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Coordinated Care Plan User Guide Guidelines and Examples
2015-07-27
COORDINATED CARE PLAN USER GUIDE 1
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Table of Contents
Purpose ...... 3 Guiding principles for coordinated care plans ...... 3 Coordinated care plan template information fields ...... 4 All sections ...... 4 My identifiers ...... 5 My care team ...... 10 My health issues ...... 12 My known, current allergies and medications ...... 14 My plan to achieve my goals for care ...... 18 My situation and lifestyle ...... 22 My recent health assessments ...... 29 My most recent hospital visit ...... 30 My other treatments ...... 32 My current supports and services ...... 33 My appointments and referrals ...... 34 Appendix A: Assessment types and examples ...... 35 Appendix B: Field options for care coordination tool ...... 36
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Purpose
This document describes how the coordinated care plan template is intended to be used and the purpose of each individual information field that is part of the plan. A “user” of the coordinated care plan could be a care coordinator authoring the plan, a clinician viewing the plan, the client/patient for whom the plan was made, or an informal caregiver. The descriptions in this guide allow users to have a common understanding of the information contained therein so that these clinical documents can be used consistently and reliably.
Note: This user guide applies to coordinated care plans regardless of how they are created (e.g., using the Care Coordination Tool or the Microsoft Word template).
Many Health Links continue to develop coordinated care planning processes that define how providers, clients/patients and their families work together to coordinate and deliver care for Health Link clients/patients. The coordinated care plan user guide is not meant to impose any particular processes on Health Links nor be a substantive tool to help Health Links develop those processes. However, recognizing that there should be some common aspects of care coordination in place in order for the coordinated care plan to be a useful tool, the user guide does suggest some guiding principles on using care plans (noted below). These guiding principles may inform the development of coordinated care planning processes, although for the most part, they simply reflect the work that is underway in many Health Links already.
Please note that information collected using the Care Coordination Tool is personal information or personal health information and must be collected, used, and disclosed only for the purposes of providing health care or assisting in the provision of health care to the client/patient to whom the coordinated care plan relates, as permitted by and in compliance with PHIPA.
Guiding principles for coordinated care plans Trust When potential users of coordinated care plans trust in their quality, accuracy and reliability, they are more likely to adopt and embed coordinated care plans into their workflow. This creates a positive feedback loop whereby the more coordinated care plans are used, the greater their value, since more frequent use leads to more comprehensive and timely information being captured in care plans. Comprehensive and timely information furthers users’ trust in care plans, and the cycle continues. Thus, it is crucial that guiding principles that ensure the integrity of coordinated care plans are agreed upon and shared by all users. Value Adoption
Below are five guiding principles to encourage the trust, use, and value of coordinated care plans:
1. The client/patient is informed of all information included in the coordinated care plan, who has access to the information and how the information is intended to be used. 2. Each coordinated care plan is developed with direct input from the client/patient. Care plans reflect the client/patient’s stated goals, needs and preferences and are written in clear, accessible language, using the client/patient’s own words where possible. 3. Coordinated care plans are accessible to clients/patients and the circle of care in any setting where care may be delivered. 4. Coordinated care plans are actively used and reliably maintained according to the clinical practices established in each Health Link by all in the circle of care. 5. Coordinated care plans are based on current evidence and use generally accepted clinical guidelines.
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Coordinated care plan template information fields
This guide applies to coordinated care plan template version 1.0.0. All sections Two information fields are common to all sections: “Last verified” and “Last verified by”. They help to establish the authorship of each section as well as the currency of the information in that section.
Information field What it tries to capture Paper form / CCT Format Examples The most recent date and time on which the information in Last verified Free text / Auto-populated YYYY-MM-DD HH:MM:SS 2014-01-18 14:51:43 this section was verified and/or reviewed for accuracy The name of the individual who most recently verified Last verified by Free text / Auto-populated Kate Austen and/or reviewed this section
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My identifiers This section helps to establish the identity of the client/patient by providing both basic information about him/her (e.g., name, date of birth, address), as well as other information that will help the care team understand the client/patient, such as his/her ethnicity, religion, marital status and living conditions.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
Given name The client/patient’s given name Free text Michael
Mike Preferred name The name by which the client/patient prefers to be identified Free text Do you prefer to be called by a different name?
Surname The client/patient’s surname or family name Free text Jones
The client/patient’s identified gender Drop down (Refer to list below) Gender Option Description Male The client/patient identifies as a male Female The client/patient identifies as a female Transgender male The client/patient identifies as a transgender male Transgender female The client/patient identifies as a transgender female Other The client/patient identifies as a gender other than the ones listed Decline to answer The client/patient declined to answer Date of birth The client/patient’s date of birth Free text / Date picker YYYY-MM-DD 1965-10-15
A flag to indicate that the client/patient’s date of birth is an Date of birth estimated? Check box estimate The name of the Health Link from which the client/patient’s Health Link Free text / Pop-up Barrie Community coordinated care plan was created
Address The address of the client/patient’s primary residence Free text / (2 lines) 123 Main Street, Apt 234
City The city of the client/patient’s primary residence Free text Barrie
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
Province The province of the client/patient’s primary residence Drop down ON
Postal code The postal code of the client/patient’s primary residence Free text A1A1A1 M4W2A2
Telephone # The client/patient’s primary telephone number Free text XXX-XXX-XXXX 613-555-1234
The client/patient’s health card number, if they have one Health card # Number 0123456789 (version code is not required) Whether or not the client/patient has provincial health Drop down (Refer to list below) Issued by coverage Option Description (Select a province or territory) Uninsured The client/patient does not have any insurance for core services Other insurance The client/patient has non-OHIP (or other provincial) insurance for core services (e.g., RCMP) Unknown It is unknown if the client/patient has any insurance for core services Decline to answer The client/patient declined to answer An alternate telephone number by which to contact the Alternate telephone # Free text XXX-XXX-XXXX ext XX 613-555-1234 ext 44 client/patient
Email address The client/patient’s primary email address Free text [email protected]
The method by which the client/patient prefers to be Drop down (Refer to list below) Preferred contact by contacted Option Description Telephone The client/patient prefers to be contacted by telephone Email The client/patient prefers to be contacted by email Translator The client/patient prefers to be contacted via a translator Other The client/patient prefers to be contacted by a method other than the ones listed (e.g., mail) Decline to answer The client/patient declined to answer Mother tongue The client/patient’s mother tongue Free text / Type ahead Arabic
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The official language in which the client/patient is most Drop down (Refer to list below) Official language comfortable Option Description English English is the official language in which the client/patient is most comfortable speaking French French is the official language in which the client/patient is most comfortable speaking Neither The client/patient is unable to speak in either official language (neither English nor French) Decline to answer The client/patient declined to answer Free text / Type ahead Polish Ethnicity/culture The client/patient’s self-identified ethnicity or culture (Refer to list in appendix B) First Nation – Status The client/patient’s self-identified religion or social group (in Free text / Type ahead Religion CCT, choose “Other” to record multiple options and/or a Hindu (Refer to list in appendix B) social group)
