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

Who?

• Physicians, physician groups, health

care services, health care

What?

• A website for sharing:

–Charting templates

–PDFs

When?

•

www.SimplyCharting.com

• Visit the website and create an

account

• Ability to attach custom forms coming

soon

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

Why?

• Improve use of the EMR

• Streamline patient care

• Save time

• Contacts:

–

danfinnigan@gmail.com

–

paul.bernard.jones@gmail.com

• 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

What is the SAR?

Components of the SAR

i. Dashboard

ii. Enrolled Patients Screening Summary

iii. Breast: Enrolled Patients (50-74)

iv. Cervical: Enrolled Patients (21-69)

• 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

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)

 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

How Does it Help?

Abnormal screen, follow-up needed /Invalid result, re-test required /Overdue for screening

How Does it Help?

Action required

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

• 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

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 email from eHealth Ontario • Welcome e-mail 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

Registering For ONE ID

Amanda Hertel, Local Registration Authority, Waterloo-Wellington

Location: Grand River Hospital, Kitchener Phone: 519-749-4300 x 6977

Presented by:

Flexible Sigmoidoscopy Program

in Waterloo Wellington Region

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

Who is Eligible?

Average Risk Individuals:

● Age 50-74

● 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

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

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

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

Regional Colonoscopy

Network

Presented by:

Cheryl Shoemaker RN, BScN, CON(C) Regional Colorectal Screening Coordinator

What is the Regional

Colonoscopy Network (RCN)?

• Unique

• Centralized • Standardized

Who is part of the RCN?

• Waterloo Wellington Regional Cancer

Program

• 20 local endoscopists with hospital

privileges

• 4 participating hospitals

Grand River Hospital St. Mary’s Hospital

When can I refer patients?

• ColonCancerCheck program

• 1st _{degree family history (accepts ≥ age 40)}

• FOBT +’ve (50-74)

• Highly suspicious symptomatic patients for colorectal cancer

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

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

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

How do I access the RCN?

• Referral forms available at:

Information Booth

On line www.cancercare4primarycare.com

In conjunction with referral please:

Attach previous colonoscopy report Attach FOBT result

Cancer Screening

SAVE LIVES!

An Overview of the

Diagnostic Assessment Program

(DAP)

GI (Colorectal) Thoracic

Breast Prostate

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

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."

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

Diagnostic Assessment Programs

Site Referral Criteria

Goal Patient Experience

Breast Diagnostic

Assessment Unit

- 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

Reduce wait time from suspicion to diagnosis Nurse navigated and supported

-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

Colorectal Screening DAP Regional Colonoscopy Network (RCN) Cancer Screening; +FOBT 50-74 yrs of age or 1st _degree relative with CRC Symptomatic – patients with 1or

-reduce wait time for colonoscopy

appointment in the region as well as joint relationship with the DAP for cancer

-patient contacted by clerical secretary to book colonoscopy and by RN to assess and counsel on bowel prep.

Contact information Waterloo Wellington

Diagnostic Assessment Programs - 519-749-4370

Pre-Diagnosis

Breast Diagnostic Assessment Unit

fax 519-894-8328

Nurse Navigator-Tanya MacDonald

Colorectal – Regional Colonoscopy Network /Symptomatic referrals fax 519-749-4232

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

-specialty oncology nurse triages referrals, contacts patient,

completes history, assesses symptoms and provides interventions/ teaching

-patient booked into DAP for

Contact information for Waterloo Wellington Diagnostic Assessment Programs – 519.749.4370

Post Diagnosis

Thoracic Diagnostic Assessment Program

Fax 519-749-4384

Administrative Secretary – Dawn Borman ext 5458 Thoracic Nurse Navigator – Anita Riddall

Colorectal and Prostate Diagnostic Assessment Program

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