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Preventive Care for Older People (PCOP)

Introduction

Preventive health care and chronic disease management for Canada’s aging population have become increasingly complex with multiple practice guidelines and competing primary care demands. The Preventive Care for Older People (PCOP) tool is designed to streamline preventive care for older adults, particularly those with multiple complex conditions. 

Embedded within clinicians’ EMR and specifically designed for Telus PS Suite, this innovative tool facilitates the integration of the latest evidence to support decision-making in primary care for clinicians caring for patients aged 65 and above. 

Download and install CEP’s EMR integrated, point-of-care tool to enhance your daily practice in caring for older adults. 

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About the tool

Recognizing the need for streamlined approaches, the Rourke Baby Record, the Greig Health Record, and the Preventive Care Checklist Form have become widely used knowledge mobilization tools. In response to evolving population demographics, the Centre for Effective Practice partnered with primary care clinicians to develop a digital decision support tool tailored for older adult patients, building on elements from existing models to create a comprehensive reminder system for preventive care. 

The PCOP EMR tool supports primary care clinicians with: 

  • Delivering culturally sensitive screening strategies, prioritizing patient preferences and shared decision-making, and ensuring equitable access to preventive care across diverse demographics.
  • Engaging in discussions with their patients about lifestyle factors influencing overall health, such as substance use, dietary habits, physical/sedentary activity, social isolation and/or loneliness, elder abuse, and poverty.
  • Determining who should and who should not receive screening for various health domains: hearing, vision, cognition, mental health, falls, lipids, diabetes, hypertension, fragility fractures, cancer, and immunizations. 

The PCOP EMR tool was developed using the CEP’s integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. Clinical leadership was provided by Dr. Amy Freedman and Lorna McDougall. Drs. Kieran Moore and Daniel Warshafsky from the Office of the Chief Medical Officer of Health, and Dr. Serina Dai informed the development of the tool. End users and clinical experts were also engaged throughout the tool development process (e.g., usability testing sessions) to provide feedback and support the EMR tool’s refinement. 

The tool is among several clinical tools developed as part of the Knowledge Translation in Primary Care Initiative. Funded by the Ministry of Health, this initiative supports primary care providers with the development of a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative (KTinPC)


Clinical leads

  • Amy Freedman

    MD, CCFP (COE), FCFP

    Dr. Amy Freedman is a family physician at St. Michael’s Academic Family Health Team in Toronto, Ontario and the Physician Lead for the SMHAFHT Home Visit outreach team. She also practices in long term care and in supportive housing at Baycrest.

    Dr. Freedman is an assistant professor in the Department of Family and Community Medicine at the University of Toronto. She enjoys teaching and mentoring medical learners in the care of older adults in family medicine and has received several teaching awards for her work in this area. Her research and educational interests include social isolation and loneliness in older adults and the care of older adults in the office and at home.

    Dr. Freedman provided clinical leadership for the development of the PCOP tool and was offered compensation for her role. 

  • Lorna McDougall

    MSN, NP-PHC

    Lorna McDougall NP is a primary care nurse practitioner at St Michael’s Academic Family Health Team in downtown Toronto, and the NP co-lead for the SMHAFHT Home Visit program for homebound older adults. She holds an adjunct clinical appointment at the Lawrence Bloomberg School of Nursing at the University of Toronto.

    Ms. McDougall has a special interest in health equity in primary care for people who are homebound and isolated.

    Ms. McDougall provided clinical leadership for the development of the PCOP tool and was offered compensation for her role. 


Conflict of Interest

Usability participants received a token of appreciation (e.g., gift certificate).

Expert Reviewers


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