The client/patient’s marital status Drop down (Refer to list below) Marital status Option Description Never married The client/patient has never been married Married The client/patient is currently married Common law The client/patient is currently in a common-law relationship Separated The client/patient is separated from his/her spouse Divorced The client/patient is divorced from his/her spouse Widowed The client/patient is widowed/a widower Decline to answer The client/patient declined to answer Unreported The client/patient did not provided this information The client/patient’s current living arrangements Drop down (Refer to list below) Where I currently live Option Description Private dwelling Residence that is privately owned or leased by the client/patient Assisted living home Residence that provides support services but no medical monitoring Retirement home Residence that provides care for seniors
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) Group home Residence that provides for persons with developmental disabilities Long-term care home Licensed home providing 24-hour nursing care or supervision Hospital Institution that provides treatment to injured or sick persons Hospice Home for end-of-life care Correction centre Institution that houses offenders serving sentences from 60 days to 2 years Shelter Temporary residence for homeless persons Rooming house Residence where inhabitants share a kitchen and bathroom Homeless Lacking stable, permanent, appropriate housing Other Residence other than the ones listed Decline to answer The client/patient declined to answer Those people with whom the client/patient currently lives Drop down (Refer to list below) People who live with me Option Description No one The client/patient lives alone Partner only The client/patient only lives with his/her partner Partner and others The client/patient lives with his/her partner and others (e.g. children) Children only The client/patient only lives with his/her children Parent(s) or guardian(s) The client/patient lives with his/her parent(s) or guardian(s) Sibling(s) The client/patient lives with one or more of his/her siblings Other relative(s) The client/patient lives with one or more relatives other than the ones listed (e.g., cousin, uncle) Other The client/patient lives with one or more people other than the ones listed Decline to answer The client/patient declined to answer People who depend on Those people who are dependent on the client/patient (e.g., Free text My two children me to whom the client/patient is a caregiver) Hugo Reyes The name of the client/patient’s primary contact (should Who is your main “go-to” person Primary contact Free text match what is recorded in “My care team” section) who you would want involved in your care?
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
The relationship of the primary contact to the client/patient Drop down (Refer to list below) Relationship to me Options [primary contact] Brother Daughter Friend Grandparent Sister Spouse / Partner Caregiver Extended family Grandchild Parent / Guardian Son Other – free text (specify) Telephone # The primary contact’s primary telephone number Free text XXX-XXX-XXXX 613-555-1234 [primary contact] Benjamin Linus The name of the client/patient’s emergency contact who is to In an emergency, if Donald Emergency contact Free text be contacted when primary contact cannot be reached wasn`t available, who would you want us to call?
The relationship of the emergency contact to the client/patient Drop down (Refer to list below) Relationship to me Options [emergency contact] Brother Daughter Friend Grandparent Sister Spouse / Partner Caregiver Extended family Grandchild Parent / Guardian Son Other – free text (specify) Telephone # The emergency contact’s primary telephone number Free text XXX-XXX-XXXX 613-555-1234 [emergency contact]
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My care team This section records the members of the client/patient’s care team, including both formal and informal caregivers, and provides some information to describe each member’s role in the care team. This section also serves as a “directory” for anyone who may view the care plan. Where possible, individuals should be identified although in some cases it may be more appropriate to identify an organization (e.g., a retail pharmacy). Where care team members are listed elsewhere in the care plan (e.g., “primary contact”) their name and contact information should be the same as it is listed in this section.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
Care team member name The name of the particular care team member Free text James Ford
The care team member’s professional role or relationship to the Free text / Type ahead Dietician Role or relationship client/patient (Refer to list in appendix B) Parent / Guardian If applicable, the organization with which the care team member is Organization name Free text Guelph FHT, Home, N/A affiliated
Telephone # The care team member’s primary telephone number Free text XXX-XXX-XXXX 613-555-9999
Whether or not the client/patient sees the care team member at least Drop down (Refer to list below) Regular care team once a year on a planned basis member Option Description Yes The client/patient sees the care team member at least once a year on a planned basis No The client/patient does not see the care team member at least once a year on a planned basis A flag to identify which member of the care team is the lead care Lead care coordinator Check box coordinator and primary author of the coordinated care plan A flag to identify which member of the care team the client/patient relies I rely on most at home Check box on the most at home or informally – up to client/patient’s discretion
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) An indication of “caregiver burnout” - the ability of informal members of Drop down (Refer to list below) The people I rely on the care team to continue to provide support to the client/patient most at home are feeling Option Description Able to continue They have no difficulty in continuing to provide care for the client/patient Not satisfied They are dissatisfied with some aspect of the situation, but are able to continue providing care Angry or distrustful They are angry or distrustful due to some aspect of the situation, but are able to continue providing care Unable to continue They cannot continue providing care to the client/patient without new supports Other They feel other than the ones listed; free text (specify) Not applicable This field is not applicable to the client/patient Decline to answer The client/patient declined to answer
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My health issues This section records the various factors that may negatively affect the client/patient’s health ranging from physical and mental conditions to social conditions. This section serves to provide a holistic assessment of the client/patient’s health by giving brief descriptions of each aspect of their health as well as some chronology by providing dates of health issue onset. Entries in the physical health row should pertain to problems, issues, or concerns of the body as should entries in the mental health row pertain to problems, issues, or concerns of the mind. Social health relates to social determinants of health such as relative income level, relationships with others, or any aspect of a client/patient’s social history that may affect their health
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
The category of health issue Drop down (Refer to list below) Issue type Option Description Physical Health The client/patient’s issue is related to physical health (e.g., arthritis) Mental Health The client/patient’s issue is related to mental health (e.g., anxiety) Social Health The client/patient’s issue is related to social health (e.g., isolation) A plain language description of one of the client/patient’s health Description Free text Arthritis issues (it can be related to physical, mental or social health)
Clinical description A clinical description of the client/patient’s health issues Free text Osteoarthritis
The approximate month and year the client/patient first became Free text / Date picker 2014-10 Date of onset aware of the issue or was diagnosed with the issue YYYY-MM,YYYY-MM-DD 2014-10-23 An indication of whether the issue is stable or not – note that this Stability is at the discretion of the care team considering likelihood of Drop down (Refer to list below) deterioration, disease flare, crisis, or other relevant factors Option Description Stable The client/patient is stable in regards to the particular health issue Unstable The client/patient is unstable in regards to the particular health issue Not applicable Stability is not relevant to the particular health issue Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) ED visits due to pain How severe are your symptoms? Notes Any other notes to explain or contextualize the issue Free text What triggers tend to cause your disease to flare?
