Speaker 1

OK. Well, healthcare should be focused. Instead, the increasing burden of administrative tasks has reduced the time physicians can devote to direct patient care and support of work life balance, according to the Canadian Federation of Independent. Business physicians in Canada are spending 18.5 million hours on unnecessary paperwork and administrative tasks every year. I'm going to say. That number again 18 point. 5 million hours of of unnecessary paperwork, which is the equivalent to 50. 5.6. Million patient visit. Now in May, the CMA created a working group tasked with improving physician Wellness by reducing admin burden. The working group defined admin burden as a result of unnecessary complex and redundant clerical tasks that require the most administrative. Effort by physicians to complete and provides the least value to patients and healthcare. Now this may be the result of inefficient, inefficient processes, burdensome technology, and unreasonable demands on their time. To name a few. Admin burden can drive physician burnout low professional fulfillment. And a desire to decrease clinical hours and can lead to moral distress in physicians. But there are potential solutions and today we are going to hear three of them. The role individual employers can play. Change management and physician engagement when implementing new solutions. And finally, the many promises of artificial intelligence. And other technology and that brings me to our three speakers who are with us this afternoon. Current Pullman is executive vice president of advocacy for the Canadian Federation of Independent Business CF. IB's research has sparked legislative change for small businesses. The report patients before paperwork, estimated the amount of admin burden on physicians in each province and territory. And what could be gained by eliminating red tape? Doctor Nicole Stockley understands the impact of red tape on family physicians, particularly in rural communities. She is joining us virtually from Conception Bay South, where she practices full skilled community based family medicine. Nicole served as the President of the Newfoundland and Labrador College of Family Physicians from 2017 to 2019 and is now Director of External Engagement. And one of her main objectives is to educate policymakers about ways to reduce physician administrative burden. And Doctor Shandy, Chandresh, Sini Dr. Shandy chandrasena. My apologies. He's chief medical officer at Ontario, MD and his practice family medicine in Ottawa for the past 20 years. She's a member of the Omas Burnout Task Force and is passionate about alleviating digital burden and advocating for the efficient use of technology. This is our panel for this afternoon. Thank you for joining us. And is I think is Nicole there. Is Nicole, are you there? Ohh, great. OK, wonderful. Wonderful. OK, alright. And a quick note to the audience and we'll be conducting a quick poll after each presentation really to gauge the effectiveness of that solution. So have your smartphones and computers ready and during the poll. You will receive. A pop up window with a question. And will have two. Minutes to select and submit your response. The result will be displayed on the screens. And following all three presentations, we will have a Q&A session followed by a special announcement. So Corinne, we're going to. Start with you, OK?

Speaker 3

Great. Thank you so much and good afternoon. Thank you for the opportunity to be here. Now, you may be wondering how a Business Association got involved in the health summit and you speak looking a little bit about some of the work we've done at CFB and I'm going to talk a little bit more about work, but more specifically around employer notes asking doctors to get notes for their employees. But first I want to tell you a little bit about CFIB.

Speaker

There we go. Oh.

Speaker 3

Oh, I should mention that I have no disclosures of the disclosure form is right above me here on the right. So thank you.

Speaker

All right.

