Transcript HQCA Physician Panel Report IF Session 3

HQCA Physician Panel Report
IF Session 3
1
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.
2
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.
3
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.
4
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
5
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
6
Proxy Panel Attachment Algorithm
• Based off of 6-criteria algorithm with tiebreakers:
1. Sole visits
2. Frequency of procedure codes*
3. Frequency of diagnostic codes*
4. Frequency of visits, excluding certain codes*
5. Frequency of visits
6. Most recent visit
* HQCA modifications making list more sensitive than Alberta Health 4
cut method
.
7
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.
8
Data Sources
• Physician Claims Database
• Alberta Health and Wellness
• Inpatient ; Ambulatory Care Coding System (ACCS)
• Emergency and Urgent Care ; Discharge Abstract
Database (DAD)
9
HQCA Physician Panel Report Consent
Update
• 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.
10
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
11
Report shows utilization of the
panel:
•
•
•
•
•
GP Visits
Specialist Visits
Emergency Department Visits
GP Sensitive Condition Visits
Inpatient Length of Stay
Gender Distribution
• What is the largest age group, and what percentage of
patients are in this age category. (page 2)
15
Age Distribution
• What percentage of patients see only this provider?
(page 15)
17
Physician (GP) Continuity
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.
22
Clinical Risk Grouper Distribution
CRG Distribution Continued
GP Visits
GP Visits Continued
Specialist Visits
Specialist Visits Continued
Emergency Department Visits
ED Visits Continued
GP Sensitive Condition Visits
GPSC Visits Continued
Sicker Patients
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)
Chronic Conditions
Mental Health Conditions
Top 10 Most Frequent Diagnoses
Frequency of Diagnoses Continued