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OECD’s PaRIS

WILL SHED LIGHT ON FAMILY DOCTORS’ CONTRIBUTION TO PRIMARY CARE

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PaRIS is the Organization for Economic Cooperation and Development (OECD)’s PatientReported Indicator Surveys initiative where countries work together on developing, standardising and implementing a new generation of indicators that measure the outcomes and experiences of health care. The PaRIS survey assists countries in improving care for people living with chronic conditions by measuring outcomes and experiences with the primary and ambulatory care services that they use.Familydoctorsarethecornerstoneofchronic careandthePaRISsurveywillshedlightonfamily doctors’ contribution to improving quality of care for people living with chronic conditions. Currently, 20 countries (Australia, Belgium, Canada, Czech Republic, France, Greece, Iceland, Israel, Italy, Luxembourg, Netherlands, Norway, Portugal, Romania, Saudi Arabia, Slovenia, Spain, Switzerland, United Kingdom, and United States) are participating in the first round of the PaRIS survey. PARIS QUESTIONNAIRES AND IMPLEMENTATION PLANS ARE PILOTED IN A FIELD TRIAL

The PaRIS survey of People Living with Chronic Conditions is the first ever large-scale international survey on the outcomes and experiences of people with chronic conditions andtheirprimarycareproviders. A conceptual framework has been developed through a systematic, replicable and inclusive process, including the following domains: patient reported outcomes; patient reported experiences ofcare;healthandhealthcarecapabilities;health behaviours; individual and sociodemographic factors;deliverysystemdesign;andhealthsystem design,policyandcontext. byCandanKendir,JoseMValderas

Based on the framework, a comprehensive patient questionnaire has been constructed by using existing validated measurement tools consisting of the following sections: Your health (PROMIS Global-10, WHO-5, and others), Managing your health and health care (PorterNovelli and others), Your experience of health care (P3CEQ and others), About yourself (demographic variables). In addition, a provider questionnaire was developed collecting information on service delivery. The questionnaires were cognitively tested before being piloted in a Field Trial. The PaRIS conceptual framework and questionnaire developments will be presented in the upcoming WONCAEurope2022ConferenceinLondon. Most countries sample providers first, and then patients through participating providers. Few countries sample providers and patients separatelyduetoexistingdatasystemsinplaceor administrative issues with retrieving patient contacts.

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Countries developed written plans, so called Country Road Maps, detailing implementation of the PaRIS survey in their respective countries to address country-specific characteristics while ensuringinternationalcomparability.

Participating countries are now piloting PaRIS questionnaires as well as their implementation plans. This enables improving the questionnaires, ensuring adequate performance and offering insights into how the questionnaires could be modified to reduce the burden of administration while balancing comprehensiveness and metric performance. The main Survey will begin in the endof2022.

Successfully building a survey on this scale is a joined effort and requires the support of policy makers, patients, care providers and academics from across the globe. WONCA has been involved in the design of the PaRIS survey as part of the initial reflection committee, namely Task Force, with contributions of WONCA leadership and membership, including Amanda Howe, Job Metsemakers and Jose M Valderas and in the development and implementation as advisor to the decision-making committee, namely the Working Party for PaRIS, with contributions of Anna Stavdal. In addition, many family doctors from WONCA have taken roles in the PaRIS survey as:

WONCA HAS BEEN INVOLVED THROUGHOUT THE PARIS SURVEY IN VARIOUS ROLES

• National Project Managers (Zalika KlemencKetis from Slovenia and Bohumil Seifert from Czech Republic)- responsible for the implementation of the PaRIS survey in their respectivecountries, • Consortium partners (Jose M Valderas, University of Exeter and National University of Singapore , Chair of WONCA Working Party on QualityandSafety)-oneoftheConsortiumleads is assisting the OECD methodologically in the development of patient and provider questionnaires and implementation of the PaRIS survey, including development and implementationoftheanalyticalstrategy, • Experts in the Technical Advisory Committee (Mehmet Akman, Chair of WONCA Working Party on Research; Michael Kidd, Past WONCA President; Toni Dedeu, WHO European Center for Primary Health Care)- providing methodological adviceoninternationallevel,and • Team members in the International Project Management team (Candan Kendir, OECD)developing and managing the PaRIS survey on internationallevel. Other family doctors have contributed in addition to the ones named here and many more are anticipatetocontributeinthenearfuture.

