Please complete this program evaluation and record the time you spent in OHT activities between January 1 and December 31, 2020.

The OCFP’s OHT Planning and Delivery of Integrated Care Program enables family physicians engaged in the work of OHTs to receive up to 60 CPD Mainpro+® credits for their OHT participation, where 1 credit is equivalent to 1 hour of their OHT work to plan and deliver integrated care.

You will receive a certificate following each credit cycle (enter your credit hours in questions #8 and #9)

January 1 to June 30, 2020
July 1 to December 31, 2020

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* 1. Full Name

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* 2. Email address. Your Certificate of Attendance will be sent to this address.

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* 3. How long have you been practising?

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* 4. In what practice model(s) do you work?

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* 5. Name of OHT(s). Please check all that are applicable.

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* 6. I have participated in one or more activities of an OHT between January 1 and December 31, 2020

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* 7. I understand that it is my responsibility to track the time I have spent on these activities, and report credits at a 1:1 ratio (1 credit for each hour), up to a maximum 60 Mainpro+® credits for the year.

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* 8. Attestation: I confirm that I have spent the following number of hours on OHT activities between January 1 and June 30, 2020.

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* 9. Attestation: I confirm that I have spent the following number of hours on OHT activities between July 1 and December 31, 2020

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* 10. Did the Program meet the stated Learning Objectives?

  Strongly Disagree Disagree Neutral Agree Strongly Agree Not Addressed
The overall OHT Planning and Delivery of Integrated Care Program met the stated Learning Objectives.
1) Define the vision of their local OHT within the context of their local priority populations in their
attribution area. Planned measures will be developed consistent with the quadruple aim
2) Interpret their practice and community level data to define and create plans around integrated care
for the priority patient populations within their OHT
3) Analyze their patient-level data to proactively identify those who have the greatest needs and
establish a plan for coordinating services from multiple sectors to ensure these needs are met
through a Patient Medical Home/Neighbourhood lens
4) Develop an approach to the OHT implementation based on analysis of the gaps between
population needs and local resources and reflecting the OHT building blocks that their local team
will be designing with their input, and the general timelines for any changes that are likely to affect
them
5) Describe the priority populations identified for focus by their local team

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* 11. Please share any other comments you have below:

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