Baseline vitals
165 Height Height of client/patient using the specified unit of measure Number 65
The unit of measure of the client/patient’s height Check box / Radio button (Refer to list below) Height units Option Description cm Centimetres in Inches Weight of client/patient using either the imperial or metric system – 95 Weight Number up to provider discretion to pick one and ensure it is noted 209
The unit of measure of the client/patient’s weight Check box / Radio button (Refer to list below) Weight units Option Description kg Kilograms lb Pounds Most recent HbA1c test result (a proxy for the average level of 4.2 HbA1c Number blood sugar over time) 22.4
The unit of measure of the client/patient’s HbA1c Check box / Radio button (Refer to list below) HbA1c units Option Description % Percentage DCCT (Diabetes Control and Complications Trial units) mmol/mol mmol/mol IFFC (International Federation of Clinical Chemistry units)
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My known, current allergies and medications This section lists known allergies and intolerances. This section also lists current and past medications, providing details such as drug name, method of drug delivery, the pharmacy that provides the drugs, and the prescriber’s name. The start dates and change dates create a chronology of the client/patient’s medication usage and how they may have changed over time.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
Allergies Indication provided by the client/patient that, to the best of No known allergies his/her knowledge, there is no known history of allergy or Check box (NKA) intolerance to medications or substances. Name of the compound or factor, which elicits a reaction – Corn Substance if it’s a medication follow the naming guidelines in the Free text Aspirin medication section Whether the reaction between the client/patient and the Drop down (Refer to list below) Allergy or intolerance substance is that of allergy or intolerance Option Description Allergy Immune system dependant hypersensitivity reaction to said substance Intolerance Inability to digest or dispose of said substance A description of which bodily system is most affected by Drop down (Refer to list below) Symptoms exposure to the substance Option Description Skin The skin is primarily affected by said substance Respiratory The respiratory system is primarily affected by said substance Gastrointestinal The stomach and intestines are primarily affected by said substance Behavioural The mental or motor response of the client/patient is primarily affected by said substance Blood The blood is primarily affected by said substance Other The parts of the body that are primarily affected do not fall under the ones listed; free text (specify) Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The level of danger in regards to the substance allergy or Drop down (Refer to list below) Severity intolerance as perceived by the care team Option Description Mild Symptoms could be ignored by client/patient with minimal effort Moderate Symptoms cannot be ignored by client, but do not limit his/her daily activities Severe Symptoms cannot be ignored by client, limit his/her daily activities, and require extensive treatment Life-threatening Symptoms endanger client/patient’s life without treatment Decline to answer The client/patient declined to answer Current medications Date of last medication The date on which the most recent medication reconciliation Free text / Date picker YYYY-MM-DD 2014-10-14 reconciliation was performed by a qualified member of the care team The names of all the care team members who directly Free text / Drop down – select from care Performed by Sayid Jarrah contributed to the care plan team A plain language description of the most recent change My last medication (addition, deletion, modification, etc.) to the client/patient’s Free text Increase ibuprofen change was medication A plain language description of how that change made the Drop down (Refer to list below) It made me feel client/patient feel Option Description Better The medication change made the client/patient feel better Worse The medication change made the client/patient feel worse About the same The medication change did not produce an effect that could be detected by the client/patient Other The medication change made the client/patient feel other than the ones listed; free text (specify) Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) A description of the aids that the client/patient uses to take Drop down (Refer to list below) Aids I use to take my his/her medications medications Option Description Dosette A container intended for the storage and organization of a client/patient’s medication Blister packs Packaging used for storing and protecting a client/patient’s medication Someone administers medications Someone other than the client/patient administers the client/patient’s medication None The client/patient does not use any aids to take his/her medication Other Any aids other than the ones listed; free text (specify) Decline to answer The client/patient declined to answer Challenges I have taking A plain language description of the challenges the I have difficulty remembering to Free text medications client/patient has in taking his/her medications take my medication The generic name of the particular medication that the Drug name Free text Ibuprofen client/patient is currently taking The quantity of the particular medication that the client/patient Dose Free text Number + unit of measurement 20 mg is currently taking
The route by which the client/patient takes the particular Drop down / Type ahead Route Oral medication (Refer to list in appendix B) The prescribed method or frequency at which the Direction Free text Daily client/patient takes the particular medication The reason that the client/patient was prescribed/directed to Reason Free text Pain/arthritis take the particular medication The pharmacy from which the client/patient acquired this Pharmacy name Free text Rexall, Oak St. 613-555-9999 particular medication The date that the client/patient started taking this particular Start date Free text / Date picker YYYY-MM-DD 2013-10-26 medication
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The date of the most recent change to any aspect of this Change date Free text / Date picker YYYY-MM-DD 2013-11-14 particular medication
The care team member who prescribed/directed the Free text / Drop down – select from care Prescriber Jack Shephard client/patient to take this particular medication team (includes ‘Other’ free text) Do not take with aspirin or Special notes or Any other notes that do not fall into previous categories Free text alcohol, reviewed by Kate instructions pertaining to the client/patient’s medications and their use Austen at patient’s home
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My plan to achieve my goals for care This section describes the analysis of the current situation and the “care plan” for the client/patient. The client/patient informs the plan generally by communicating his or her priorities and concerns about his or her health. More specific goals are articulated below which should represent the agreed upon goals for the client/patient and care team. Several specific actions to achieve the goals are listed, each with a person responsible for ensuring the completion of the goal identified. The “Plan for future situations” subsection describes what the client/patient should do in certain situations, such as a sudden decline in health or function. Finally, there is a sub-section to provide process-related information about the client/patient’s advance care planning.