Speaker 3

Oh, there we go. OK, my apologies. So a little bit about the Canadian Federation of Independent Business, we're actually a Business Association that represents independently owned Canadian companies right across Canada, they're. Well, none of them. They're all small name sized companies. Nobody's publicly traded. There are no branch plants and multinational corporations, but we represent 97,000 right across Canada and all sectors of the economy and in all regions of Canada. We do a lot of things, primarily advocacy. We provide other services as well, like savings programs and advisory services to small. Companies to help them out as much as possible. And we also do a lot of what we call member survey research. So when we do our advocacy work, we actually gather the information for our members through surveys in order to sort of guide our lobbying focus. And that's what we do. And so over the years, of course, we've sort of seen the issues that are most important. So one of the big ones for many years for businesses of all sizes and sectors, of course, is red. Tape now or administrative burden or rules and regulations. Whatever you want to call it, it's all those unnecessary things you feel you have to. Too, because it's not the sexiest topic out there, it's hard to get real focus from governments on it. And so we created something called the red Tape Awareness Week back in 2010 and every year since then, we have a week in January where we focus all of our media efforts and our lobbying efforts on just on red tape and over. The years we've. Been able to move the needle in many ways. Because the one thing we've learned is once we do get a focus on red tape by govern. Comments. Actual movement can be made and it can be quite impactful on those that it affects. So This is why it was important for us to get more involved. But why healthcare? Well, we do these surveys as I mentioned and on this side, you can see that we asked about what are the priorities for government to focus on. This is just just from late last year. And as you can see #2 is addressing healthcare. Challenges now, as a small business organization, we've never seen that high a priority given to healthcare from our membership before. So we were thinking about well, how do we, what do we do to sort of get involved in this particular issue in a bigger and better. Way and So what we did is also ask a little bit more about well, what should be done. To both we. Ask both small business owners and the public through a public opinion poll. Should governments reduce unnecessary paperwork for doctors so they can focus on patient visits and as you can see, almost 90% in both categories are like, well, duh. Yes and so. That of course, sort of prompted us to say, OK, let's take our expertise in this and see what we can do. So as we were doing that assessment, we came to understand that Nova Scotia was doing some really innovative work and and some research and subsequent work on doing something about this. So they were actually looking at measuring the burden on physicians identifying the areas that were really problematic and putting together a plan on reducing that. So what we did is work with them a little bit and got a better understanding of how they were doing it. Though to be fair, some of the work they. Were doing were. Based on work we had done on looking at the red tape, Burton across Canada among small business. Donors. So we understood how they were approaching this and we thought, let's take a look what they're doing. Of course, many of you may already know that in Nova Scotia, they found, of course, a lot of ability think is it similar to what we found nationally? Well, we took their data and did it nationally, but they were able to identify about 50,000 hours of work could be. Reduced even if they just cut it by 10%. And so I think that was important data for us to understand. And So what we did is we took their. Here methodology and we said, OK, let's extrapolate this across Canada and understand what will happen and that's what this slide is showing. So we're taking Nova Scotia's data and what they learned from Nova Scotia then did a calculation right across Canada based on what we understood and we're able to come up with the numbers that Adrian was talking about. So overall, we figured out that 48.8 million. Hours is being spent by physicians on administrative work across Canada. 38% of that, so around 18 billion is actually what we call unnecessary. So that's work that's either. And we'll move to the next slide. It's either work that can be completely eliminated. So of that 38 percent, 14% could be completely eliminated or 24% could be moved to other people. To do it doesn't have to be the physician who does it. Somebody else could do that. And if you did that, you started to eliminate that. That was a massive amount of time that you saved for that physical. So even if you just take 10% of that, say 10% of that 38%, you try to reduce the burden by just 10%. If you look at the Canadian perspective, that would actually free up time. So that money is five and a half million more patient visits could be given or on the other side of it. We know that things like burnout and stress are also prevalent and pretty not not very good right now in the Medicare medical profession. Can help reduce and bring some more work life balance, so it doesn't. It didn't take a lot of effort to do that and so we felt it was really important to then take this information as part of our red tape Awareness Week, this earlier this year in 2023 and we put it out there as a challenge to all provinces. We said look, here's the total. Here's what's been done in one province and how effective it's been, and I will say in that province, they're going to likely reach that goal and surpass it. In fact, the premier just came out Nova Scotia recently and says we're going to go further and fast. Sure. Because I think there's a recognition, especially on the political level, that there's this is something they can do to potentially help that this particular sector of the economy. So we took that information, put it across Canada and put a challenge out there. We were really pleased to see that almost immediately, Manitoba stepped up and they've actually created. The whole task force that's been working on this since the beginning of the year, they've already identified. They've already measured the burden. It was similar to Nova. Scotia slightly higher. Of course, as they're slightly bigger province and they were able, but they actually determined that 44% of the administrative burden was actually unnecessary Manitoba. So they're now they've identified the problem areas and now they're working on the second-half of the year to reduce that by 10%. And they're aiming to do this by the end of the year, so. It doesn't have to take long to do. It just takes a concerted effort and a focus. And so I think that's something that we want to replicate. We have since learned Yukon has approached us as well, and so they're interested in doing something with another jurisdiction. We do know also that British Columbia, Ontario, and I think Newfoundland, Labrador, which we're going to hear about in a minute, are all making efforts in other ways as far as we know to also reduce the paper burden. There may be other jurisdictions. They've not been as public about it, so if there are others I'm not aware of, we'd love to hear from the folks listening today. What those what they may be happening over there. And of course this is the sort of process we've been recommending to governments right across the country. We meet with provincial governments, we push them to think about this. We meet with their provincial medical associations as well. It's really a simple process. You measure, you identify the impact. You look at the sources and and what the top irritants are. You set the with that your target and most importantly. To assign responsibility to a group within government who actually do this and they have to take that time and it's best of that particular group within government as working with the Provincial Medical Association. Together and they report to either administer or premier. It's not unnecessarily just a bureaucratic exercise. It's actually something that's accountable. Then things can happen. So that's been what we've been doing. One of the issues that has come up, of course, has been doctor's notes that employers require their employees to give when they are saying they're sick. So we wanted to explore this, this this came out in the Nova Scotia data. It came out in the Manitoba data. It's not a simple issue. And so this is just a quote from one of our Members about why it's complicated. So essentially the fact is they understand that doctors are stretched, that it's a bad thing to do. But on the other side, they need to understand like, what are they supposed to do if they feel like someone is abusing something the the actual system that's in place so it can be a real challenge. So we did some more work to have this discussion. We went did some more research asking our Members, do you currently require? Employers to provide a doctor's note. As proof of illness and as you can see here, about 54% actually don't. So over half are not even requiring it right now, but of the other group that does, there's only about 2% that do it all the time and then the. In that like well if it's. More than a. Few days or more than. A week or if I feel like. It's occasionally and things are, so it is something that is being. Used but then we asked a little bit about should they continue to be allowed to do this right, because we know the conversation will move more in this direction and the feedback was yes, actually 12% want it to be done all the time. Only 10% said no, it's not necessary. So there is this real appetite among employers to still have that. As a way to get some accountability when they're confronted with the potential employee they think is actually abusing the system and this has become more important because there are provinces now requiring what they call mandatory paid sick. Phase and that may be a good thing on its surface, but that costs small employers a lot of money. So at the federal level, they have 10 paid sick days a year, and we're already seeing evidence that they are taking more, no more absences this year than there was in the previous year. So that that's where the the tricky part comes in for a lot of small employers. So these are some of. The alternatives, so we did. Ask those business owners in the survey. What else would you accept? As an employer, if you couldn't date a doctor's note or something along those lines. These are some of the ideas that. Came up, signed declarations from an employee or an attestation from the employee could work if it was accompanied with, for example, the ability for them to use that as a as a way to say, OK, I'm going to dismiss this person and here's my evidence why that it could be used in sort of the court. System in that regard, another is a note from another health professional. This is something Nova Scotia has done. They've actually implemented legislation to allow other health professionals to provide this kind of. A note what came up a lot was pharmacists in our feedback, a lot of Mrs. owners felt that pharmacists could write the note, then they would be acceptable confirmation of appointment emails, urgent care bracelets or parking receipts, prescription receipts, lab requisitions. Even a video. Call with the employees so they can see them physically right and look them in the eye and say. Really sick. And so those are. Some of the things that I think. Some employers would. Consider. So that's what I wanted to put on the table. I think there's openness to finding other alternatives to the doctor's note, but I wanted to make sure it was understood in this room that there is a sort of the other side of the coin to that issue. Right there is something that people want to have to bring accountability, and if you're a small employer, you don't have an HR department, you need some other tools to help you make sure that you're keeping your employees accountable. So I'm going to leave that with that and I look forward to the conversation and the questions that come.

Speaker 1

Karen, thanks so much and and and. Thank you for the work. As well, because I think it's the kind of work my sense is that it's the kind of work that does give. People hope, right, that it actually is possible to change the way in which we which you know we operate and and and that there are solutions to these often. Kind of daunting challenges that are being that we're facing so. Thank you. Thank you. Thank you. Well, right now we're going to. Open our first poll. So what I'd like you to do is please. Check the event app. For a pop up window with the first poll question and I'm going to read that question now. So the first poll question is. Could revisions to processes enacted by employers, for example sick notes, potentially reduce admin burden for physicians? Once again, could revisions to processes enacted by employers, for example sick notes, potentially reduce admin burden for physicians? The possible answers are, I believe so. It has potential and I am unsure so you will have two minutes to make your selection and then you will hit submit. So let's open the poll right now and you have two minutes.

Speaker 2

Building for all.

Speaker

OK.

Speaker 1

OK. Are we there? I think we're back. We are back. OK, so the two minutes are up and I think we have the results. So again, the question could revisions to processes enacted by employers, for example, sick notes potentially reduce admin burden for physicians? 68% of you said I believe so. 26% says said it has potential. And 7% of you say I am unsure, so that's that's pretty significant. There seems to be a lot of optimism, a sense that that there are possibilities with this potential solution. OK. So we are now going to go to Nicole. Nicole, are you there? Doctor Nicole Stockley? In Conception Bay. Nicole, are you there?

Speaker 4

I'm here. Thank you. I don't know if I'm a disembodied voice or a giant head on the screen, but pleasant to.

Speaker 1

OK, great to see you. Take it away, Nicole. Well, I'm not going to. Say you're a giant head.

Speaker 4

Be here.

Speaker 1

But you are you are with us. And we can see you.

Speaker 2

OK, good.

