Who? Physicians, physician groups, health care services, health care professionals

Transcription

1 Simply Charting

2 Who? Physicians, physician groups, health care services, health care professionals

3 What? A website for sharing: Charting templates PDFs EMR-specific custom forms

4 When? Visit the website and create an account Ability to attach custom forms coming soon

5 How? Log onto the website Select the EMR your site uses Search the collection for posted templates and forms Share your custom forms and templates to the community

6 Why? Improve use of the EMR Streamline patient care Save time Contacts:

7 Screening Activity Report (SAR)

8 7 What is the SAR? A supplementary, electronic tool for primary care physicians Contains screening activity data for enrolled patients eligible for breast, cervical and colorectal cancer Released online twice per year (Spring and Fall) Purpose: To support physicians in improving their cancer screening rates and appropriate follow-ups Help providers better understand CCO s cancer screening guidelines

9 8 Components of the SAR i. Dashboard ii. Enrolled Patients Screening Summary iii. Breast: Enrolled Patients (50-74) iv. Cervical: Enrolled Patients (21-69) v. Colorectal: Enrolled Patients (50-74)

10 9 Dashboard A one-page summary of the number of patients that fall within each screening category These categories are mutually exclusive, therefore, a person is assigned one screening status per screening program Comparison of the physician screening rate relative to other physicians in the LHIN and province

11 10 Enrolled Patients Screening Summary Downloadable in PDF and Excel formats The Overall Screening Status represents someone s most urgent status across the three cancer screening programs. (i.e. If a patient is red in one screening program, this status will show red indicating that the patient requires at least one action)

12 11 How Does it Help? Updated more regularly than the TPSR Easily accessed, manipulated and searched Contains validated data from Cancer Care Ontario Allows you to create easy to read reports with all of your patients data

13 12 How Does it Help? Action required bnormal screen, follow-up needed /Invalid result, re-test required /Overdue for screening Due for screening in < 6 months Physician review required Colonoscopy in the last 10 years or flexible sigmoidoscopy in the last five years Review patient history: Patients whose screening result is unknown. Abnormal screen, follow-up underway or completed No screening action required: normal screen Enrolled and eligible individuals who are up-to-date with recommended screening

14 13 Who is eligible to receive a SAR? Patient Enrolment Model (PEM) primary care physicians: Must be PEM as of the date the report is generated Must have at least one enrolled patient who is eligible for at least one of the three screening programs as of the date the report is generated An ehealth Ontario ONE ID is required to access the report. Patient enrolment family practice models include: Comprehensive Care Model Family Health Organization Family Health Group Family Health Network

15 14 Registering For ONE ID Each physician and delegate is registered (face-to-face) and enrolled by an ehealth Ontario LRA using the ONE ID application With this they will receive: Unique ONE ID user-id and password Registration Confirmation from ehealth Ontario Welcome from CCO Secure access to the SAR PHYSICIANS In order to be eligible for ONE ID registration and enrollment for the purpose of accessing the SAR, a Physician must be: Sponsored by CCO Patient Enrollment Model (PEM) based Active with the College of Physicians and Surgeons of Ontario (CPSO) DELEGATES A delegate can be sponsored by more than one PEM physician A PEM physician can sponsor more than one delegate A delegate will not be able to access their delegating physician s SAR until the delegating physician is registered, enrolled, and appoints them as a delegate in ONE ID

16 15 Registering For ONE ID Amanda Hertel, Local Registration Authority, Waterloo-Wellington Location: Grand River Hospital, Kitchener Phone: x (preferred) amanda.hertel@grhosp.on.ca

17 Flexible Sigmoidoscopy Program in Waterloo Wellington Region Presented by: Debbie Reichert RN Coordinator Flexible Sigmoidoscopy at GRH Christine Couture RN Coordinator Flexible Sigmoidoscopy at SMGH