Information field What it tries to capture Paper form / CCT Format Examples (red) & probing questions (blue) Care team members The names of all the care team members who Free text / Drop down – select one or who contributed to Jack Shephard, Kate Austen, James Ford directly contributed to the care plan more members from care team this plan Enjoying time with my family What is most The single highest priority of the client/patient What parts of your day do you look forward to the important to me right both within and outside the context of their Free text most? What is really important to you and your now health family?
What concerns me Being able to afford my prescription medication The single greatest concern of the most about my Free text What is most concerning about the state of your client/patient within the context of their health healthcare right now healthcare? Walk my daughter down the aisle at her wedding on The client/patient’s articulation of his/her key What I hope to June 30 goals (not limited to medicine or healthcare), Free text achieve What are the top 3 things you want to be able to do? considering the advice of the care team What do you want to improve or work on?
Who suggested the goal Drop down (Refer to list below) Suggested by Option Description Me The client/patient suggested the goal Formal caregiver A formal caregiver (e.g., physician) suggested the goal Informal caregiver An informal caregiver (e.g., client/patient’s daughter) suggested the goal Decline to answer The client/patient declined to answer
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Information field What it tries to capture Paper form / CCT Format Examples (red) & probing questions (blue) Make an appointment with the physiotherapist and What we can do to The actions that the care team will take to follow exercise regimen Free text achieve it accomplish those goals (i.e., the “follow-up”) What are some steps we can take to work toward this goal? The names of care team members who will be Who will be Free text / Drop down – select one or Jack Shephard, Kate Austen, Me responsible for completing the actions more members from care team (includes responsible Who do you want to help you do this? described ‘Other’ free text, and ‘Me’)
A measurable articulation of the client/patient’s Weigh 80 kg Expected outcome Free text goal How will you know when you’ve achieved your goal?
Those barriers or challenges, identified by any Spouse unwilling to modify diet with me Barriers and care team member that could prevent the Free text How confident are you that we can do this? What challenges client/patient from reaching his/her goals do you think might stop you from getting there? Lost 3 kg since March 2013 Results achieved so A description of the client/patient’s progress Free text What progress have you made toward far towards completing the goal accomplishing this goal? A future date on which progress on the Review date client/patient’s goals will be assessed by the Free text / Date picker YYYY-MM-DD 2014-10-14 care team and the client/patient
My plan for future situations
A situation that the client/patient may be faced Severe chest pain Future situations with, based on their current situation, in the Free text What are some future situations that we should plan near future for? Actions that the care team has agreed the What I will do Free text Call 911 client/patient should do in this situation Actions that the care team has agreed the What I will not do Free text Do not bathe independently or take Tylenol client/patient should not do in this situation
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Information field What it tries to capture Paper form / CCT Format Examples (red) & probing questions (blue)
Those people who will help the client/patient in John Locke Who will help me this situation and are aware of their inclusion Free text Who are some care team members who will be in the plan ready to help you if these things happen? The primary telephone number(s) for the Telephone # persons listed to help the client/patient in this Free text XXX-XXX-XXXX 613-555-0000 situation A future date on which the client/patient’s plan Review date for future situations will be reviewed by the Free text / Date picker YYYY-MM-DD 2013-10-26 care team and the client/patient
The client/patient has been informed by a (Refer to list below) I have received member of their care team about advance Drop down Is there someone whom you trust to care out your information about care planning wishes if you are unable to speak for yourself? advance care Option Description planning Yes The client/patient has received information about advance care planning No The client/patient has not received information about advance care planning Decline to answer The client/patient declined to answer Not applicable This field is not relevant to the client/patient I do not know what this is The client/patient does not know what advance care planning is I would like more information The client/patient would like more information about advance care planning (Refer to list below) Affirmation of whether the client/patient has an I have a completed Drop down Does your attorney for Personal Care know your oral or written advance care plan advance care plan healthcare wishes? Option Description Yes The client/patient has a completed advance care plan No The client/patient does not have an advance care plan Decline to answer The client/patient declined to answer
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Information field What it tries to capture Paper form / CCT Format Examples (red) & probing questions (blue) My ACP is located The physical location of the client/patient’s I have a copy in my jewelry box and my daughter Free text here advance care plan has a copy too I want my life to be prolonged and that I am As I understand it, The client/patient’s plain speak interpretation provided with all life-sustaining treatments my advance care Free text of what his/her advance care plan entails applicable to my condition. plan says What is your advance care plan? The client/patient has a legal document that I have a Power of gives someone else the right to act on their Drop down (Refer to list below) Attorney (POA) for behalf for care and medical treatment personal care Option Description Yes The client/patient has an attorney for Personal Care No The client/patient does not have an attorney for Personal Care Decline to answer The client/patient declined to answer My POA document is The physical location of the client/patient’s Free text In a drawer at home located here POA document The name of the attorney for the Name of POA client/patient’s personal care POA (note: it can Free text Walt Lloyd attorney be a family member or personal friend)
The relationship of the attorney for Personal Drop down (Refer to list below) Relationship to me Care to the client/patient Options Brother Daughter Friend Grandparent Sister Spouse / Partner Caregiver Extended family Grandchild Parent / Guardian Son Other – free text (specify) The primary telephone number(s) for the Telephone # Free text XXX-XXX-XXXX 613-555-9999 Power of Attorney
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My situation and lifestyle This section begins to capture some of the social determinants of health about the client/patient that will likely impact health and care. Where possible, the impact of the information on the client/patient’s health and care is the focus of the data, rather than the information itself (e.g., impact of income, rather than the magnitude of income).