Speaker 4

Like a Ouija board. This is my declaration for the CME creditation for this CMA conference, I have the declared affiliations that were just projected on the screen. All right. If I could just get. My presentation put up. Perfect. So as I was introduced, my name is Nicole coming to you from my home in new Philana Labrador and very much appreciate the opportunity to do this. I practice comprehensive family medicine in my community and I'm paid through a fee for service model. I have several leaderships. Wells, as you could see on the the, the, the slide before this one, but my primary one is with the new plan, Labrador College and family position. So based on the title of this, I'm. Guessing you're all. Wondering if this is just going to be about. My love for my ER. And it's it's not. It's not quite that given that I usually look like this when I'm dealing with technology. It's it's not exactly a love story per se. And when it comes down to it, when? We talk about. Emma's emo processes. In this case, we. Aren't even going. To talk about. The EMR I use in fact the specific emmer isn't even. Part of the. Story what we are. And we're not. Even going to debate whether emr's. Are inherently good or bad. There's a ton of studies that support just about every position. But what we are? Going to do is. Just accept that there is no going back. So instead of focusing on the emirs themselves, this story is about Edocs NL, our provincial EMR program. Ohh my goodness.

Speaker

There we go.

Speaker 2

I'm going to.

Speaker 4

Tell you about what makes our program different. Why it's the program? Not the specific. EMR that is making an impact for our positions and ultimately help address the administrative burden in our province. Edocs and all started in 2015 with a partnership between 3 organizations, the Department of Health and Community Services for Newland and Labrador, the Newland Labrador Medical Association, and the new plant Labrador Center for Health Information. Together they created a sustainable provincial program independent of a specific EHR vendor. That supports best practices and helps providers care for their patients. Early on, it was recognized that physicians needed to be at the table and to participate as equals to government representatives. Therefore, every edocs annual committee has 50% representation from physicians, and those physicians are appropriately supported for their time. Committees deal with the budgeting selection of vendors, data sharing, and secondary use requests. One committee in particular, the Clinical Advisory Committee, focuses primarily on what physicians need. They're made-up of both salaried and fee for service positions that they create workflows. Look at pitfalls, analyze forms and templates, and overall they work with the purpose of streamlining the EMR experience and making it work better. The importance of physician representation is widely recognized as a key part of Edos NL success, as supported here by our Assistant Deputy Minister. So what does all this mean? And wait a minute, wasn't this supposed to be about addressing admin burden? Absolutely. So to talk about what Edocs NL does, let's look at some of the biggest admin frustrations that may or may not be directly, ER, related. Let's start first with. Onboarding so prior to 2016 and the creation of educational, the vast majority of. Community family clinics in new flannel. Labrador was still paper based. A very few number. We're using various ER's, but they were completely doing their own thing, so they had to deal directly with vendors for onboarding, customization, problem shooting. All of those components. Over the last seven years, almost 70% of our family physicians in new Plano, Labrador have moved to the provincial EMR system. There aren't a lot of holdouts, and those that are are very close to retirement and are sticking with their paper for now. With E Doxil, the onboarding process is highly customized to the needs of. Each clinic, it is very much a start where the people are process, practice advisors, spend time in clinics to understand current workflows for both the providers and the medical office systems and help translate them into the EMR system. They create efficiencies. Then they come back as often as needed to further customize EMR features or to do teaching sessions. The admin win here is you don't need to learn the infant out to the ER yourself, and you don't have to deal with the vendor directly. In fact, with practice advisors you have direct access to a real human who can help you troubleshoot your problems. They are the ultimate tech support because not only do they know the EMR really well, they know your EMR really well because they help set it up. They are the people who can swoop in when someone feels like they're drowning in inefficiencies and get you. Back on track. They are the ultimate tech support. This tech support goes even further as E docs also deals with many of the behind the scenes aspects of the. Mr. as Fred, the program director, points out. Physicians don't need to be involved in things like software changes. And Edocs takes care of that for us. In these manual. Labrador we are in the process of changing from 4 Regional Health authorities to 1 provincial health authority. Each RHA has had its own set of forms for ordering labs, diagnostic imaging and had different consult consult processes that may or may not have utilized essential intake system. Now those processes are all going to be revamped and many, many updated forms will no doubt be created. Edocs has and will take care of recreating all of the forms in the EMR system and will automatically push it out to the clinics. So the admin win here is that, yeah, it still might be another form to. Fill out, but at least you know that it's. Always the right form. And when we don't, and while we don't necessarily consider charting and visit documentation as part of our admin burden, it can take so much time to do.

Speaker

It well.

Speaker 4

Templates and macros help, but who has time to learn how to create all of them? Well, educts and all does. They provide ways for us to chart more easily and more efficiently. And then there are complex. Visits and all the different EMR functionalities. What about dealing with chronic illnesses and preventative screening? Well, that's what something called. Practice 360 comes in this component of the EDOCS program is designed to increase clinical value and practice efficiencies for providers. It has produced a provincial preventative care plan. In doing so, creating a set of locally relevant best practice based ER tools. And the best part about it? Is I didn't need to create it. A few simple clicks and. It's now integrated into my EMR. And tailored to my provincial guidelines, preventative care simplified. And when it comes to more complex complex. Chronic illnesses epoxy now supports us there too. So far they've created tools for both COPD and diabetes, both which cause a lot of hospitalizations and ER. Visits and our. And these tools include decision support, simplified templates at a glance, patient summaries, autogenerated requisitions and dashboards reflecting patient population data. There are plans to expand. To other illnesses soon. So far less time is spent sifting through patient data. To facilitate learning how to best utilize all these tools, Edocs holds education events that combine guideline based CME with ER training. We also produce multiple resources, including webinars, videos, user guides. But what if those tools don't work for me? In my practice. Well, that's where a practice advisor will sit down with you and look at your practice and where you are struggling. Edocs NL wants to ensure that the tools. They produce are. The best and most efficient they can be. So for example, I was having a lot of difficulty integrating a diabetes tool into my practice. I found it. Was pretty cumbersome and it was probably more ideally suited for a diabetic clinic with nursing staff and other providers there to see the. In contacting E dot NL, they sent a representative to my clinic who sat down with me while I saw a patient and watched me use the tool. Then they made notes about how it could be better tailored and where I got tripped up and voila, they produced a new tool that was much more tailored for fee for service family physicians. Therefore, the ongoing optimization of EMR tools ultimately reduces charting and can improve patient care.

Speaker

So now let's.

