Please see below for the following updates:

• Reminders and instructions for Epic Systems Training registration
• Status Update about the Funding of Direct Oral Anticoagulants (DOACs) under the Ontario Drug Benefit Program
• EPIC - Order set Consolidation
• AFP Innovation Fund (IF) Call for Proposals – Submission deadline August 21/24
• REMINDER: Submit your 2023/2024 Annual Activity Reports – Active Staff Members ONLY
• REMINDER: 2023/2024 Annual Activity Reports – Courtesy Staff ONLY - Please fill out the online survey
• Keep up the great work conserving blood culture bottles

Please be reminded that all Unity Health staff and physicians who will use the new Epic EPR system once it launches on Nov. 30 are required to complete Epic Systems training ahead of go-live. Physicians are responsible for registering themselves. Training registration is now open. Please see below for important reminders and step-by-step instructions on how to register. 

Registration instructions 

Training has been preassigned in Elevate, Unity Health’s Learning Management System (LMS). To enrol in a classroom training session, please see this tip sheet, this how-to video or follow the steps below. You can also find an introduction to Elevate in this short overview video.

1. Sign into Elevate (https://elevate.unityhealth.to) using your Unity Health credentials. This is the same network username and password that you use to log into other Unity Health systems. 
   • Note: You can access Elevate through any browser and on any device. You do not need to be logged into Citrix or FortiPortal, or on a Unity Health device. 
2. Once logged in, you’ll see a My Learning Progress widget on the right-hand side of the home page, below the Elevate banner. In that widget, find the course you want to enrol in. 
   • Note: You won’t be able to see your Epic Systems training courses until 7 a.m. on June 24. If you still don’t see your courses after that time, click on “View All” at the bottom right-hand side of the widget. 
3. Click on the course title you want to enrol in. 
4. In the Enrolment Options box, click on the “Choose Session” button. 
5. From the available list of sessions, select the one you want to enrol in. 
6. Click the “Confirm” button to enrol in the chosen session. 

If you encounter any issues trying to register once the training registration window opens, please log a ticket with the HelpDesk using the ServiceNow portal (NOT via phone or email). A member of the EPR Education team will review your ticket and get back to you as soon as possible. 

Reminders 

• Training courses have been pre-assigned in Elevate. Physicians are only responsible for selecting the date, time and location that they want to attend training.  
• ALL Unity Health physicians are required to register for training. A training exemption will be made available for physicians who have recent and related Epic experience but until the exemption process opens in August, all physicians should still secure a spot for training. 
• Physicians will have to dedicate one day for Epic training, to be done in-person. 
• Physicians do not need to register immediately on June 24 but please note that classroom training sessions will be available on a first come, first served basis.  
  • Each track has a collection of date/time options that are fixed and cross the three sites.  
  • Based on information provided by clinical groups, some tracks include Saturday options. 
  • There are enough classes for everyone, and everyone will have to choose one. 
  • Epic requires that all physicians at Unity Health be registered by Aug. 30. 
• Registration is NOT restricted to your home site. It's recommended that you choose the date/time that works for you, and do not restrict yourself by only looking at one site. 

Thank you in advance for your attention to this. If you have any questions, please see the resources available on the EPR System Training page on UnityNet or email [email protected]. 

DOACs are now general benefit!  This will be a huge opportunity to switch (appropriate) patients currently on warfarin for VTE treatment, as previously these were only covered with an LU codes for afib. 

July 24, 2024 - Direct-oral anticoagulants (DOACs) are approved by Health Canada as agents used in the treatment of blood clots. Currently, several DOACs are designated as Limited Use (LU) Benefits on the Ontario Drug Benefit (ODB) Formulary (the "Formulary"). These DOACs are funded under the ODB program for eligible recipients who meet the applicable LU clinical criteria on the Formulary, such as criteria related to the use of a DOAC for the prevention of venous thromboembolic events, stroke, and non-valvular atrial fibrillation. Eligible recipients who do not satisfy the LU clinical criteria on the Formulary can have their authorized prescriber submit a funding request to the Exceptional Access Program (EAP) for case-by­ case approval.

As of the effective date of the July 2024 update to the Formulary, DOACs will no longer be designated as LU Benefits under the ODB program and instead will be designated as General Benefits (GB) on the Formulary. This change in designation from LU Benefit to GB will apply to brand and generic versions of DOACs, including apixaban (brand: Eliquis), dabigatran (brand: Pradaxa), edoxaban (brand: Lixiana) and rivaroxaban (brand: Xarelto).