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
A description of the client/patient’s involvement with the labour force Drop down (Refer to list below) How I work Option Description Student Client/patient is enrolled in a school or college full-time, or is home-schooled Self-employed Client/patient’s income comes directly from own profession or business Full-time Client/patient has a formal employer and works 30 hours or more per week Part-time/seasonal Client/patient has a formal employer and works less than 30 hours per week or only for part of the year Volunteer/unpaid Client/patient is performing services willingly and without pay Unemployed Client/patient is without a job either by choice or by circumstance, excepting retirement Retired Client/patient has left/ceased to work; reasons may include age, personal choice, or legal reasons Other Client/patient is in a work situation other than the ones listed, free text (specify) Decline to answer The client/patient declined to answer A measure of the client/patient’s sense of whether or not his/her income Drop down (Refer to list below) How adequate impacts his/her health – up to client/patient’s discretion my income is for Option Description my health More than adequate The client/patient feels living and health related expenses are easily covered by his/her income Adequate The client/patient feels living and health related expenses are covered by his/her income Less than adequate The client/patient feels living and health related expenses are close to being met by his/her income Much less than adequate The client/patient feels living and health related expenses are not being met by his/her income Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
Identifies the supplementary benefits that the client/patient receives Drop down (Refer to list below) Supplementary Option Description benefits that I Private insurance Insurance plans that are arranged between the client/patient and a third-party receive Canada Pension Plan (CPP) Provides pensions and benefits when contributors retire, become disabled, or die Available to people who have contributed to the CPP and who are not able to work regularly at Canada Pension Plan Disability (CPPD) any job because of a disability Guaranteed Income Supplement (GIS) A federal government supplement for individuals with low income Ontario Disability Support Program (OSDP) Provides financial support for qualifying disabled persons in financial need Ontario Drug Benefits Pays most of the cost of prescription drugs for qualifying clients/patients Ontario Guaranteed Income Supplement (GAINS) Provides financial aid to qualifying seniors Ontario Works Provides financial aid & services for qualifying persons in temporary financial need Special Service at Home (SSAH) Provides services and financial aid to families caring for a disabled child Veteran’s benefits Various benefits provided to qualifying military veterans Other Supplementary benefit other than the ones listed; free text (specify) Decline to answer The client/patient declined to answer An indication of the client/patient’s sense of compliance with his/her Drop down (Refer to list below) I follow my recommended diet recommended Option Description diet Yes The client/patient follows his/her recommended diet No The client/patient does not follow his/her recommended diet I don’t have one The client/patient does not possess a diet recommended by a medical authority The client/patient does not know if he/she possesses a recommended diet or, if he/she I don’t know possesses one, whether he/she follows the recommended diet Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) A measure of the client/patient’s sense of how his/her food source impacts Drop down (Refer to list below) How adequate his/her health my food is for Option Description my health More than adequate The client/patient feels his/her nutrition requirements are being easily met Adequate The client/patient feels his/her nutrition requirements are being met Less than adequate The clients/patient feels his/her nutrition requirements are close to being met Much less than adequate The client/patient feels his/her nutrition requirements are not being met at all Decline to answer The client/patient declined to answer A description of the primary day to day mode of transportation for the Drop down (Refer to list below) How I travel client/patient Option Description Independently The client/patient is able to travel independently without the aid of another person Dependently on friends or family The client/patient is able to travel with the help of friends or family Dependently on public transit The client/patient is able to travel with the help of public transportation services (or a taxi) Dependently on accessible transit The client/patient is able to travel with the help of accessible transit (e.g., Wheel Trans) Decline to answer The client/patient declined to answer A measure of the client/patient’s sense of how difficult it is for him/her to Drop down (Refer to list below) How difficult it is travel (e.g., to appointments) to travel Option Description Not at all difficult The client/patient feels he/she has no difficulty travelling Somewhat difficult The client/patient feels he/she has some difficulty travelling but it does not affect his/her independence The client/patient feels he/she has much difficulty travelling and this negatively affects his/her Very difficult independence Homebound The client/patient is unable to travel outside of his/her home Bedbound The client/patient is unable to get out of his/her bed Decline to answer The client/patient declined to answer
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) A measure of the client/patient’s sense of how difficult it is for him/her to Drop down (Refer to list below) How difficult it understand written information about their health and/or treatments is to read and Option Description understand Not at all difficult The client/patient has no difficulty in understanding information about his/her health information Somewhat difficult The client/patient has some difficulty in understanding information about his/her health, but is able to cope about my health Very difficult The client/patient is extremely limited in his/her capability to understand information about his/her health Decline to answer The client/patient declined to answer A measure of the client/patient’s sense of how his/her housing impacts Drop down (Refer to list below) How adequate his/her health my housing is Option Description for my health More than adequate The client/patient feels his/her housing requirements are being easily met Adequate The client/patient feels his/her housing requirements are being met Less than adequate The clients/patient feels his/her housing requirements are close to being met Much less than adequate The client/patient feels his/her housing requirements are not being met at all Decline to answer The client/patient declined to answer An indication of whether or not the client/patient currently smokes products Drop down (Refer to list below) I smoke tobacco containing tobacco Option Description Yes The client/patient smokes products containing tobacco No The client/patient does not smoke products containing tobacco Decline to answer The client/patient declined to answer # of The client/patient’s estimate of the number of cigarettes per day he/she Number 5 cigarettes/day smokes The client/patient’s estimate of the number of pack-years he/she has smoked; pack years = number of packs smoked per day multiplied by the # of pack years Number 3 number of years spent smoking (e.g., half a pack per day X 20 years = 10 pack years)
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) If applicable, the date that the client/patient quit smoking, or the date of the Quit date Free text / Date picker YYYY-MM-DD 2014-10-14 most recent quit attempt