Speaker 4

Zoom out of this. Let's leave direct patient related admin tasks. What other administrative work do we deal with? Well, billing. Edocs and L supports our fee code system by creating templates that meet the requirements for certain enhanced codes. And with our provinces upcoming move to a blended capitation payment model, E docs will be there to assist with any ER related processes, including rostering of patients billing templates. And whatever comes up. Edos also partners with other physician focused organizations within our province, most notably my queue and my practice. My queue is a program that provides family traditions with support and programming to address processes in their clinics that they feel could be improved. My practice on the other hand. Is a program that trains. And supports family positions as they navigate transitions into and out of practice. Edox and L supports both programs by creating tools within the EMR to aid participating physicians. Through my queue, Doctor Mehta found ways to increase the time she had available to spend with patients. Edocs and I'll. Also AIDS physicians in many more unseen. Ways and has the potential to deal with issues. On a broader set. For example, E dot panel is currently working to change the interface for our E console system to better integrate it into the Mr. they ensure the seamless flow of patient information from our from healthy NL, which is our EHR to the emmers. They monitor the integration of labs, diagnostic imaging reports, prescription medications and other patient information, and they are the ones who are ultimately responsible for quality assurance, which is a very unique feature of E docs and L and is one of the significant differences when you compare us to other provinces. They coordinate with other E health services and this is going to become especially important over the next year because our practically DOS based Meditech is about to finally be replaced and as the new health information system is introduced, EDOCS and L will be involved and able to advocate for positions with an understanding of the environment. Something that vendors just can't do. By doing so, edocs and L directly engages physicians and empowers them to become involved and indeed take control of quality improvement within their clinics. And that's what all of this really. Boils down to physician engagement and physician empowerment. Standing on the front lines, we see the inefficiencies. We know how our time is being spent and where it's being. Wasted. We are the. Ones who have to navigate the system level issues complete the unnecessarily complicated forms and follow the convoluted referral pathway. It's our experiences that are needed at decision making tables and our voices shaping ways to ultimately improve patient care. Because, let's face it, we'd rather all be here. Instead of. So in conclusion, is the ER the solution? No. Is a single ER the solution maybe? Is having a well supported Co governed ER program that meets physicians where they are and is available to prevent and address administrative issues? With the solutions. We think that might be a large. Part of it. Thank you.

Speaker 1

Thanks so much, Nicole. And on behalf of the entire group here, I think we're going to award you the most colorful slides this afternoon. Thank you. Thank you so much for that great, great images. Thank you. We're going to move to our second poll question right now, following Nicole's presentation and the the poll question is, could an approach such as that presented by Doctor Stockley potentially reduce admin burden within your healthcare setting? Again, could an approach such as that? Presented by Doctor Stockley potentially reduce admin burden within your healthcare. Adding the possible answers are, I believe so. It has potential and I am unsure and again you have two minutes to make your choice and then. We will close. The poll, so the two minutes start now.

Speaker

You guys are so.

Speaker 1

Because we know you're so quick, we're going to close the poll now. I think we think you've made your. Choices by now so. I think we have the. Results. Do we have the results yet? I think coming up soon. So again, the question could an approach such as that presented by Doctor Stockley potentially reduce admin burden within your healthcare setting? And we're still waiting for the results. Are they almost there? Maybe we. Yeah, we can see here, you. Can see I I. Just can't see the percentage. OK, 523711. OK. So 52% like to the question, could an approach that? Such as that presented by Doctor Stockley potentially reduce admin burden within your healthcare setting 52%, according to this gentleman. Said. I believe so. 37% says it has potential and 11% says say I am. I am unsure. OK. Alright then. Well, that's interesting. OK, we're going to move on to Shandy. So Shandy you are.

Speaker 4

Wonderful. Hello, everyone. I'm always surprised when the room is filled in the afternoon, so. Thank you. So my conflict slide is up there and I'm going to give you some. Numbers two point. Two million 1994 and 49. So 2.2. Million is the number of Ontarians that don't have a family doctor. So when we expand that that. To the country, it becomes one in 519 is the extra amount of work on average that a family physician will work on administrative tests per week. 94 is the percentage of family physicians who are completely overwhelmed with their administrative burden and their tasks, and 49 percent is the number of family physicians who are saying they're going to modify or decrease their clinic hours in the coming years. So I'm.

Speaker 1

Going to just.

