Understanding your patient panel

Improved panel management enables family doctors to understand both the patients they are taking care of, and what those patients need. The concept is simple: better information about patients leads to better care for patients. Accurate and optimized patient data is foundational to the transition to the patient medical home.

Panel management is a proactive process doctors can undertake to better understand their patients and their care needs, and to engage clinical team members appropriately.

The Practice Support Program (PSP) is implementing a newly developed phased approach to panel management. This approach guides physicians and their teams toward data-informed, proactive care. The three phases are:

1. Empanelment: Help doctors ensure that their list of active patients is accurate and up-to-date, and that their panel size is assessed to balance capacity.
2. Initial Panel Clean-up: Help doctors develop accurate and up-to-date registries for 3-5 chosen disease indicators.
3. Panel Optimization: Help doctors develop accurate and up-to-date registries for 10 to 15 disease indicators to support planned pro-active care. Clinic staff roles are assigned and appropriate staff time is dedicated to ongoing panel management.

This phased approach to panel management is based on the learnings from a pilot project by PSP and the experiences of other jurisdictions, such as Alberta.

In addition to enabling better care to individual patients, BC family doctors tell us that higher quality EMR data helps them understand their patient population as a whole, rather than only focusing on individual patients. This deeper understanding of their patient population empowers doctors to advocate for resources their patients need in the community, and bolsters doctors’ ability to actively look after all of their patients.

To hear directly from some of these doctors, read their stories:

• Dr Bill Cavers, Victoria: Building EMR expertise: It’s like using Photoshop after finally reading the manual
• Dr Jonathan Kerr, Comox Valley: QI “nerd” turned patient panel assessment advocate
• Dr Katayoon Kiani, Coquitlam: Getting patient information right, right from the start