Mastering the FHO+ 75% Continuity Threshold in Ontario

When Dr. Chen called me last Tuesday, she wasn’t worried about a complicated diagnosis or a drug shortage. She was staring at her first continuity of care report and wondering how a two-week vacation with a locum had dropped her score into risky territory.

For Ontario family physicians, continuity of care metrics matter more than ever, and that number is not just a report card.

When that score falls, the pressure on a capitated practice can escalate quickly. Those fixed monthly funds your practice receives for each enrolled patient represent committed revenue, so any operational disruption that threatens continuity is not a rounding error. It is a line item that can turn a stable quarter into a scramble.

The continuity rule now reaches beyond your office walls

Most physicians I talk to initially assume continuity is simple. If my patient sees me, it counts. If they see someone else, it doesn’t.

In practice, the math is more involved.

In practice, continuity calculations can capture more than just your direct office visits. That means your score can shift even when you are not physically in the clinic.

A locum covering your practice for a week, an after-hours ER visit, or an inpatient consult can all create documentation gaps that affect your numbers.

For some practices, this is actually good news. Properly documented cross-coverage helps demonstrate continuity of care. For others, it means a coverage gap they did not even know existed is now a liability.

The difference between those two outcomes is usually paperwork.

The real enemy is invisible until it isn’t

My brother Jason spent 18 years as an Advanced Care Paramedic, and if there is one thing he drilled into me, it is this: handoffs fail when information sits still.

A locum sees your patient, writes a note, and that note disappears into a fax machine or a hospital portal that your MOA never checks. Three weeks later, you have no record of the encounter, and your continuity report shows a hole.

This is not a clinical failure. It is an operational failure.

When your staff must sort documents manually across multiple channels, something will get missed.

I have spoken with clinic managers in Hamilton and Stoney Creek who told me they only discover a locum’s chart note when the patient calls for a refill and no one knows what was prescribed. By then, the billing period has closed and the continuity window has snapped shut.

The resulting gap does not care whose fault it was.

Fix the flow, protect the percentage

You cannot control whether a patient visits the emergency department at midnight. You can control whether your clinic captures that visit and accounts for it correctly.

That starts with protocol.

Every locum agreement should specify how documentation gets back to your office within 24 hours. Every cross-coverage arrangement should name a point person who confirms incoming records are matched to the patient roster. These are boring details, but under the current framework, boring details are what keep your revenue intact.

This is exactly why we built OpsMed to handle the documents that never stop coming. Incoming faxes and reports get sorted, categorized, and routed by automation so your MOA sees a prioritized inbox instead of an unsorted pile.

Anything with clinical implications sits in a review-first queue. You look at it, you confirm it, and only then does it get filed. We do not touch diagnosis or treatment. We just make sure the information stops getting lost.

Our platform also tracks every billable minute you spend on indirect care, like reviewing those locum reports or coordinating referrals. As compensation frameworks evolve, capturing that time accurately is becoming increasingly important.

We built OpsMed to bring document flow and time logging into a single workflow. Our infrastructure is hosted in Canada, and we design our security controls to align with PHIPA requirements.

Check your score before it checks your wallet

If you have not looked at your continuity report yet, pull it up today.

If your score is already in good shape, great. Build a buffer anyway, because one maternity leave or one ED rotation can move that number faster than you think.

If you are hovering near the cutoff, audit your coverage agreements this week. Then audit your fax tray. The two are more connected than they look.

We offer a free Clinic Efficiency Check-Up for Ontario family practices. It is a 20-minute call where we map your current document flow and hand you a one-page visual report showing exactly where information is getting stuck.

If your practice qualifies, we will also run a free 30-day pilot so you can see the difference without signing a contract. No gimmicks. Just a chance to fix the pipes before the pressure builds.

Your continuity score should never be a surprise. Let’s make sure it isn’t.

Stay safe, Marc

For Ontario family physicians, continuity of care metrics matter more than ever, and that number is not just a report card.

Explore our clinic automation services or book a free revenue analysis.