Understanding the data

Frequently Asked Questions

Here are Frequently Asked Questions (FAQs) for the Primary Healthcare Panel Report. More questions? Send us a note: primaryhealthcarereports@hqca.ca.

What are the panel reports?

  • Panel reports provide family physicians with a personalized summary about their patients (their panel) including:
    • panel characteristics (size, burden of illness, deprivation indexes),
    • screening rates,
    • continuity, and
    • patient utilization of services both inside and outside clinic walls (visits to emergency departments (ED), to family doctors, hospitalizations).
  • The reports are confidential, available annually, and require no additional data collection in order to be generated for a physician.

Why does the HQCA produce panel reports?

  • Panel reports were developed to support physicians to better understand their patient panel and the care their patients receive.
  • The HQCA has a legislated mandate to measure, monitor, and assess health service quality and patient safety; and to identify effective practices for the improvement of health service quality and patients safety. Panel reports are one mechanism that supports this mandate and overall improvement in the health system.

Where does the data in the panel report come from?

  • The panel report is a combination of administrative health data and your patient panel list.
  • The administrative data is from Alberta Health and Alberta Health Services e.g., physician billing activity, inpatient hospital, lab use, pharmaceuticals, diagnostics, Emergency Department, cancer screening, vaccination data
  • The panel list is either estimated by the HQCA (proxy), or is provided by the physician (confirmed), or is provided by the CII-CPAR initiative for participating physicians.

How does the HQCA know who is on my patient panel?

  • The panel list is either estimated by the HQCA (proxy), is provided by the physician (confirmed), or is provided by the CII-CPAR initiative for participating physicians.

What is a proxy panel?

  • It is an estimate of your patient panel derived from the proxy algorithm developed by the HQCA.

How does the HQCA estimate who is on my proxy panel?

  • The HQCA uses a proxy algorithm to assign patients to a single physician. The proxy algorithm is probabilistic, so it goes through steps (or cuts) for each patient to produce an estimate that there is a highly probable relationship between a physician and a patient.
  • To be included in the algorithm, the patient must have visited a primary care physician in the last three years at a primary care setting and be an active patient (covered under the Alberta Healthcare Insurance Plan (as of one year prior to the release of the report)).
  • Any patient that is assigned to a physician is a patient they billed for at least once in the previous three years.

How did the HQCA develop the proxy algorithm?

  • The HQCA reverse engineered the patient-provider relationship (through patient activity, diagnostic codes and procedure codes) for over 200,000 patients from over 200 confirmed patient lists to develop the algorithm.

Is the proxy algorithm the same as the Alberta Health 4-cut method?

  • The HQCA uses a 5-cut method to generate proxy panels whereas Alberta Health uses a 4-cut method to determine panel size and PCN funding. This means there might be differences in panel sizes between the HQCA proxy panel and panel size determined by Alberta Health.

What is a confirmed patient list?

  • A Confirmed Patient List (CPL) is a list of patients where the patient and physician have agreed that this physician is their family physician and most responsible for their care.
  • A confirmed list is created from your Electronic Medical Record (EMR).
  • Physicians can work with their support team (e.g., Improvement Facilitator, Panel Manager, etc.,) to send the HQCA their confirmed list for a CPL report. If participating in the CII-CPAR, the confirmed list will come directly to the HQCA from the CPAR.

What if I am participating in CII-CPAR? Do I need to submit my list to the HQCA as well?

  • If you are participating in CII-CPAR, and interested in receiving a Confirmed Patient List (CPL) report, you do not need to submit your CPL to the HQCA. Simply request your CPL report from the HQCA annually. We will generate your panel report based on your panel list from CPAR.

How can I use this report?

  • Use it to help identify “what matters to you?”
    • Use the data to make appropriate and strategic decisions based on what matters to you and the needs of your business and patient panel. Take the guesswork out of planning. Use the information to determine your ideal panel size based on how many days you work and how often your patients use healthcare services, learn about when your patients go to the ED and for what reasons, and what is the relationship between your continuity rate and other measures like screening rates and service utilization.
  • Self-identify areas of interest using peer benchmarks.
    • Peer comparisons provide you with an external perspective on your practice so you can identify areas where you are practicing differently from your peers or your patients are using the system differently from others in their geographic area.
  • Identify actionable business and improvement opportunities.
    • Having the ability to drill down into the data makes practice change more manageable and actionable. For example, identify gaps in screening and key preventive interventions. Focus your efforts on those patients who need it the most e.g., go from identifying all patients not screened for diabetes, to those who are at high risk and not screened (e.g., patients with cardiovascular disease and no diabetes screening on record).
  • Strengthen your patients’ medical home.
    • Gain insight into what happens outside of your clinic walls and your EMR. See how your patients use other healthcare services like ED visits (and for what purpose) and family doctors. Data informs how to allocate resources and identify services needed and improvement opportunities based on your panel.