Speaker 4

Let that sit with you a little bit. As you're doing. The math and figuring out how is that? Going to impact me. And so This is why administration burden, it's not a me problem, it's not a physician problem, it's not a clinic problem. This is a health system problem. It's going to affect all of you. So we need to come up with health system solutions. So as chief. Medical officer of a digital health subsidiary. Of the OMA. My focus is on technology. Energy. So technology is a double edged sword. It can actually cause more burden. But Co designed and executed properly. It can actually be the solution. So today we're talking about solutions and you've heard many solutions in the morning today and also with my colleagues. So I'm going to talk about some of the things that we've been doing. So you might have read the paper healing the healers. So the Ontario Medical Association Burnout Task Force came out with five health system level solutions and decreased physician. Burnout two of them related more to technology and we're going to. Focus on those two. To get today, the first one is about streamlining administration and ministry of tasks and and the burden of administration. And the 2nd is really about integrating technology and integrating these processes into our workflow in a seamless manner. So both these solutions had a number of recommendations regulation. And a standard policy suggestions, privacy and security. And they talked about exploring technology, innovative technology to solve some of these solutions. And so that's what we've been focusing on. So in my medical practice, when I think of administrative burden, what hits me is what comes into my inbox. It's that. Onslaught of reports. That's before I even know who I'm seeing that day. So those are the labs, the clinical results, the diagnostic imaging, the forms, the reports from the hospital. The reports that patients need filled out. That's what I'm seeing. And so that to me is where a good chunk of that burden is. A recent survey by O CFP, which is the Ontario College of Family Physicians, they identified that this burden equated to 19 extra hours per week. So that's about. 1 1/2 to two clinic days. So let's look at this. So Omid looked at this and we LED what was called an M task force. So HRM, for those of you who aren't in in Ontario is the hospital report manager. So this is a technology that allows the hospitalist to seamlessly send their reports directly into our EMR's and allow them to be. Integrate it so it bypasses your. Facts and your and your. No, sounds great, does it not? It's integrated, so it must work really well. Well, it's an excellent technology, but when it was when it was started, we didn't have any regulations or guidelines as to what you can actually send through it. So I think everyone here is going to understand what the problem is because with no guidelines as to what. And go through it, everything is going through. So what we did is we identified the top pain points for these documents that are coming through. We we stood up a task force that included and here's the solution. It has to include everyone. It included physicians, health system, delivery systems, physicians, I said that would hospitals, government and decision makers. It had everyone at. The table and we all came out. Together with recommendations about what the report should look like, what reports can we send? Let's avoid duplication. What reports are necessary? And so those guidelines and recommendations are going to be published next month in fact. And I think we can learn a lot from that. So in terms of forms, because I did mention forms, they're quite burdensome for physicians. We've got OA has their forms committee and again we have a joint committee with the ministry, the Provincial Ministry to work on these forms. Where can we look at forms that could be streamlined, that could be limited completely, that don't necessarily have to. Be filled out. Like physicians, and that's what we're we're doing a best practice guidelines has been developed around forums, but it's not just paper forms. We're talking about digital forms. We're we're advocating strongly for no portals that are not integrated into our systems. No other log. Means don't create more burden for us and don't offload work that doesn't necessarily have to be done by a physician just because it's easy to do with technology. So let's look at existing technology. So I love what Nicole was saying about having help with the technology that we have and we're also offering that. So how do I use my ER more efficiently? How do I use the tools that are out there more efficiently? Because can I not move the needle while we're waiting for those health system solutions? Can I do something in the meantime? Time. And that's really where our practice advisory service and our peer leader program comes in. We're clinicians throughout Ontario has access to that help. Now. We're not lucky enough to have one ER, we have 13. So there it's a bit more complicated, but we are there to help individuals and clinicians and physicians on a one to one. Basis on a clinic basis with their staff and their workflows on a group basis and also on a regional basis. We also have an education offering with modules, A conferences, seminars and webinars. Which will help. With this learning, So what happens? What happens is this is what I hear. I don't have time for this. I don't have time to go to your webinars. I don't have time for you to send someone into my clinic and train my staff. So why can't we have technology that just works? Why do I need to spend all this time learning about it? So that's where the new solution is coming in. The solution to everything is. AI artificial intelligence, right? Like it doesn't matter what the problem is. The solution nowadays seems to. Be well, AI of course. So why can't I have Siri or Alexa in my office? Why can't they write up my notes? Why can't they send my forms order my labs go through my inbox? Why am I still doing it? And that's what I want, so maybe that's the solution. And so there are a lot of great, great. Solutions out there with the AI number of vendors have just like the number, has just skyrocketed. Great solutions, great tools. So now the question becomes, is it really going to move the needle? So what we're doing at OMD, along with some partners, is we put in a proposal with the provincial government for, of course funding. We're always asking for funding. I think that's what all of us are doing to say, OK, can we look at AI? Can we step back a bit? And before we just adopt all of this, can we look at? It and look at the. Regulations can we assess? Is it really going to move the needle on an administrative burden? Is it really going to alleviate the problems that I want solved? No one's done that, so we need to do that, and if we don't do that, we need to set these standards and guidelines and assessments so that we can shape this technology to solve the problems that we need solved and not let that technology dictate. How we're going to practice and how Healthcare is going to function and more importantly, it's going to identify the gaps. Where do we want. This technology to go. Where do we want the the road map? What? What? What should it look like? We should have input into that. So really I'm talking. About when there's a technology that's out there that. Looks like it's. The best thing since sliced bread, we should step back and look at it and say, well, let's assess it. Is it really going to do what we want to do and will we have some impact on it in the future? So just to recap those solutions there. The first one it's working with at a health system level with stakeholders and Co design solutions that solve actual pain points. So it's really about physician, clinician, Wellness and patient care. So quintuple aim, how many out there have heard of the quintuple? I'm hoping everyone's head comes out, but there's only a few, so the quintuple aim is a framework that identifies that physician Wellness translates into better patient care, better patient outcomes, better population health, and lower cost to. The health system. So ideally this would happen at the ideation stage where. Nations, government and hospitals and patients and others would Co design the system and avoid further burden and better patient care. We're not there yet. Where we are is identifying the problems that are there and coming up with solutions to fix those problems and coming up with those solutions with stakeholders and those that can actually make those decisions and coming together, so finding solutions, we need solutions in the short term. Medium and long term and working on better workflow in the clinics, better education, better technology that fits in those those solutions may work in the short term because let's face it. We need a quick. Fix. We need to keep these family doctors doctoring. So third AI. This could be the solution and but we need to examine it. We need to look at develop guidelines. We need to assess it. We need to shape that technology. So remember 19. So 19 hours of administrative work. That's extra. So if you reduce that, I could gain. One extra clinic day a week, and that's one extra day for patient care at actual pajama time for me. So it's estimated that the physician can take on 200 extra patients if we can gain one. Day. So think about the 47,000 family doctors in Canada and the 15,000 family doctors in Ontario. How? Many patients, can we? See how many times. Can we actually spend our pajamas doing pajamas stuff instead of administrative burden? So help us be doctors and allow doctors to doctor. And allow us to find that joy that we're missing in medicine so that physicians, new learners, will want to go into family medicine and it won't be a reflection of what doctor Karen was talking about this morning. So thank you.

Speaker 1

Thank you much, Sandy. So right now we'd like to go to our final poll question. And the question is, could solutions such as those presented by Doctor Chandrasena potentially reduce admin burden within your healthcare setting? Right again, could solutions such as those presented by Doctor Chandrasena potentially reduce admin burden within your healthcare setting and the possible answers are I believe so. Some have potential and I am sure. So the poll is open now.

Speaker

OK.

Speaker 1

And the poll is now closed and we have our results. So good solutions such as those presented by Doctor Chandrasena potentially reduce admin burden within your healthcare setting, 40% say I believe so. 41% say some have potential. And 19% say I am unsure. So some optimism there also a little. Bit of skepticism as well. So we're going to tackle that in the conversation that we're going to have right now. I'd like to invite the virtual audience to post their questions in the Q&A tab or use the virtual floor mic and people in this room can also use the Q&A tab or raise their hand. And have one of our staff members and one of our staff members just raising the microphone. She will come to you with the that microphone and you can pose your question. We'd love to. Hear what your favorite solution was and why or tell us how you'd apply some of these solutions in your own healthcare setting. So why don't we take the first question? Is there a question out in the audience that we can take right now? Is anyone ready for? To to pose a question, there's actually a question right here at the front. The gentleman in the front.

Speaker

OK.

Speaker 1

If you can read it out, that would be great, Sir. Yeah, and. The microphones right there, yeah.

Speaker 5

All right. So my question, I wrote it on the forum too, but it's for Edocs NL. Well, I just want to what is the governance structure, how like what is the relationship set up so that? You have confidence that what you're doing represents. Like physician? Well, because I think part of this. Is like a. You know, we we we hear 13 emars in Ontario, we're like that's. Nice. We have 30 in BC. And so like getting to one is not even like. Plausible, but it's how do you actually know without people getting ideological about whether they want singular solution versus a complete free market? And how are you? Yeah. So I just wanna know how you've built that out and what are some measures of success?

Speaker 1

Our suckling we're just not hearing here right now. I'm not sure if you're on mute right now.

Speaker 4

I'm not.

Speaker 1

No. OK, we can. Hear you now.

Speaker 4

Ohh. Perfect yeah. It's a great question. I'll try to tackle. Some of it. So as I was talking about the governance structure is set up so that every committee and all of the boards are 50 percent, 50% of the seats are held by position. New Zealand has the benefit of not really having had much in the way of emirs before Edox NL was created and so it's kind of a situation where we don't really know what we're missing out on because we didn't have any of the other ones. And so because we. Are kind of starting from scratch, we were able to go out and look at what different vendors offered and figure out what would fit best in the setting that we had. Which was really important because everything was really being built from scratch. The the idea of. You know data. Being taken from a hospital and being sent to me in my clinic. When I started practice in 2016 was just futuristic because I was still completely paper based. With that wall of of charts so. As we're moving. Forward now we're actually in a point now where our current vendor, the time is up on that contract. And so there's going to need to be a a process of. Picking a new one. And that is coming from several different committees, and there's a feedback mechanism through our Medical Association as well. So there's there's lots of different ways for physicians to be involved and for their voices to be heard. And I think it leads to to, to a really good physician LED. Force for finding these solutions.