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INDIVIDUAL FAMILY DOCTORS WILL BENEFIT FROM PARTICIPATING IN THE PARIS SURVEY

The support of family doctors can substantially improveresponseratesamongpatients;inreturn, family doctors will receive feedback data on the outcomesandexperiencesintheirpopulations. IndividualfamilydoctorsareinvolvedinthePaRIS survey in various roles, as informants (by completing a provider questionnaire themselves), as partners of the local research team (amongst others, by selecting and recruiting eligible patients) and as stakeholders or end-users. InternationalandnationalPaRISteamshavebeen working to limit additional workload, for example by collecting responses on service delivery from other primary care providers in the same clinic or dedicating additional people to support family doctors in retrieving patient lists. The OECD and its partners are committed to the highest standards of international compliance with data protection laws, regulation, and rules. More information on data protection and privacy can befoundhere. The results of the PaRIS survey will be fed back to family doctors and their practice team, where relevant, therefore, they can see how outcomes and experiences of their population compares to those of regional, national, and international peers. No benchmarking across practices will be reported publicly as the PaRIS survey has not been developed for this purpose. Interested family doctors could identify their national contact person here and retrieve more information regarding the PaRIS survey in their respectivecountries. EXTENDING THE COLLABORATION VIA THE WONCA WORKING PARTY IN QUALITY AND SAFETY

The WONCA Working Party on Quality and Safety is planning to build upon this successful and mutually benefitting collaboration as part of the WP´ s strategic plan for coming years. The appointment of Candan Kendir as WP’s Executive as liaison with the OECD will facilitate further development of the collaboration with OECD in quality and safety in Primary Care in coordination withWONCAleadership.

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RE-LAUNCH PLANETARY HEALTH COURSES

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On July 15th all three Planetary Health courses of TelessaúdeRS-UFRGS in partnership between TelessaúdeRS-UFRGS, Planetary Health Alliance (PHA) and World Organisation of Family Doctors (WONCA) will be relaunched in an online event on the youtube channel of TeleRS at 8PM UTC. To watchtheevent,clickhere.

Recently, the WHO-Civil Society Working Group to Advance Action on Climate Change and Health, launched an open letter to universities on the importance of climate change in health education:Acallforstrengtheningclimatechange education for all health professionals. The document mentions all three Brazilian courses about the topic as examples of resources for learningaboutit.

For the coordinator of TelessaúdeRS-UFRGS Roberto Umpierre, it is a great honor to have the workdevelopedwithintheprojectrecognizedand recommendedbyamultilateralorganizationsuch as the WHO. “It is a TeleRS commitment to strengthen our area of education. We are always innovating in search of protagonism in the segment, and trying to reduce the time between the production of knowledge and its arrival at the audience in assistance. Now we are going even further, with our courses reaching healthcare professionalsaroundtheworld. ”

Altogether, more than 6,000 people have already signed up for the courses. The international versions had the participation of people from more than 69 countries, from all continents, with the exception of Antarctica. In the last edition, all courses had more than 90% of participant satisfaction. The WONCA version of the course was especially important for primary care health professionals around theworld.

Family doctor Paula Henry, from Trinidad and Tobago, says that taking the course helped her improve her clinical skills and think outside the box.

“The course was extremely relevant to our practice. Teaching about heat-related disorders, for instance, was very helpful because we have a lot of environmental workers, and the course helped us pay more attention to conditions like heatstroke, ”shesays. Air and water pollution, Food and food systems, Mental health, heat waves, infectious diseases are some of the topics covered in the courses. In the new edition, which will be launched in July, the planetary health course focused on Primary Care will also have a new module on migrations. Professor Charlotte Scheerens is a Research Associate at the University of Ghent and Harvard Medical School and one of the authors of this module.

According to Scherrens the goal is to provide timely, effective, appropriate, and efficient healthcare in the context of changing migration flows, climate shocks and stresses to which our healthcare systems will need to prepare and adapt.

“To minimize barriers to accessing health services for migrants and their families, health systems need to become more inclusive for climatemigrants. ”

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S RE-LAUNCH PLANETARY HEALTH COURSES

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The course relaunch event will have the participation of Dr. Carlos Faerron Guzmán, representing the Planetary Health Alliance - PHA, Dr. Özden Gökdemir, representing WONCA Environment, and the family and community doctor Mayara Floss, one of the creators of the course. The event will be led by the professor and coordinator of TelessaúdeRS-UFRGS, Roberto Umpierre.

All courses are free and available on the Moodle TelessaúdeRS distance learning platform. Enrollment opens on July 11 and classes can be held until the end of the year, at the student's pace. Anyone can enroll in any or all of the courses. More information can be obtained by emailingead@telessauders.ufrgs.br.