An indication of whether or not the client/patient currently uses alcohol Drop down (Refer to list below) I drink alcohol Option Description Yes The client/patient consumes products containing alcohol No The client/patient does not consume products containing alcohol Decline to answer The client/patient declined to answer The client/patient’s estimate of the highest number of drinks he/she has had # of drinks in in one sitting in the last 14 days (beer: 341ml/drink, wine: 148ml/drink, Number 3 one sitting spirits: 44ml/drink) The client/patient’s estimate of the number of drinks he/she typically has in # of drinks/week Number 5 one week An indication of whether the client/patient has ever used other substances Drop down (Refer to list below) I have used beyond alcohol, tobacco, and medications prescribed to him/her other Option Description substances Yes The client/patient has used the above described substances No The client/patient has not used the above described substances Decline to answer The client/patient declined to answer A description of the other substances that the client/patient has used in the Drop down (Refer to list below) Substance past Option Description The client/patient has used marijuana, a plant that produces the psychoactive THC, which may distort perception, disrupt Marijuana cognitive functions and cause loss of motor function Cocaine The client/patient has used cocaine, a stimulant commonly used in powdered and freebase (crack) forms The client/patient has used a hallucinogen, a drug belonging to a class of psychoactive substances that include LSD, ketamine, Hallucinogens etc., which may cause hallucinations Stimulants The client/patient has used a stimulant, a drug belonging to a class of substances that increase alertness, attention, and energy
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) Opiates The client/patient has used an opiate, a drug belonging to a class of depressant painkillers derived from the opium poppy The client/patient has used a sedative, a drug belonging to a class of substances that induces sedation by reducing irritability or Sedatives excitement The client/patient has used a solvent, a drug belonging to a class of substances that are inhaled by people for their psychoactive Solvents effects The client/patient has used any substances other than the ones listed (e.g., non-prescribed use of prescription drugs, other Other people’s prescription drugs); free text (specify) Decline to answer The client/patient declined to answer An indication of how recently the client/patient has used each of the Drop down (Refer to list below) How recently substances he or she indicated he or she has used in the past Option Description More than 6 months ago The client/patient has used the above indicated substance at some point in time more than 6 months ago Within the last 6 months The client/patient has used the above indicated substance within the last 6 months Decline to answer The client/patient declined to answer An indication of how frequently the client/patient has used each of the Drop down (Refer to list below) How frequently substances he or she indicated he or she has used in the past Option Description Daily The client/patient uses the above indicated substance on a daily basis Weekly The client/patient uses the above indicated substance 1-2 times a week Monthly The client/patient uses the above indicated substance 1-2 times a month Less than monthly The client/patient uses the above indicated substance less than once a month Other The client/patient uses the above indicated substance on a frequency other than the ones listed Decline to answer The client/patient declined to answer An indication of whether the client/patient, in his or her opinion, has Drop down (Refer to list below) I gamble responsible gambling practices responsibly Option Description The client/patient believes he or she is gambling responsibly Yes (see, for example, the Short Problem Gambling Screener available at www.problemgambling.ca)
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) No The client/patient acknowledges that they do not gamble responsibly Unsure The client/patient is unsure whether they gamble responsibly Decline to answer The client/patient declined to answer Most recent date The most recent date that the client/patient has gambled Free text / Date picker YYYY-MM-DD 2013-05-13 I gambled # of days in last The client/patient’s estimate of how many days in the last 90 days on which Number 4 90 days he gambled at least once The client/patient’s estimate of whether or not he/she gets the indicated Drop down (Refer to list below) I get 30 minutes amount of physical activity of physical Option Description activity 5x/week Always The client/patient always gets the above described amount of exercise Sometimes The client/patient sometimes gets the above described amount of exercise Never – I am unable to The client/patient never gets the above described amount of exercise because they’re unable to Never – I don’t want to The client/patient never gets the above described amount of exercise because of lack of motivation Decline to answer The client/patient declined to answer The client/patient’s estimate of whether or not he/she has had social Drop down (Refer to list below) I have had social interaction in the last 7 days interaction in the Option Description last 7 days Yes The client/patient has had social interaction within the last week No The client/patient has not had social interaction within the last week Other Specific details as to the client/patient’s social interaction within the last week; free text (specify) Decline to answer The client/patient declined to answer Other considerations Any issues that should be brought to the attention of the care team that have Only able to get four hours of Free text (e.g., sleep not been covered by any of the previous fields sleep a day habits)
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My recent health assessments This section lists the health needs that have been identified by the client/patient’s providers. This section attempts to capture a more quantitative assessment of the client/patient’s health using the results obtained by various health assessments. Refer to appendix A for assessment type details.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The assessment type that was conducted for the Assessment type N/A / Drop down (Refer to appendix A) client/patient The name of the particular assessment that was Assessment name Free text LACE (for Hospital re-admission risk) conducted for the client/patient An indication of whether or not said assessment has Drop down (Refer to list below) Completed ever been completed for the client/patient Option Description Yes Said assessment has been performed for the client/patient No Said assessment has not been performed for the client/patient The date that the most recent instance of Date completed Free text / Date picker YYYY-MM-DD 2013-04-13 said assessment was completed Where applicable, the numerical outcome of 11 (major or minor depressive Score Free text / Number said assessment; may include the score description disorder) Where applicable, the actions that were taken by the Actions taken Free text None care team in response to said assessment
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My most recent hospital visit This section provides some information about the client/patient’s most recent hospital admission or ED visit. The section tries to capture details about the visit such as any complications that may have arisen during the visit, the attending physician at the time, and any follow-up appointments or advice that may have occurred or been given out respectively.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue)
The name of the hospital where the client/patient most The Ottawa Hospital Hospital name recently visited the ED or was admitted (not meant to Free text / Type ahead Have you been to a hospital or an capture out-patient visits) ED in the past 6 months?