Speaker 1

OK. Thank you. Did that answer the question sufficiently, Sir? Did you have a follow up?

Speaker 5

I think for. Justin, if you're gonna go into vendor negotiation.

Speaker

Yeah. And then maybe this body and then. Be able.

Speaker 5

To do this.

Speaker 1

Can this body do this on the scale for the entire province?

Speaker 5

We decided. That, that's just how it.

Speaker 1

Is did you hear that, Doctor Stockley? No, you're going to come back with a microphone. OK? Because I. Was having a little bit of trouble hearing as well.

Speaker 6

OK.

Speaker

OK.

Speaker 5

I'm sorry, I wasn't expecting to do a follow up and and anyone? Else should just. Talk, but it's more about it with you say you're in the process of kind of a vendor renegotiation. So is this process going to be set up to a public procurement like type of system where the vendor has to reapply? Do you know that? Yet and again is this like you have enough confidence from the Medical Association and physicians that this makeup of the group enables you to do another provincial, I guess renegotiation to see if that vendor is going to continue being the vendor?

Speaker 4

I'm not quite sure the process of of that negotiation process, regardless of who the vendor is chosen, because it will be through EE docs and L and the the contract will be through them. It will be deployed provincially and so my understanding is there will be a rollout kind of step by step. As the clinics all transfer over, but we're a year or two. Away from that. Right now and again that will be the first time that's ever happened as well. So I'm sure there's going to be lots of lessons learned and and lots of things to put. In place ahead of time.

Speaker 1

OK. Thank. Thank you for the question and.

Speaker 5

You good luck.

Speaker 1

Thank you for the. Answer Do we have another? Over here. Yes, we do. OK.

Speaker 6

My name is. Angus Pratt once again and I am still here with the patient voice and I guess my concern about EMR is which I understand to be electronic medical records and just to make sure that that I've got that. Is patient access to the. Things my colleague from British Columbia talks about 30 different systems. The patients are lost, totally lost as we try and support each other. We can't find some people have access. Some people don't. And then there's the whole Doctor piece about whether the patient should have. Access to these records, particularly imaging records. Before they have them interpreted to them by the medical professionals and these sorts of questions and and I'm wondering how they were addressed in Newfoundland specifically, but I'm also interested in hearing how they were addressed in Ontario and and what sorts of things are. Being done there.

Speaker 1

Shandy. Why don't we start with you and? Then we'll go to Nicole.

Speaker 4

So that's. A big question.

Speaker 3

You don't pull your punches.

Speaker 4

So you know. Access to data is something that's really in the forefront for Ontario, so it's starting out with the data from a hospital. So right now the data from hospitals, they're able to get that we in Ontario, we have what's called a clinical viewer connecting Ontario, which is a platform that allows the hospitals to put their data their. Consult nodes diagnostic. Imaging what they've done onto one platform and the future is for that platform to be accessible to patients. So that's where it's going on the road map where the barrier is is getting primary care data or community data because there's so many EMR's and we're not integrated and we're not interoperable. So I would love to give you my data. But what does that data look like when it comes out? So without getting to the nitty gritty of things, what's happening is, is that when we start on ER's for physicians, we all took our EMR's and we started using it the way that it worked. For us, it wasn't really standardized how we enter the data. It's not coded properly for everyone. Everyone uses it differently and so now the question becomes when we take that data out like data fields and we're mapping it against other data fields, are we actually getting the right information and we're realizing we're not. So there is a lot of work. That's that's out there on that interoperability piece. Patient summary is one of them. So with again, without getting into too much. Detail wouldn't be great if when you see me and I know your medications and I know what's happening. But when you go to the emergency, that physician also has a complete list of your medications, your allergies, your past medical history. It's a no brainer. Of course they should have that, but we're not there yet. But that's what we're working on is OK? Let's start with some basics. Can we just get the medication out of the MRI's and into one central location that everyone has access to that needs it, and that work is happy? Learning and and and there is potential because that work is happening a lot faster now than they it has been because they've been talking about it for the last. 1015 years. And and then there's patient portals that we're talking about. So I think it's an important conversation. And the reason I said it was a hard question is because it's really complicated. It's not as simple as. This is my data. I want access to it. It's like I would love to give you. Access to your data but. How do we get it out of the M? Ours all the MR's. And how does it look the same everywhere? So I have to say I feel like Newfoundland's going to have a much better kind of a go at it because they're all in the same system and maybe edocs Newfoundland is, is coding it properly. And putting that data where it should be.

Speaker 1

Nicole, would you like to take that question? Let's take a stab with that question.

Speaker 4

Yeah. So I guess in Newfoundland, we kind of have the benefit, right? We wake up first, but the weather comes from West to east, so we kind. Of get to watch things. Happen and then when it gets to. Us we kind of have a bit of an. Idea of of what's going on. Because we're starting from scratch, one of the. Things that edocs. Now is directly related to and responsible for is that translation. So our EHR, our electronic health record, that's something called healthy NL and that will be what patients are going to be. Able to access. Right now that exists. Between our ER, our electronic medical records in our. Clinics and what is currently Meditech and will soon be something else where the data is coming from the hospitals. Right now, information can only flow from the hospital. To our health record and then from the health record to our ER. 'S but that. Changing so even in. The last year or so I can now order things directly through. I can order investigations for patients directly through that EHR back to the hospital. So we're starting. To get that 2. Way flow of of information. There's been a. Lot of work done on patient access and that's coming. I don't know when, but. My understanding is it's actually within the next 6 to 12 months they're going to be able to start having patient portals and slowly rolling out different sets of data. As we kind of get used to it and figure out what people need and and how best to present it so that it's it's easy to access and it's easy to understand and that patients can then be even a bigger part of of that interaction with with the healthcare system and. To be own take ownership of their own their own health data.

Speaker 1

Shandy. I was curious like given given the position that you occupy, what do you make of the approach that Newfoundland and Labrador is taken in terms of introducing the single ER and and do you think a similar kind? Of approach could. Be implemented in Ontario?

Speaker 4

You know that's tricky. Also, it's tricky because we've invested in our technology right now. We've invested our EMR. So EMR's, our electronic medical. Records and those traditionally tend to be the ones in the communities the hospitals have HIS hospital information systems, and those are also invested. And they're also separate among the hospitals and the province. And so when I started practice, Oh my gosh, I'm not going to say because I'm going to date myself, but I. Was a paper Doctor. You know, with the charts and then fully computerized into Emrs. So for the last 10 years since I've been on an, ER, 12 years, I've invested a lot of money into my ER. So that's that's my. I've established workflows, I've established templates, custom forms. I've trained my staff, I've I've added on add-ons. That's all done. It's up to each individual doctor to do that. So then for us to go to a single Mr. that would be first, we'd have to choose and agree on it. And second, how are you going to convince all these physicians and community clinics that are like small businesses that have already put this investment in that they need to now switch to something else?

Speaker 3

That's that's a.

Speaker 4

Huge financial and time commitment.

