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