Tailored Data Reports for Learning and Quality Improvement

The CHC Practice Profile combines practice data extracted from the EMR to our sector's Business Intelligence Reporting Tool (BIRT) with provincial billing and administrative data provided by ICES. It was developed by the Alliance and ICES as a CHC counterpart to the MyPractice report. MyPractice is generated using OHIP billing data and sent out annually by Ontario Health to primary care providers and teams that use OHIP billing or shadow billing. As salary-based organizations, CHCs do not bill for services through OHIP, so we developed the CHC Practice Profile to ensure our members had access to the same performance indicator data. 

The Practice Profile consists of three documents: 

• The Report and Appendices include aggregate data for clients of every CHC within the Alliance, on the following indicators
  • Complexity (SAMI)*, which reflects illness burden and expected need for primary care services
  • Other health care utilization, including use of acute care services
  • Other primary care models accessed, called ‘overlapping clients’
  • Sociodemographic characteristics
  • Cancer screening
  • Opioids dispensed
• The Electronic Data File is an Excel workbook members can use to drill down on particular indicators and select peers for comparison. 

 *SAMI, which stands for Standardized ACG Morbidity Index, represents the predicted health system usage of an organization's average client, expressed as a ratio of the predicted health system usage of the average person residing in Ontario. For example, if an organization has a SAMI score of 1.5, their average client is predicted to use the health system 1.5 times as much as the average person in Ontario, whose score would be 1.  SAMI is used to calculate the optimal panel size for CHCs in Ontario. The SAMI 101 video at the bottom of this section provides a more detailed explanation of how SAMI scores are calculated and used. 

The practice profile report is an important tool for organization-level learning and quality improvement as well as for advocacy. It provides data, such as new opioid starts and cancer screening rates, that can inform Quality Improvement Plans (QIPs). It describes the health system journey of CHC clients - such as hospitalization rates and access to multiple primary care models - that can inform planning within OHTs or Primary Care Networks. 

The Percent-to-Panel report compares the current panel size of each organization to its expected panel size. Panel size is a measure of primary care access. Operating at or close to 100% of panel size indicates that an organization is operating at a level of effectiveness and efficiency that balances sustainability and access to care. Each organization's current panel size as a percentage of their expected panel size is included in their Sectoral Accountability Agreement (SAA) with Ontario Health as Access to Primary Care.

• Current panel size is calculated using a standardized query provided in our sector's Business Intelligence Reporting Tool (BIRT).  It reflects the number of clients who have had:
  • At least one encounter with a primary care provider (physician or NP) at the organization at any time, and
  • At least one encounter with a physician, NP, RN, RPN, or physician assistant at the organization within the past 3 years.
• Expected panel size is calculated by adjusting the province-wide baseline target to account for client complexity
  • The baseline target is 1137.5 clients per full-time physician or NP. This is based on the Family Health Team baseline target of 1300, pro-rated to the shorter work week (.875) worked by CHC physicians.
  • The adjusted target per provider FTE is calculated by dividing 1137.5  by the organization's SAMI score.  A higher SAMI score indicates greater clinical complexity, so the higher the SAMI score, the lower the adjusted target panel size will be.
  • The adjusted target for each organization is calculated by multiplying the adjusted target per provider FTE by the total number of funded provider FTEs at the organization. This number is calculated by the Alliance based on the MD/NP FTEs provided through a membership survey. 

Client complexity is not the only thing that impacts panel size. Studies show that other factors such as levels of support staff and the number of exam/consult rooms are also significant influences. To reach 100% of target panel size, and organization must have optimal levels of support. Organizations looking to increase their panel size may find these resources interesting: 

• The Ins & Outs of Optimizing Panel Size: A WEQI approach (2022 webinar)
• SAMI 101: Introduction to Panel Size and Complexity (below)

The panel size handbook provides a more thorough explanation of the panel size calculations as well as the contextual and balancing indicators that may impact an organizaton's capacity to reach 100% of their target panel. 