The type of hospital visit (e.g., ED visit, admission) Drop down (Refer to list below) Type of visit Option Description ED visit only The client/patient only visit the ED Scheduled admission The client/patient was directly admitted into the hospital ED visit then admission The client/patient visited the ED and then was admitted to the hospital Visit date The date that the visit started Free text / Date picker YYYY-MM-DD 2013-04-13
Date of discharge The date that the client/patient left the hospital Free text / Date picker YYYY-MM-DD 2013-04-18 (if applicable)
Reason for visit A plain language description of the reason for the visit Free text Severe shoulder pain
A plain language description of the complicating issues that Complications Free text I couldn’t move my arm may have exacerbated the visit Hospital physician The name of the physician most responsible for the Free text John Locke name client/patient during the visit Hospital physician The telephone number for said physician Free text XXX-XXX-XXXX 613-555-9999 telephone #
Key advice from A plain language description of the key advice from said Increase ibuprofen to 400 mg, 3x Free text hospital physician physician or a summary of the discharge order daily and start physiotherapy
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Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) Follow-up The name of the primary care provider with whom a follow- Free text / Drop down – select from care team appointment Kate Austen up appointment has been made (includes ‘Other’ free text) made with Date of follow-up The date on which said follow-up appointment is scheduled Free text / Date picker YYYY-MM-DD 2013-05-21 appointment
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My other treatments This section lists common interventions that are related to or may influence the client/patient’s current health status. This section includes information about the use of equipment, current self-monitoring, any coaching received and other interventions. It is intended to capture primarily medical or clinical activities, whereas the subsequent section is intended to capture activities more related to social health and well-being.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) Significant surgeries and/or implanted A list of surgical devices the client/patient Pacemaker, Peritoneal Free text devices (e.g., pacemaker, transplant, stent) depends on or significant surgical changes dialysis catheter Health education or counselling (e.g., A list of the counselling or education services Diabetes education Free text group counselling) that the client/patient is currently receiving program The date of the next planned health education or Next planned date Free text / Date picker YYYY-MM-DD 2014-01-13 counselling session Assistive devices (e.g., oxygen cylinder, A list of the assistive devices that the Uses a walker, CPAP Free text wheelchair) client/patient uses machine Self-monitoring routines (e.g. daily home A brief description of the self-monitoring that the Free text Blood glucose monitoring blood pressure readings) client/patient conducts A brief description of any treatments or Other treatments (e.g., traditional healer) interventions that the client/patient is undertaking Free text Acupuncture or exposed to other than the ones listed
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My current supports and services This section describes all the formal and informal supports and services provided to the client/patient that are more related to the client/patient’s social health and well-being, as opposed to the preceding section which was focused on medical or clinical activities. This section includes basic information about who the primary contact is and contact information for each support or service, and what and when services were provided.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The name of the client/patient`s primary contact or support/ Contact name Free text Benjamin Linus service provider for a particular support/service If applicable, the name of the organization with which said person Organization name Free text YMCA is affiliated
Services provided If applicable, a description of the services provided Free text Aerobics class
Telephone # The primary telephone number for the contact Free text XXX-XXX-XXXX 613-555-9999
Email address The primary email address for the contact Free text [email protected]
The date on which the client/patient started using the particular Start date Free text / Date picker YYYY-MM-DD 2012-09-21 support/service
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My appointments and referrals The “Appointments and referrals” section lists the basic information on upcoming health-related appointments. These could include visits to or from formal or informal supports or services or visits to or from care team members.
Examples (red) & Information field What it tries to capture Paper form / CCT Format probing questions (blue) The date of an upcoming appointment with a member of the Date Free text / Date picker YYYY-MM-DD 2013-10-24 care team
Time The time of said upcoming appointment Free text 24 hour time HH:MM 14:15
Free text / Drop down, select from care Provider name The name of said member of the care team Jack Shephard team (includes ‘Other’ free text)
Purpose A brief description of the purpose of said appointment Free text Weight loss follow up
A brief description of any other important context related to Notes Free text Delilah here at 0900 said appointment (e.g., information to bring, travel plans)
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Appendix A: Assessment types and examples
Assessment type Description Example
A measure of the client/patient’s capability of recovering after stress Frailty Rockwood Frailty Scale events
A measure of the client/patient’s desire and ability to make use of Test of Function Health Literacy in Adults (TOFHLA) Health literacy information that promotes and maintains good health Rapid Estimate of Adult Literacy in Medicine (REALM-SF) A measure of the client/patient’s ability to perform basic tasks of ADL InterRAI ADL Hierarchy Scale everyday living like dressing and eating A measure of the client/patient’s ability to perform activities related to IADL InterRAI IADL Involvement Scale independent living like housework and shopping
Pain A measure of the amount of pain felt by the client/patient InterRAI Pain Scale
A measure of the possibility that client/patient will be readmitted into LACE Hospital re-admission risk a hospital within a specified time interval after hospital discharge MAPLe InterRAI Cognitive Performance Scale (CPS) Cognition A measure of the client/patient’s cognitive ability or impairment General Practitioner Assessment of Cognition (GPCOG) A measure of the client/patient’s propensity for causing physical or Aggressive behaviour Aggressive Behaviour Risk Assessment Tool (ABRAT) emotional harm to others InterRAI Severity of Self-harm (SOS) Risk of self-harm A measure of the client/patient’s likelihood of hurting him or herself OCAN Safety to Self InterRAI Depression Rating Scale (DRS) Mood A measure of the client/patient’s emotional state Positive and Negative Affect Schedule (PANAS)
Risk of falls A measure of the client/patient’s risk of falling FRAT (Falls Risk Assessment Tool)
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Appendix B: Field options for care coordination tool
The table below lists the options available for some of the “type ahead” fields in the CCT.
