReferrals in the Ocean portal is 1 year after the eReferral is sent/received. When an Ocean site receives a warning that eReferrals are scheduled for removal, these referrals will move to the ‘Deletion Warning’ folder. Users can extend the amount of time that Ocean retains these referrals by one of the following methods:

    1. Add an Appointment Date: If you are ready to make an appointment for the referral, the referral’s scheduled removal date will be adjusted to 30 days after the appointment date you just provided.


    2. Add an Anticipated Time to Appointment: If you are not ready to provide an exact appointment date for the referral, you can add an ‘Anticipated Wait Time to Appointment’ in the Scheduling section of the eReferral. The scheduled removal date will be adjusted to 60 days after the estimated wait time. (Example: If the referral was sent July 31, 2023 and was scheduled for removal on July 31, 2024, entering an Anticipated Wait Time of 18 months would give you a total of 20 months, and the referral would therefore be scheduled to be removed March 31, 2025).


    3. Extend the Scheduled Removal Date: If your eReferral is scheduled to be removed from your Ocean site but you are not yet able to provide an exact appointment date, you can extend the scheduled removal date by 60 days. To do this, open your ‘Deletion Warnings’ folder and click the refresh symbol on the far right (see below for example):

    4. Assign the eReferral for Review: If the eReferral requires the attention of someone at your site, you can assign it to them in Ocean for review. This will change the scheduled removal date to 365 days after the review was requested. (See Ocean’s website for instructions on how to assign to another user on your Ocean site).


    eReferral and eConsult in the West Region

    Discover newly added services and programs live on Ocean eReferral and new Specialists who have been onboarded to respond to eConsults!

     

    eReferral

    • Dr. David Plemel - Ophthalmology (London)
    • Dr. Maya Tong - Ophthalmology (London)
    • Dr. Shaobo Lei - Ophthalmology (Windsor)
    • Fowler Kennedy Sport Medicine Clinic – Western University/Fanshawe (London)
    • House of Sophrosyne (Windsor)
    • North Lambton CHC – Hepatitis C / Harm Reduction Care Team (Forest)
    • Waterloo Medical Weight and Wellness Clinic – Dr. Jennifer Dignam (Waterloo)


     

    eConsult *SW & WW only

    • Dr. Cara MacRae – Pediatrics (WW)
    • Dr. Paul Straus – Obstetrics and Gynecology (WW)
    • Dr. Sanjeeban Mishra – Clinical Immunology and Allergy/Internal Medicine (WW)
    • Dr. Samira Jeimy – Clinical Immunology and Allergy (SW)
    • Dr. Vitor Breda – Psychiatry (SW)
    • Dr. Ayler Ansarian – Psychiatry (WW)
     

    Check Out Our Destination Lists:

     

    eReferral Destinations:


    WATERLOO WELLINGTON
    SOUTH WEST
    HAMILTON NIAGARA HALDIMAND BRANT
    ERIE ST. CLAIR

    eConsult Specialists:


    WATERLOO WELLINGTON
    SOUTH WEST
    HAMILTON NIAGARA HALDIMAND BRANT

    Contact: eConsult@HITSeHealth.ca

    ERIE ST. CLAIR

    Contact: digitalhealth@transformsso.ca

    * NOTE: TransForm Shared Services Organization in Erie St. Clair (ESC) and HITs eHealth Office in the Hamilton Niagara Haldimand Brant (HNHB) region, support the deployment of eConsult in their respective regions. For more information, please visit their websites, or email TSSO at digitalhealth@transformsso.ca, or HITs at eConsult@HITSeHealth.ca.

     

    Highlights in the West Region

     

    eReferral (as of August 9, 2024)

     
    • 1,349,629+ eReferrals processed across West region
    • 3,670 Adopted eReferral senders
    • 1,543 Specialists and specialty services receiving eReferrals
    • 558,067+ Patients supported

    * NOTE: Sender data reported in previous West DT Newsletters and Regional Quarterly Updates reflected the total number of referrers who sent eReferrals into the West Region, regardless of their location. The data above and Sender data going forward will reflect the number of senders located within the West Region only.

     

    eConsult *SW & WW only (as of August 9, 2024)

     
    • 92,990 eConsults sent across SW and WW
    • 1,915 Primary Care Clinicians with OTNhub access
    • 323 Registered Specialists
    • <1 day Median response time
     

    Regional eReferral Highlights

     

    *Data above as of August 9, 2024. NOTE: Sender data reported in previous West DT Newsletters and Regional Quarterly Updates reflected the total number of referrers who sent eReferrals into the West Region, regardless of their location. The data above and Sender data going forward will reflect the number of senders located within the West Region only.

     

    Quarterly Spotlight -

    ESC & SW Cataract Central Intake

     

    The Erie St. Clair and South West Cataract Central Intake went LIVE on Ocean eReferral at the end of March 2024, and has had a successful first quarter processing referrals for non-urgent cataract surgery consults. The Central Intake, hosted by St. Joseph's Health Care London, has 22 participating Ophthalmologists in the SW and ESC regions, and in the first quarter processed over 1200 referrals from over 110 senders!


    Central intake participation benefits include supporting patient access to care with the potential to reduce wait times, offering a single point of contact with a standard referral form, allowing for improved communication pathways, equitable distribution of referrals, increased insights, and greater consistency of quality referral data.

    To submit a non-urgent cataract referral, click the link for your region below!

     

    Erie St. Clair Cataract Central Intake

    South West Cataract Central Intake

    Interested in eServices?

     

    Interested in eReferral?


    Clinics/clinicians can complete our:

    eReferral Expression of Interest

    to be added to our onboarding queue.

    Interested in eConsult?


    Clinicians can complete our Intake Form for Specialists or Intake Form for Primary Care

    For more information visit us online: Ontario eServices Program

     
     
     

    www.ehealthce.ca

  • Chronic Airborne Benzene Exposure-Related Clinical Guidance and Follow-up

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  • Ontario eServices Program Updates

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    Ontario eServices Program Updates

    The Ontario eServices Program (funded by Ontario Health) is currently working with Ontario Health to develop and ensure a more sustainable long-term provincial plan for eReferral that is in alignment with the provincial 'Patients Before Paperwork' strategy. The new process will support and accelerate implementation of eReferral and is part of a broader, clinically led, patient-centered system approach to improve how providers communicate across the health care system.

    Ontario Health is undergoing a public procurement through a Request for Proposal for Vendor(s) of Record to provide eReferral Management Solution(s). As a result, the Ontario eServices Program has been directed to 'pause' onboarding any new eReferral Users (both Senders and Receivers) until the Request for Proposal process is complete and Ontario Health has given the direction to resume onboarding to eReferral.

    The Ontario eServices Programs focus this fiscal year is on increasing active use and re-engagement, including increasing patient notifications (pt. emails included on referrals).

Page last updated: 29 Nov 2024, 09:44 AM