Sometimes I feel this is not my data because it does not reflect how I practice, why is that?

  • The measures in the panel report are derived from patient activity and the services patients’ use, so a physician might see patient information results that are incongruent with their practice. For example,:
    • a physician might not offer comprehensive annual care plans but sees that their report shows patients with care plans. Why? The patient might have received a care plan from another physician.
    • a physician might see that their patients are being dispensed a pharmaceutical they did not prescribe? Why? The patient obtained a prescription from another provider.

Do I order a proxy or confirmed report?

  • A proxy panel will be a good estimate for physicians who have practiced in a stable practice for at least three years, because the proxy algorithm uses three years of administrative health data to assign patients to physicians, and for physicians who saw few patients that belong to other family physicians (e.g., in an after-hours or walk-in clinic). Request this option if you cannot provide a confirmed patient list (i.e., a list of patients who agree you are their main family physician).
  • If a physician has panel identification and management processes in place, a confirmed panel list (CPL) will be more accurate.
  • Physicians who share patients where both physicians are considered most responsible might have smaller proxy lists than expected. This is because patients can only be assigned to one proxy panel. A CPL would be more accurate for physicians who share patients.
  • Physicians who work in more than one clinic should consider requesting two CPLs or one CPL with all the patients listed together.
  • A CPL will also be a more accurate representation for new physicians, because patients in a new physician’s EMR might be assigned by the HQCA to another physician’s proxy panel if they are new to practice or took over patients from an existing practice.
  • The panel report does not include patients who fall under the reciprocal billing agreement (insured by other provincial healthcare plans outside Alberta), because they do not appear as active patients (covered under the AHCIP).

Will my panel list be more accurate if I participate in CII-CPAR?

  • The measures in the panel report are most accurate when your panel truly represents the list of patients for whom you are the most responsible provider. Participating in CII-CPAR is the most accurate process to validate and share your panel information. To get started, with CII-CPAR visit this website.

How is my privacy protected?

  • Physician-level panel reports are confidential and are not shared with anyone other than the physician unless requested by that physician.

Where can I order my personalized panel report?

  • Request your personalized report by visiting request.hqca.ca.
  • Engage your PCN’s Improvement Facilitator to review the data in your report to inform your planning and improvement activities.

Where does the data come from?

This short video explains how report measures are selected and what data sources are used to develop the panel reports.

If you’d like the slides and speaking notes to embed in your own presentation please email us at primaryhealthcarereports@hqca.ca.

Webinar – Primary Healthcare Panel Reports: a webinar for Improvement Facilitators

Co-hosted by the Alberta Medical Association and the HQCA, we hosted a webinar on March 28, 2019 for Improvement Facilitators (IF) in Alberta introducing them to the 2019 Primary Healthcare Panel Report.

Understanding continuity data

Continuity of care is about improving Albertans’ health through developing stronger, ongoing relationships between patients and their family physician/nurse practitioner and care team (relational continuity), increasing information sharing (information continuity), and enhancing care coordination (management continuity).

This module is all about relational continuity, as the Primary Healthcare Panel Reports contain measures that address relational continuity.

Data resources

Data Dictionary

The Primary Healthcare Panel Report Data Dictionary provides information on the description, rationale, interpretation, calculations, data sources, limitations and alignments of all the metrics in the HQCA’s Provincial Primary Healthcare Panel Report. This information is intended to help improve the understanding and interpretation of the metrics and their presentation in the report.

Proxy Algorithm

The HQCA proxy panel algorithm is an estimate of a physician’s active panel based on the pattern of family physician billing claims over a three year period. The current data period covers the years April 1, 2016 to March 31, 2019.

The algorithm predicts which family physician, from all those seen by a patient over the three year time period, is most likely to be the patient’s main family physician. If there is a tie between two or more family physicians at any step, assignment moves to the next step. The proxy panel will be most accurate for physicians who had a stable practice during the data period and who saw few patients of other family physicians (e.g., in an after-hours or walk-in clinic).

If you have specific questions, email: primaryhealthcarereports@hqca.ca or contact us at 1.855.508.8162.