Dialogue Volume 13 Issue 4 2017 - Page 47

PRACTICE PARTNER cated for a number of years that physicians should have real time access to medication profiles for patients. “The College encourages physicians to ac- cess their PCPR reports and use the infor- mation to better understand the care they provide to patients,” said Dr. Rocco Gerace, College Registrar. “Physicians then have an opportunity to access resources to improve their care, if necessary,” he added. Canada ranks second only to the U.S. in per capita consumption of prescription opioids. According to HQO, one in seven Ontar- ians fills a prescription for opioids every year. More than 9 million prescriptions for opioids were filled in the province in 2015/16. Over the last year, the College has increased its number of opioid prescribing investigations. “From a quality improvement approach, we don’t know the right amount of people who should be on an opioid,” says Dr. Kaplan. “But if you’re vastly different, you should probably think whether your pre- scribing is clinically appropriate.” Perhaps the nature of your particular patient population can explain prescribing variations. Even that information, he says, can be useful to know. Overall, the information in MyPractice could lead you to create a query in your EMR (like patients prescribed in the past year), and can trigger conversations with patients about safe use, overdose prevention, tapering, pain consultations or other ways to manage chronic non-cancer pain. Connect to Mentoring and Workshops The PCPR section of the HQO website also includes a sample MyPractice (not actual data but an example of what the report includes), and links to supports to improve patient care. For instance, HQO is collaborating with partner organizations across the health system to help clinicians manage their patients’ pain. That includes the appropriate use of opioids. Among those resources:  entoring support that connects family M physicians anywhere in Ontario with experts in chronic pain and addictions;  igital tools like Ontario Telemedicine D Network’s eConsult;  ntarioMD’s EMR Physician Dashboard, O for optimizing the use of your EMR and the data in it to understand current patterns of care (expert users of these tools are also available to help through a peer leader program);  afer opioid prescribing webinars S and workshops (available through the University of Toronto Faculty of Medicine, Continuing Professional Development); and  uality improvement decision support Q specialists and analytic support for FHTs (available through the Association of Family Health Teams of Ontario). Dr. Kaplan reminds us that one of the principles of family medicine recommends viewing your entire practice as a “population at risk”. Physicians are encouraged to orga- nize their practices to ensure that patients’ health is maintained, whether or not they’re visiting the office. To do that, doctors must be able to evaluate new information to assess the effectiveness of care provided. Dr. Kaplan says that PCPRs enable physi- cians to do that – by allowing them to better understand their practice, and assist in find- ing patients in need of attention. Treating patients with complex problems, pain, high doses of opioids, addiction – these are all difficult issues. There are no easy answers. But the addition of meaningful pre- scribing data to MyPractice is an important step in enabling physicians to understand and manage their opioid prescribing for the benefit of their patients. MD ISSUE 4, 2017 DIALOGUE 47