The Sociodemographic Data Placemat was developed by the Alliance as a learning tool to support sector-wide improvement in the collection of complete and useable sociodemographic data. In 2020, Alliance members unanimously agreed to set the ambitious goal of achieving a sector-wide 75% completion rate for five key sociodemographic indicators:  income, education, race/ethnicity, gender identity, and sexual orientation. 

To help members track their progress and set improvement targets, a Sociodemographic Data Quality Placemat is generated for each eligible CHC every quarter. The placemat shows the organization's current rates of complete, unusable, and missing sociodemographic for each of the five key indicators.  

To help our members achieve their shared goal, the Alliance has produced a number of resources for learning, quality improvement, and implementation of better data-collection processes. These include:

• Foundations of Equity, a year-long learning collaborative that was held from May 2022 through April 2023.
• RALI-SDD: Our first Rapid Action Learning Intensive (RALI) was developed to support spread and scale of the successful change ideas from the Foundations of Equity learning collaborative. This is a self-paced, self-directed, coach-supported learning program. To learn more or sign up, email QI@AllianceON.org.
• Driving Forward: How (and why) to continually advance sociodemographic data collection in your organization. This recorded webinar showcases some of the key learnings from our ongoing journey of improving sociodemographic data collection and use (see embedded video below). 

The CHC OHRS Benchmarking Report uses Ontario Healthcare Reporting System (OHRS) data. This includes include both financial and statistical CHC data, such as organizational expenses, compensation expenses, individuals served, and service provider interactions. It allows centres to better understand organizational performance and compare their organizational performance to that of their peers. The report will be released three times per year, and contains data for the second, third and fourth quarter (year-end). See the video at the bottom of this section for more information.

The benchmarking report is presented as an Excel workbook with multiple worksheets. Each worksheet contains a report that looks at a different level or part of a CHC, from the organizational level down to functional centre groupings or individual functional centres. 

• At the organizational level, viewers can see how their organization compares to peers in terms of overall cost per unique individual served, cost per service provider interaction or group interaction, and number of service provider interactions or group interactions per individual served.  
• Major functional groupings include administrative services; general clinical programs; therapy clinics; chronic disease clinics; and health promotion, education, & community development programs. At a high level, viewers can see how their organization compares to the selected peer group in terms of % budget spent on administrative services and the average cost per interaction and group interaction for each major functional group.
• Each major functional group and each individual functional centre within it also has its own worksheet, allowing viewers to do a deeper dive. At this level, they can see different data for each functional group, including the percentage of the total expense spent on compensation or management and operational support; the average cost per interaction or group interaction; the percentage of all interactions that are group interactions; and more. 

CHC have found a variety of ways to use the OHRS Benchmarking Report for organizational learning. Some have found opportunities to improve their operational efficiency in one or more areas. Others have used it to gain insight into what makes their organization unique, such as a dedicated focus on one aspect of care or population health. And some have used it as a data validation tool to check that they've submitted their quarterly data to the Ministry correctly. 

For more information about the benchmarking report, please email LHS@AllianceON.org or view the recorded webinar below. 

This report was developed to support members when completing their Quality Improvement Plans (QIPs). It uses practice data gathered by our sector's Business Intelligence Reporting Tool (BIRT).  Data included is for a set of Common QIP indicators developed and ratified by Alliance members in 2019. These common QIP indicators are informed by our sector's core values, as reflected in our shared Model of Health and Wellbeing, our collective QI efforts, and our Health Equity Charter. 

The original five indicators ratified by the membership were:

• Completion of Sociodemographic Data Collection
• Stratified Cervical Cancer Screening Rate
• Client Feels Comfortable and Welcome at CHC
• Client Perception of Timely Access to Care
• Client Involvement in Decisions about their Care
  • NOTE: In 2025-26, we removed Client Involvement in Decisions about their Care, because it is no longer one of the indicators used by Ontario Health. 

More information about the Common QIP indicators can be found in the documents below:

• Key information on the Common QIP Indicators (Updated December 2022)
• Technical Specifications for the Common QIP Indicators (Updated December 2022)
• Data Sources for the Common QIP Indicators (Updated January 2024)
  • Multi-Sector Service Accountability Agreement (MSAA) Indicator Technical Specifications (Ontario Health, 2022). These are the source for some of the common QIP indicators.