Data, measurement and feedback are necessary aspects for quality improvement in just about every industry, and health care delivery is no exception. One data product from HQC that uses all these components is the patient panel report, common in family medicine and primary care practices. But what is a panel report, how are they used and how can they improve quality in the health system?
What is a panel report?
A panel report features information about a physician’s patient population (otherwise known as a panel). Using health databases, a report is produced, providing a wealth of information about a physician’s patient roster. This can range from the total number of patients and demographics to frequency of visits and prescription history—at a basic level, it as a useful report that sheds a contextual light on a patient population (referred to as a panel). At a deeper level, however, this valuable data can also be used to better understand the needs of patients, their health system usage and how best to maintain access and care delivery in a clinical setting.
What are BestPractice physician panel reports?
The BestPractice physician panel report is a standardized report developed specifically for use by Saskatchewan family physicians. Using administrative health databases, it provides physicians with select information about their patient panel (such as health service use) over three years. The reports are updated and feature new indicators based on feedback on how they can be improved for physicians.
The reports are voluntary and provided to physicians who request them. While they do not contain any identifiable patient information, the report data is protected under Saskatchewan’s Health Information Protection Act.
Why were the BestPractice physician panel reports created?
A critical strategy for improving the health of Saskatchewan residents is providing family physicians with measurement and feedback, to stimulate improvement and innovation in how care is delivered in the community. As part of this goal, the panel reports were piloted to family physicians in the Prince Albert area, beginning in late 2018; after that successful pilot, they were launched province-wide in 2019.
Panel reports and similar initiatives are gaining traction as a valuable quality improvement tool in other jurisdictions. Alberta has been using panel reports for well over a decade; their involvement in the process even led to the development of the four-cut methodology used by other organizations in administering panels (see below). British Columbia offers incentives to family physicians supporting aspects of longitudinal family practice, which includes panel management. In Ontario, panel reports are available to family physicians as well as executive directors of family health teams and community health centres. And across the pond in the United Kingdom, the National Health Service’s Summary Care Records provide similar patient information, created from general practitioner records, which can be used in other areas of the health system to create a continuum of patient care.
How do the panel reports work?
In Saskatchewan, the BestPractice physicians panel reports initiative is supported by the Saskatchewan Medical Association, the Department of Academic Family Medicine at the University of Saskatchewan College of Medicine, the Saskatchewan College of Family Physicians and the Health Quality Council. Data is provided from health databases from the Ministry of Health and eHealth Saskatchewan under a data-sharing agreement (eHealth Saskatchewan also provides technology and infrastructure support). A physician expert panel guided the development of the project, providing useful feedback from a clinical perspective.
Panels are determined using the four-cut methodology, developed by Alberta Health Services, which uses billing data to assign patients to physician panels based on the frequency of their visits. Residents who had visited a family physician are considered for the panel in one of the following categories:
- Single provider – if an individual has only seen one provider, they are assigned to that provider.
- Majority provider – if an individual has seen more than one provider, but one was seen for the majority of visits, they are assigned to that provider.
- Last physical – if an individual has seen multiple providers the same number of times, they are assigned to the one who performed their last physical exam.
- If an individual has seen multiple providers the same number of times and not had a physical, they are assigned to the provider they saw last.
How do panel reports lead to improvements in care?
For physicians, understanding their panel can help them to improve their practice. The reports provide actionable and timely data that can support decision-making, quality improvement, and in turn better clinical outcomes and a higher quality of care. Having this information is key to optimizing continuity of care, understanding the clinical needs of patients and maintaining appropriate access for patients. It also provides context of how a family practice fits within the broader health system.
Similar clinician-focused initiatives in the province also focus on quality improvement in the delivery of health services. Choosing Wisely Saskatchewan is part of a national organization aiming for reducing unnecessary patient tests and treatments, with the understanding that “more” doesn’t always mean “better.” HQC’s Clinical Quality Improvement Program is for health-care leaders looking to make real-world quality improvement changes in clinical settings.
The BestPractice physicians panel reports initiative also feature an education component in quality improvement where physicians can learn more about their reports and what the information is telling them about their practice. These learning modules, particularly the group sessions, allow for meaningful discussion with peers and a deeper perspective on their learnings, facilitating improvement in care.
How can Saskatchewan physicians request their panel reports in Saskatchewan?
Saskatchewan family physicians can sign up on the BestPractice website and within two weeks, their panel report will be generated and sent to their email. Once enrolled in the program, physicians will automatically receive their updated personalized report as they become available.
Additional learning opportunities for professional development credits
An educational component, in partnership with College of Family Physicians of Canada (CFPC), aims to help physicians read and make use of their reports while earning professional development (Mainpro+) credits. There are three modules:
- The Introduction module
- The Interpretation module, which functions like a user guide and explains how to read each of the indicators included in the report.
- The Investigation module, which includes an investigation guide that invites participating physicians to delve deeper into the information on each page and consider what their results are telling them.
For the Interpretation and Investigation modules, physicians have a choice to either download an independent learning guide or participate in live webinars (the sessions are not recorded). With each completed module, physicians can earn Mainpro+ credits through CFPC.
Physicians wishing to learn more about continuing professional development credits can visit the Mainpro+ website.
I am a patient in Saskatchewan. How can I be part of the panel reports?
If you are a member of the public, you can ask your family physician if they are involved in the program.
An effective QI tool for physicians
Panel reports have proven to be a successful quality improvement tool, in Saskatchewan and beyond. With access to relevant data on their patient panel, physicians can continue to make informed choices and provide appropriate, high-quality care to a changing population.
For more information on the primary care reports, please visit the BestPractice website.
- News: Updated BestPractice panel reports launch June 22, 2021
- News: Better care for Saskatchewan patients aim of new reports available to province’s family physicians
- BestPractice website