Speaker 1

Would it be better for patients?

Speaker 4

So I think you. Know that's a really great question. So I think if we're looking at data portability, absolutely, it would be better for patients. It would be because then we would be able to communicate with other systems. But I think we have to address the fact is how are we going to get there. How are we going to make those decisions? Who's going to control those decisions? And not all humors are are created equal some. Are so much. Better than others and they meet different needs. And so there's a lot of arguments that if you only had a single EMR, are they going to get lazy, like are they going to, are they going to progress? Is, is, is that ER vendor going to progress and create better functionality? And why would they? They're the only one in the market. So I think it opens up a bit. Of can of worms there.

Speaker

OK.

Speaker 1

Did you? Do you have a perspective on this? No. Touch it. OK. Good to stay with us. OK, well, we have a question here. It's from Heidi lahar. Actually, not Heidi. Sorry. It's from George Carson.

Speaker 4

Please stay out of this.

Speaker 1

It's kind of a statement question, George says. Shouldn't you deal with admin burden for all physicians, not just family doctors? Specialist matter too? Yeah.

Speaker 4

Absolutely. Absolutely. So you know what it should. Be for all physicians, not just family doctors. I have to say. But I used. A lot of the stats for family medicine, because where OMD operates as a kind of where our intersection is, it's the community. So when we were first established, it was because the hospitals were looking after the physicians and the hospitals. And we looked after the physicians in the Community because they didn't have the same access or the same resources. And so because of that, over time, we're focusing on specialists in the community and family doctors in the community. When we talk about admin burden, absolutely it's all physicians, cause forms are for everyone. There's plenty to go around the inbox, it's for everyone. Messages are for everyone. So absolutely right. But when we look at these solutions. Those solutions are actually for everyone, so.

Speaker 1

And for and. For professors too, for. Yeah, absolutely. And the universities absolutely OK. We we have. A we have a. Kind of a question, well, a comment here from Tamara Hintz, who says the government in Saskatchewan wants to aggressively move towards sharing medical records. With patients as a child psychiatrist, our division has significant concerns regarding what information is shared with parents, guardians and guidelines around this have not. Been brought forward yet? You're Nicole. You're you're you're nodding your head. What? What do you think of?

Speaker 4

That comment, yeah, we've had a lot of the similar discussions in Newfoundland and Labrador. And when we when we start with the patient portal, it will be start. We'll be starting with kind of objective data, so laboratory results. Where we end up with consult notes. Things is to be determined and we've had a lot of discussion about that as well. You know, there's there's this, you want to have patients to have access to all of their information because you want them to be as active and engaged and and you know at the end of the day it's. It's it's about them. But we also have a duty. Did you know harm and and to protect as well. And so it's it's a very complicated discussion and I think there's going to be no one-size-fits-all for any of this, whether it's consult letters, referral letters and even some.

Speaker 7

Report some results.

Speaker 1

OK, I want to come back to our audience here in this. Room. But I do want to ask. I I do want to ask you a question right now, Corinne and the question is. Is is this? You know in your research, have you come across jurisdictions, whether it's in North America or other parts of the world that are doing a good job at reducing admin burden and what can we learn or what can be learned? From those jurisdictions.

Speaker 3

Yeah, I mean. It is, as I said earlier, it's not the sexiest topic, so to get governments or to sort of focus on it in a concerted way is a challenge. Certainly we've seen other jurisdictions in the UK, for example, and even a portion of the United States have done some sort of bigger work, not necessarily only on physicians. And on paper burden more generally. But Canada is actually a bit of a world leader on the general idea of admin burden because we actually have provinces who've actually looked at overall burden and made considered British Columbia is actually considered a leader in this regard. That just took the overall burden on society basically in BC and they reduced it by a third without affecting health safety. For the environment and so it's a lot of the lot of the processes I cited here for looking at the physician burden actually stems from some of the work that's done at the much bigger level, which is you measure it. You identify where the sources of it and the impacts of it, and then you you look at what are the actual biggest top ten basically irritants and you can you make an effort to figure out either to reduce them, get rid of them or streamline them. But it takes a lot of time and it takes a lot of effort and governments tend to be very resistant to doing that kind of work. Because it's it's log, it's a slog type work. But once you do it, the impacts are felt and they're meaningful impacts. People feel it on the ground. Our Members of British Columbia, when they started this process. Just feel much lighter today than they did 15 years ago before this process started.

Speaker 1

Can you elaborate on that? Like what? Does the research say like? How how are people feeling? Better. What does it mean in terms of their day-to-day?

Speaker 3

Yeah, it just needs. Well, for example, we know from a small business perspective as a small business owner, much like physicians who are small business owners, they spend a significant amount of time just trying to understand the rules and regulations, understand what they need to do, figuring out what the paperwork is and making sure that everything they're doing is. Mind. And when some of that stuff becomes either a lot easier to do or they can actually not have to do it or find a streamlined way to do it, it frees up time to actually run their business. So in the sake of physicians, that means seeing patients doing the things that they're actually being paid to do. And it we've seen that burden. So we actually measure the overall burden in Canada and we've measured that. Businesses across Canada costs about $40 billion a year and we think that's conservative. Just dealing with administrative burden. And reducing that by 10 or 15% can have a significant impact on the overall economy. So we're applying that same theory to physicians and it it does, it really does free up time. And fortunately, you also have to keep a system in place to keep it from growing again, because once you do it once, inevitably what happens is new rules come up, new paperwork. Comes up, new processes come up. So we also push really hard for governments to think about a process. We call it the one for one rule. So with the federal government level, they've actually introduced this where for every new rule they bring in, they're supposed to eliminate one of equal burden. And what that does is it forces those that are making the rules or making the paperwork of the processes to think about, do we really need that? Does that one, we really actually have to have. So the more. Actively managing the process. Rather than just instantly saying, OK, we need a rule for that or we need a form for that and not thinking more broadly. Well, do we really need that form or could that form suffice or can we? So it's kind of trying to change the dynamic of the of the, I guess the rule makers that are in our in our. Provincial and federal.

Speaker 1

Governments. OK, let's go back to our. In person, audience is there. So a question.

Speaker 2

Adrian, we have.

Speaker 3

About 5 in the queue, so we're going to bounce around a little bit. Here but we.

Speaker 2

Have about 5.

Speaker 1

OK.

Speaker

OK.

Speaker 8

Thank you so much. My name is Anwar. I'm a family physician in Ottawa. I'm not going to ask a question. I think we've bombarded you with a lot of questions, but it's more of a follow up comment about using technology. We recently had the opportunity to attend an E health conference and Chandy was there. Recently started to use ambient scribe in our clinic and so we have a lot of. Technology in our clinic, we use ear referrals and patient portals, but the ambience scribe I think for the. In the last few weeks I have been able to look my patients in the eye. I have been able to. Speak with them and. Even with a patient of mine, last week was using the very explicit terms to describe the experience with the health system. The note that was generated was professional, so I just want to share this experience. They do save a lot of burden. And we are based in Ottawa, so more than welcome to share the experience that. We have with AI.