18 What is RNFS? Colon Cancer screening program in Ontario since 2007 MOHLTC partnered with CCO to develop pilot program Screening clinics at GRH and SMGH Nurse endoscopists perform screening sigmoidoscopy Polyps detected and biopsied Referrals for colonoscopy generated post procedure

19 Who is Eligible? Average Risk Individuals: Age Have not previously had a positive FOBT No first-degree family history of colorectal cancer No history of inflammatory bowel disease No recent history of colonic symptoms e.g. rectal bleeding No previous polyps (adenoma/large) or personal history of CRC Not on anticoagulant therapy

20 Why RNFS? 75% of people who are diagnosed with colon cancer are considered average risk CAG recommended RNFS be offered Decreases incidence and mortality rates of colon cancer Simple prep No sedation Low perforation rates Added screening option

21 RNFS Stats Screened 2100 patients in KW 22 percent of patients screened referred onto colonoscopy 10 cancers and over 100 advanced neoplasias found in our community Colon cancer detection rate is 5.1 per 1000 screened individuals in Ontario

22 How to Refer? Referrals from PCP or NP s Work with PCP s to provide programmatic screening and navigate patients to appropriate screening if not eligible Transitioning to be a part of CCC program

23 Regional Colonoscopy Network Presented by: Cheryl Shoemaker RN, BScN, CON(C) Regional Colorectal Screening Coordinator Waterloo Wellington Regional Cancer Program Sept 2014

24 What is the Regional Colonoscopy Network (RCN)? Unique Centralized Standardized Great patient care

25 Who is part of the RCN? Waterloo Wellington Regional Cancer Program 20 local endoscopists with hospital privileges (surgeons and gastroenterologists) 4 participating hospitals Grand River Hospital St. Mary s Hospital Guelph General Hospital Louise Marshall Hospital (Mount Forest)

26 When can I refer patients? ColonCancerCheck program 1 st degree family history (accepts age 40) FOBT + ve (50-74) Highly suspicious symptomatic patients for colorectal cancer Established entry criteria; if unable to accommodate, will re-refer locally

27 Why should I refer to the RCN? Short wait times FOBT 3 weeks Family History 4 weeks Symptomatic 2 weeks Patient focused Booking RN telephone assessment RN preparation education Standardized split dose colonoscopy preparation Genetics assessment triage

28 Why should I refer to RCN? Colon Cancer Check hospitals: Standardized reporting & data Wait time guidelines Regional Colonoscopy Network Standardization & collaboration with stakeholders Seamless care for your cancer patients to GI DAP

29 How has the RCN helped? Cancer Screening Wait Time Benchmark 2014/2015 Timelines Target Benchmark RCN LHIN % within Benchmark FOBT 8 weeks 75% 100% 82% Family History (FH) 26 weeks 80% 100% 80% Cancer Detection through Regional Colonoscopy Network # eligible referrals 2010 Sept 2014 FOBT Cancers FH Cancers Symptomatic Cancers

30 How do I access the RCN? Referral forms available at: Information Booth On line In conjunction with referral please: Attach previous colonoscopy report Attach FOBT result Notify your patients PRIOR to sending referral

31 Cancer Screening SAVE LIVES!

32 An Overview of the Diagnostic Assessment Program (DAP) GI (Colorectal) Thoracic Breast Prostate

33 Diagnostic Assessment Programs Cancer Care Ontario: Definition: Organized diagnostic assessment programs (DAPs) provide a single point of access by concentrating and coordinating diagnostic services, multi-disciplinary consultative expertise, patient information resources and psychosocial supports.

34 Patient Navigation Patient navigation in the cancer care setting is defined by the Oncology Nursing Society, the Association of Oncology Social Work, and the National Association of Social Workers as individualized assistance offered to patients, families, and caregivers to help overcome healthcare system barriers and facilitate timely access to quality health and psychosocial care from pre-diagnosis through all phases of the cancer experience."