Field / Options My identifiers – Ethnicity / culture Abyssinians (Amharas) Brazilian Indians Gypsy Metis Slovakian African American Bruneians Hawaiians Mexican Indians Somalis Afro-Caribbean Bulgarian Hungarian Micronesians South Asian Afro-Caucasian Canadian Hututu Mixed ethnic group South East Asian Amerind Caucasian Icelandic Mongoloid Spanish Arab Chinese Inca Mozambiquans Sudanese Armenians Congolese Indian (East Indian) New Zealand European Swedish Asian Czech Indian (Hindi-speaking) New Zealand Maori Swiss Australian aborigine Danish Indonesians Nigerians Syrian Austrian Dutch Inuit Norwegian Taiwanese Aztec Egyptian Irani Oceanic Tamils Bangladeshi English Iraqi Oriental Tatars Basque Estonian Italian Other Asian ethnic group Thais Belgian European Japanese Other ethnic non-mixed group Turks Bhutanese Fijian Javanese Other white British ethnic group Tutsi Black Filipinos Kenyans Pakistani Ugandans Black - other African country Finnish Kirghiz Polish Venezuelan Indians Black - other Asian First Nation - Non-status Koreans Polynesians Vietnamese Black Arab First Nation - Status Lapps Portuguese Welsh Black Caribbean French Liberians Russian West Africans Black East African Gambians Madagascans Samoan West Indian Black Indian sub-continent Georgian Malayans Senegalese White Black North African German Maori Senoy Consumer Declined to Answer Black West Indian Ghanaians Maya Serbian Unknown Black, other, non-mixed origin Greek Melanesian Siamese
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Field / Options My identifiers – Religion Agnostic Christian: Christian Reformed Christian: Lutheran Missouri Synod Christian: United Church of Christ Jewish: Renewal Atheist Christian: Christian Science Christian: Mennonite Christian: United Methodist Muslim Baha'i Christian: Church of Christ Christian: Methodist Christian: Wesleyan Muslim: Other Buddhist Christian: Church of God Christian: Orthodox Christian: Wesleyan Methodist Muslim: Shiite Buddhist: Mahayana Christian: Church of God in Christ Christian: Other Confucian Muslim: Sunni Buddhist: Other Christian: Church of the Nazarene Christian: Other Pentecostal Ethnic Religionist Native American Buddhist: Tantrayana Christian: Community Christian: Other Protestant Hindu New Religionist Buddhist: Theravada Christian: Congregational Christian: Pentecostal Hindu: Other Nonreligious Chinese Folk Religionist Christian: Eastern Orthodox Christian: Presbyterian Hindu: Shaivites Other Christian Christian: Episcopalian Christian: Protestant Hindu: Vaishnavites Shintoist Christian: African Methodist Episcopal Christian: Evangelical Church Christian: Reformed Church Jain Sikh Christian: African Methodist Episcopal Zion Christian: Free Will Baptist Christian: Roman Catholic Jewish Spiritist Christian: American Baptist Church Christian: Friends Christian: Salvation Army Jewish: Conservative Unknown Christian: Anglican Christian: Greek Orthodox Christian: Seventh Day Adventist Jewish: Orthodox Decline to answer Christian: Assembly of God Christian: Jehovah's Witness Christian: Southern Baptist Jewish: Other Christian: Baptist Christian: Latter-day Saints Christian: Unitarian Jewish: Reconstructionist Christian: Christian Missionary Alliance Christian: Lutheran Christian: Unitarian Universalist Jewish: Reform My known current allergies and medications – Route Apply Externally Intrabursal Intrathecal Oral Tracheostomy Buccal Intracardiac Intrauterine Other Transdermal Dental Intracervical (uterus) Intravenous Otic Translingual Endotrachial Tube Intradermal Mouth/Throat Perfusion Urethral Epidural Intrahepatic Artery Mucous Membrane Rebreather Mask Vaginal Gastrostomy Tube Intramuscular Nasal Rectal Ventimask GU Irrigant Intranasal Nasal Prongs Soaked Dressing Wound Immerse (Soak) Body Part Intraocular Nasogastric Subcutaneous Inhalation Intraperitoneal Nasotrachial Tube Sublingual Intra-arterial Intrasynovial Ophthalmic Topical
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Field / Options My care team – Role or relationship Acupuncturist Nutritionist Physician - Gastroenterology Physician - Paediatric Cardiology Audiologist Occupational Therapist Physician - General Internal Medicine Physician - Paediatric Emergency Medicine Brother Optometrist Physician - General Pathology Physician - Paediatric Haematology/Oncology Cardio-Pulmonary Technologist Other Physician - General Practitioner Physician - Paediatric Radiology Care Coordinator Parent / Guardian Physician - General Surgery Physician - Paediatric Surgery Caregiver Pharmacist Physician - General Surgical Oncology Physician - Pain Medicine Case Manager Physician Physician - Geriatric Medicine Physician - Pathology and Bacteriology Chiropodist Physician - Adolescent Medicine Physician - Geriatric Psychiatry Physician - Pediatric General Surgery Chiropractor Physician - Anatomical Pathology Physician - Gynecologic Oncology Physician - Pediatrics Clinical Perfusionist Physician - Anesthesiology Physician - Gynecologic Reproductive Endocrinology & Infertility Physician - Physical Medicine and Rehabilitation Community Worker Physician - Bacteriology Physician - Hematological Pathology Physician - Plastic Surgery Counsellor Physician - Cardiac Surgery Physician - Hematology Physician - Psychiatry Daughter Physician - Cardiology Physician - Infectious Diseases Physician - Public Health Dental Hygienist Physician - Cardiothoracic Surgery Physician - Internal Medicine Physician - Public Health & Preventive Medicine Dental Therapist Physician - Cardiovascular and Thoracic Surgery Physician - Laboratory Medicine Physician - Radiation Oncology Dentist Physician - Child and Adolescent Psychiatry Physician - Maternal Fetal Medicine Physician - Respirology Denturist Physician - Clinical Immunology Physician - Medical Biochemistry Physician - Rheumatology Dietician Physician - Clinical Immunology and Allergy Physician - Medical Genetics Physician - Specialist Dietician - Registered Physician - Clinical Pharmacology Physician - Medical Microbiology Physician - Thoracic Surgery Employment Counsellor Physician - Clinical Pharmacology and Toxicology Physician - Medical Oncology Physician - Transfusion Medicine Extended family Physician - Colorectal Surgery Physician - Neonatal-Perinatal Medicine Physician - Urology Friend Physician - Community Medicine Physician - Nephrology Physician - Vascular Surgery Grandchild Physician - Critical Care Medicine Physician - Neurology Physician Assistant Grandparent Physician - Dermatology Physician - Neurology and Psychiatry Physiotherapist Homeopath Physician - Developmental Paediatrics Physician - Neuropathology Podiatrist Kinesiologist Physician - Diagnostic and Therapeutic Radiology Physician - Neuroradiology Psychologist Massage Therapist Physician - Diagnostic Radiology Physician - Neurosurgery Psychotherapist Mental Health Case Manager Physician - Emergency Medicine Physician - Nuclear Medicine Respiratory Therapist Midwive Physician - Endocrinology and Metabolism Physician - Obstetrics Sister Naturopath Physician - Family Physician - Obstetrics and Gynecology Social Service Worker Nurse Physician - Family Medicine Physician - Occupational Medicine Son Nurse - Practical Nurse Physician - Family Medicine (Emergency Medicine) Physician - Ophthalmology Speech-Language Pathologist Nurse - Registered Nurse Physician - Forensic Pathology Physician - Orthopedic Surgery Spouse / Partner Nurse Practitioner Physician - Forensic Psychiatry Physician - Otolaryngology - Head and Neck Surgery
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