Speaker

Thank you.

Speaker 1

Want to go the next question? There's another. I think we have 4/4.

Speaker 4

I have got one here.

Speaker 1

More, OK.

Speaker 3

Go ahead. Please go ahead.

Speaker 2

Yeah. Hi, Lee. I guess it's the Ottawa contingent I'm from. I'm from here. I'm a family physician as well. The question question comment to the federation actually the patients before. Paperwork was a wonderful, wonderful terminology to use and thank you because it became one of those phrases that we could use and then people like automatically know. Oh yeah, I get what you're talking about right away. So thank you. Thank you. And I really appreciate also this part about, you know, we're going to measure it. Right. And. That sounds like. Oh yeah, of course we'd measure it, but it actually is a very fundamental difference. So I had one question for you, which is how many physician practices or members for your association? And I did want to know what else you're working on, because I think you asked very good question. So from a healthcare perspective, what else you're looking at? Tell us a. Little secret. Thank you.

Speaker 3

So we actually have about 4200 what we call health offices of health practitioners. So it includes doctors, dentists, other types of health practitioners. So we do have not a huge group, but they are part of our membership as well. And thank you. We thought patience for paperwork. That's what we wanted to do is take an issue that we knew was important and and elevate it and get it in front of governments during, especially during the week that we know we have governments attention right across the country, especially at the provincial government level and other work that we're doing. A lot of the work we tend to do actually is broad based because our membership is so broad. So we have. Every sector of the economy, as part of our membership, so our focus tends to be on issues that affect multiple types. Sectors, because this we could fit this into the paperwork, which is a big part of what we do. It fits so perfectly and because I said as I showed, healthcare was such a high priority even among our Members who are not even in the healthcare system, we felt we had to do something, but we're not. We're not physicians, we're not experts on the medical field. So we just I think took what we thought we. Knew well and applied it to a sector that we thought it could really benefit, and so that's what we've continued to do. We're very open though to other approaches. We have worked with the CMA in the past on little things like tax issues, succession issues, that kind of thing. And and red other types of red tape issues as well. But for the most part, right now our focus more generally is on trying to help a lot of small businesses who were battered during COVID get back on their feet. And it's been a real challenge for certain sectors and that continue. And it's our. We continue to hear from them and so we continue to try to remind governments not to forget these businesses that some of whom are shut down for more than a year and still had to pay rent, still had to pay their taxes and do all the rest of it. That it's not over for them yet and they still need a little more time and help. So that's a little big focus for us.

Speaker 1

We want to squeeze a few more questions in before we have to shut down. Is there a question?

Speaker 7

Over here. OK. Yeah. Morley Kushner from Alberta. Question primarily for Corrine. And Shonda, you can chime in if you wish. As you may recall, Alberta's been through some interesting times with Alberta Health Services. So if, if we say. Say 10% or 15% with burden and so forth is there's reassurance from the provincial governments that they're not going to try and claw back a certain amount of money. So they say, ohh, you dogs are working 10% less. So we're going to. Take 10% back.

Speaker 3

Very interesting. And and that's the type of thing that if that did happen, we would want to know and we'd be lobbying on your behalf to say this is ridiculous. It doesn't make any sense, right? Because if you're, you know, part of that time that you're coming back is to reduce, obviously, burnout, get better work, life balance, but also to see more patients and spend more quality time. So it's not like you're doing less. Work. You're just doing more work that's focused on what it is that you're trained to do, what you're there to do. So I I think that would be unfair. Alberta is 1. We've struggled a little bit with to get some attention on this. They say the right things, but we haven't really seen any action. So we're going to continue to work. On Alberta in that regard. I think there's more work to be done.

Speaker 1

I suppose the time could be used to see more patients or see patients. For a longer period.

Speaker

Of time. Right. Right. OK.

Speaker 3

Exactly. Or that? Yeah, they could have more fundamental types.

Speaker 1

Of right. More time. I think we have time for one more question before we have to wrap things up. OK. See someone woman in the pink, I believe. I think her head is. Like another person I'm, I'm just not.

Speaker 2

There is.

Speaker 9

Straight out of here.

Speaker 1

OK. All right.

Speaker 9

And this is for Corrine. Mark Burmer, family physician in Ottawa. As others have said, great title, great initiative, but significant, but the first one is that when you talk about red. Tape and you talk about sick notes. You have the underlying premise and the employer community that we, the physician community, work for you, but we don't. We are answerable for providing you factual information. If we agree to send you that information, and surely the owners of the businesses who you represent. Would not go down onto the production line of their own business and do the work because their labor is worth many multiples of what the actual task requires, or if it was a service. Business and so the wastage you know inherent in this is terrible, that's the that's the unspoken premise that seems to be there is well you could still come back to us. You know it would be OK. I don't think it's OK as a physician. The other part is I think that you may have. Missed is that if you ask physicians what the largest chunk of their forms completion is time, it is related to disability insurance, which is purchased by your Members and the other employers in this country. And demands ridiculous details and information that have nothing to do with healthcare and the fact of the matter is the sick notes and the disability insurance should be structured so that the cost of scrutinizing and the cost of reporting. Is built in to the insurance contracts. The employers can get together and find some Commissioners of oaths. To be able. To do it and leave the doctors alone to deliver only what is necessary, care to their patients. So what? I urge you to do. My question is and ask is to go back to your Members and say the. Gig is about. To be up, we have got to leave the doctors alone. We have to find another way to do this, and when it comes to disability insurance, we need to find ways to pressure the insurers so they fall in line as well.

Speaker

OK.

Speaker 1

Thank you. Nicole, I'm going to ask you to. Respond to that.

Speaker 4

Me or reflection?

Speaker 1

Did you ever respond? Or a reflection on what what the gentleman said.

Speaker 4

Yeah. I I I think I. Think he speaks a lot of truths and when I talk to my members and and you know we we have something called the less paperwork committee that looks at, you know, just general forms. And I think anytime there's a survey done, disability forms in particular. Are very, very high on that list because they are so complex. Located and requires so much information and so much time to complete them. And it's one of those things that I think we all need to stand back a little bit and think about what is healthcare, what is what is necessary, healthcare, what is healthcare for the patient and and really go back to that patient centered model of. What? What does the patient need versus what do we need, whether we are the physicians or the employers or whoever is it's it's what does the patient need. And I think if we can refocus our healthcare system to start there, we're naturally going to find ways to reduce admin burden and and these superfluous. Forms and things that just aren't aren't necessary.

Speaker 1

OK. Well, Nicole, you have the final word for this session. Thank you so much and thank you to our panel. Thank you, Corinne. Thank you Shandy for your your comments. This was clearly a evidently it was, it was a, it was a session that people feel very passionately about and and the fact though that you have many solutions also is. You know, it provides people with a sense of possibility to to transform the way in which, you know, we, we, we or the physicians engage in the work in their work and their daily work. So thanks so much for for adding to. This conversation. Thank you.

 

 

 

 

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