35 Nurse Navigation (virtual/in person) The nurse navigator: collaboratively triages all referrals to expedite consultations Manages symptoms provides psychosocial support provides educational materials information on community resources outlines the expected clinical diagnostic pathway coordinates care acts as a pre-appointment resource

36 Site Breast Diagnostic Assessment Unit Colorectal Screening DAP Regional Colonoscopy Network (RCN) Diagnostic Assessment Programs Referral Criteria - Any women over the age of 40 with a palpable breast lump or abnormal imaging - Any woman under the age of 40 with a palpable breast lump and abnormal imaging Cancer Screening; +FOBT yrs of age or 1 st degree relative with CRC Symptomatic patients with 1or more symptoms of colorectal cancer * Goal Reduce wait time from suspicion to diagnosis Nurse navigated and supported -reduce wait time for colonoscopy appointment in the region as well as joint relationship with the DAP for cancer diagnosis Patient Experience -referral triaged by imaging technologist -Additional imaging studies completed as appropriate -onsite Radiologist reviews images and reports -patient assessed by surgeon and nurse navigator - plan of care reviewed - biopsy may be recommended and completed same day after consultation between radiologist and surgeon -patient contacted by clerical secretary to book colonoscopy and by RN to assess and counsel on bowel prep. -symptomatic patients are assessed and triaged nurse and expedited colonoscopy appointment arranged

37 Contact information Waterloo Wellington Diagnostic Assessment Programs Pre-Diagnosis Breast Diagnostic Assessment Unit fax Nurse Navigator-Tanya MacDonald Colorectal Regional Colonoscopy Network /Symptomatic referrals fax Secretary- Margaret Bedicz ext 2974

38 Diagnostic Assessment Programs (DAP s) Site Referral Criteria Goal Patient Experience Colorectal DAP Biopsy proven cancer Post colonoscopy biopsy-proven colorectal cancer -Nurse works with medical directives and orders imaging to decrease wait times for diagnostic / staging tests - Coordinates and expedites appointments Nurse Navigator/ specialty oncology nurse triages referrals, contacts patient, completes history, assesses symptoms and provides interventions/ teaching -expedited referrals as necessary - Coordinated imaging and appointments Prostate Diagnostic Assessment Program Biopsy-proven prostate cancer Nurse navigator provides psychosocial support and teaching -referral is received by navigator -patient is contacted, face to face appointment booked to review patient s information and to provide teaching and support Thoracic Diagnostic Assessment Program Any patient with abnormal chest imaging suggestive of a thoracic malignancy Reduce wait time from suspicion to diagnosis Timely access to assessment and diagnosis of patients with a suspected Thoracic malignancy Multidisciplinary consultation -specialty oncology nurse triages referrals, contacts patient, completes history, assesses symptoms and provides interventions/ teaching -patient booked into DAP for assessment within 14days target for biopsy is 28days -nurse supports patient throughout diagnostic journey provides symptom management, psychosocial support and referrals as necessary

39 Contact information for Waterloo Wellington Diagnostic Assessment Programs Post Diagnosis Thoracic Diagnostic Assessment Program Fax Administrative Secretary Dawn Borman ext 5458 Thoracic Nurse Navigator Anita Riddall Colorectal and Prostate Diagnostic Assessment Program Fax Administrative secretary Cynthia Babb / Jane Lougheed ext 6962 Colorectal Nurse Navigator Carol Gunsch Prostate Nurse Navigator Erin McKenzie

40 Feedback From Patients! GI DAP I found my experience to be excellent. Everything was very efficiently done. I appreciated the fact that everything was on-time. The nurse navigator was superb. Thoracic DAP My navigator was wonderful. She was patient, informative, sympathetic, made me feel good. Hopeful and confident of the process. 5 stars. I felt I was guided along very quickly and treated very well. Each step was explained and carried out with dignity. I felt there was a lot of compassion shown. Prostate DAP