Designating DOACs as GB on the Formulary is in the public interest and consistent with the principles governing the ODB program, which include meeting the needs of Ontarians, achieving value for money, ensuring the best use of resources at every level of the system, and making funding decisions based on the best clinical and economic evidence available. The change in designation for DOACs will address unmet clinical needs, improve patient access, and is consistent with funding recommendations from health technology assessments.

All PINs for apixaban 2.5mg will be discontinued to coincide with the July 2024 update to the Formulary and the change in the designation of DOACs from LU Benefit to GB. The affected PINs can be found in the Frequently Asked Questions (FAQs) for Pharmacies accompanying this Executive Office Notice.

The July 2024 update to the Formulary will be posted on the ministry's website at: Formulary / Comparative Drug Index (CDI) Edition 43 | Ontario Drug Benefit (ODB)

Thanks everyone for your work to date on the order set consolidation.  I appreciate that it’s a huge amount of work including cross-site collaboration. Your work on these order sets is a critical component of successful EPIC implementation – thanks so much! Please see the latest audit report of how we’re doing with the order set work.

Applications are now being accepted for Round 17 of the AFP Innovation Funds.  As in previous years, the DOM will have an internal review of the Innovation Fund applications in order to optimize the chance for successful applications.  For 2024/2025, the Department of Medicine has been allocated $480,154.40 in total for new projects, after year 2 funding from last year’s approved projects is removed.  We are suggesting a maximum budget per project of $100,000.  There is also a competition for a large budget cross-discipline proposal of up to $200,000 for 2 years.

We ask that applicants send their complete applications to Jessica Comilang by August 21, 2024.  This deadline is for both large budget and all new initial proposals for the DOM internal review process.

Please check your inbox for emails from Jessica on this topic for full details, guidelines and required forms. You must be a full member of the DOM practice plan to apply as PI. Dr. Andrew Advani is overseeing this process on behalf of the Department of Medicine this year.

Due date:  September 1, 2024

The Department of Medicine is committed to ensuring your career satisfaction and success. With this goal in mind, and due to our size, all full time DoM members are requested to participate in a biennial Faculty Review, at a minimum. This meeting provides you the opportunity for formal discussion about what is and may not be working to achieve your goals, to ensure you are meeting the expectations of your job description from the point of view of your division, department and university, and to facilitate your continued career success.  Faculty members who are in their first 5 years of a faculty appointment will be met with annually. If you have a pressing need to meet or would like to meet annually, please reach out to the PIC office so that we can accommodate this. The priority is to ensure your needs are met and we will do whatever we can in the PIC office to help you achieve your career goals.  You are also encouraged to meet annually with your Division Head to review your career goals and activities, including a discussion of your annual activity report.

Thank you to those who have already submitted.

Due date:  September 1^st, 2024

This year, we are circulating a revised online form for your 2023/24 activity report as we would like to ensure we have a full understanding of your clinical and scholarly contributions to St. Michael’s Hospital.  All medical staff holding a courtesy appointment in the St. Michael’s Department of Medicine are requested to complete this online report by September 1, 2024, which will be reviewed by myself and your Division Head.  This information will be used to inform re-appointment to St. Michael’s Hospital next year.   For those of you who hold a faculty appointment, please note that this report is separate and distinct from the reporting you provide to the University of Toronto. Your time to complete this report is appreciated.

https://knowledgetranslation.qualtrics.com/jfe/form/SV_1TCV3Bpxbgn1sGi

Thank you to those who have already submitted.

There is an ongoing global supply shortage of blood culture bottles that will to continue through the fall (see Critical Practice and Safety Alert for physicians). By adhering to evidence-based practices, we have reduced our usage of blood culture bottles by ~20%. Keep up the great work and continue to follow best practices for blood culture collection.

These are the key actions you can take:

Does your non-neutropenic adult patient have:

• Isolated fever and/or leukocytosis who do not have severe sepsis (e.g. hypotension) or suspected endocarditis?
• Nonsevere cellulitis?
• Simple cystitis or prostatitis?
• non-severe pneumonia?
• Post op fever within 48 hrs of surgery?
• If YES to any of the above, please RECONSIDER ordering blood cultures.