Health minister Terry Lake has ordered a sweeping review of telemedicine care in B.C., saying in an interview he’s concerned videoconference visits between patients in one location and doctors in another could become “virtual walk-in clinics” with unsustainable costs on the health care system. Read the Vancouver Sun story.Read More
The College of Physicians and Surgeons notes that:
“Physicians are accountable every time they decide that a physical examination is not required.
Telemedicine has the potential to reduce the risk of error by providing physicians with considerably more information. However, a decision to rely on a virtual visit to conclude a medical assessment for an acute concern will always be a high stakes one, which requires thoughtful consideration and superior clinical judgment.
The College’s depth and breadth of experience reviewing physician practices and investigating complaints indicates that telemedicine will add value for patients and providers if it forms part of an integrated whole, such as a full-service primary care clinic, a provincial or regional specialty service, or a robust outreach program for people living in remote locations. Significant risk is anticipated if physicians attempt to use telemedicine to provide episodic services in isolation to patients they are not familiar with. Telemedicine holds great promise as an adjunct to well-organized systems of care. Without the support of such systems, it is expected that telemedicine will be neither efficient nor safe.”
– (The College Connector Volume 2 | No. 3 | May / June 2014)
For more information see:
An editorial in the BCMJ by Deputy Registrar Dr. W.R. Vroom, titled:
Does telemedicine need stricter rules for engagement?
Thanks to all our members who attended the SGP AGM May 31 and provided support and feedback to the organisation. It’s always a surprise how many of you are willing to be up for a 7:30 am Saturday morning! Our officers for 2014 were introduced and their names may seem familiar: Lawrence Welsh, President; Ken Burns, President elect; Ernie Chang, Treasurer; and Elizabeth Rhoades, Secretary. They all wanted to commit to another year in their positions, and were acclaimed after the call to the membership for nominations. Let us know what you’d like to see the SGP do for you in the coming year: firstname.lastname@example.orgRead More
With the expiration of the Physician Master Agreement, PITO funding ended March 31. However, the GPSC has provided one year’s funding for the PSP Technology Group to assist full-service family physicians using any EMR to achieve Level 3 “meaningful use” (MU3). Click to read more about this program: PSP-Post-Implementation-Support
Read SGP President’s letter for more details on EMRs.
Canada Post Occupational Fitness Assessment Fees (A00032 and A00033) have been deleted as of May 1, 2014 . For ALL Occupational Fitness Assessments (OFAs), fee code A94529 should now be used, regardless of employer.
Now you can create an account for your MOA to use the billing information on the SGP website.
You must be logged in as a member to create the account
Each member can set up one MOA account.
Dr. Vroom of the College of Physicians and Surgeons notes in this month’s BCMJ: “In some circumstances telemedicine can provide a valuable medical service to communities with scarce physician resources, despite its diagnostic and treatment limitations. However, the question remains: How should telemedicine evolve in urban settings and how should it be funded? In my opinion, it is up to the primary care physician to determine how best to provide care in specific circumstances, be it face-to-face, by telephone, by telemedicine, or by e-mail. Telemedicine has tremendous potential value in enhancing comprehensive longitudinal care and should not result in more fragmented care. The implementation of this technology deserves a sophisticated utilization strategy. As for public funding, would it not be best for physician remuneration to be based on comprehensive patient care rather than on the modality used to service patients?”
Read the full articleRead More
This recent study published in JAMA showed that elderly patients who are treated by a smaller set of providers or by a single provider (ie, have greater continuity of care) may be less likely to have preventable hospitalizations. Read the study: Continuity of care and the risk of preventable hospitalization in older adults.Read More
Health Canada considers a unique electronic signature to be equivalent to a paper and pen signature. This is also the position of the BC College of Physicians and Surgeons and the BC College of Pharmacists.
“Electronic prescriptions are only permitted if the electronic prescriber’s signature is unique. Health Canada considers a unique electronic signature to be equivalent to a paper and pen signature. Therefore the signature must be a fresh new signature written on the prescription with an electronic pen pad, similar to signing a pen and paper prescription. Cutting and pasting a signature into an electronic prescription is not permitted.”
“To ensure that that the signature is unique, the pharmacist should compare the signature each time with an old prescription. Pharmacists should note that the prescriber’s signature should be slightly different on each prescription if it is unique. If you do not have an old prescription to compare or have any doubts as to whether the signature on the prescription is unique, please call the prescriber to verify whether they sign a new original electronic signature for each new prescription. A computer-generated prescription, given to the patient or faxed to the pharmacy, must have an original prescriber’s signature.”Read More
14076 Telephone calls to patients now increased from 500 to 1500 per year
See Details in our easy to use simplified guide to fees
Pharmacists have been facing increased practice audits. You can read more in this Vancouver Sun article about Pharmacist audits.
One element of these audits is the issue of “prescriber errors and omissions”.
As a result the BC Pharmacy Association is working with the College of Physicians and Surgeons of BC, the College of Pharmacists of BC and the ministry.
The College of Physicians and Surgeons reminds registrants that the details required of a “valid” prescription are:
- the name and address of the patient
- the name of the drug or ingredients and strength if applicable
- the quantity of the drug
- the dosage instructions, including the frequency, interval or maximum daily dose
- refill authorization if applicable, including the number of refills and interval between refills
- the name, identification and signature of the practitioner for written prescriptions
On a related note . . .
The BC College of Pharmacists notes that:
“Electronic prescriptions are only permitted if the electronic prescriber’s signature is unique. Health Canada considers a unique electronic signature to be equivalent to a paper and pen signature. Therefore the signature must be a fresh new signature written on the prescription with an electronic pen pad, similar to signing a pen and paper prescription.”
The College of Physicians and Surgeons notes that it:
“has received complaints that some physicians have told pharmacies that they will send their (invalid) prescriptions to another pharmacy that agrees to accept them. This is at best probably futile, in that once the other pharmacy has been audited and fined, they will also refuse to collaborate. However, this College would consider such action to be unprofessional behaviour towards our pharmacist colleagues.”
Read more about electronic signatures
In 2011, the Minister of Health released the final report into a review of the quality of medical scans in BC. Dr. Doug Cochrane, chair of the BC Patient Safety and Quality Council, conducted the review and found radiologists practising in BC were appropriately qualified, though similar events could occur in the future unless steps were taken to close gaps in existing safeguards around physician practice. In response, the Ministry developed a provincial Action Plan to: implement a timely peer review system for diagnostic imaging; establish a common electronic registry to track current information about physician licensing, credentials and privileges; create consistent rules around communication and patient notification when adverse events occur.
To implement the plan, the Physician Quality Assurance Steering Committee (PQASC) was established with representatives from key stakeholder groups – College of Physician and Surgeons of BC, BC Patient Safety & Quality Council, BC Medical Association, Chief Financial Officers Council, Vice Presidents of Medicine from health authorities, and Ministry of Health. The PQASC is working a number of key projects to ensure the health system has competent physicians, who can in turn provide safe, quality and effective care to BC patients.
One of the projects in the physician quality assurance portfolio is the Provincial Privileging Project. The goal is to create privileging dictionaries for each medical discipline, with the result that credentialing could be standardized across all Health Authorities.
A privileging dictionary includes:
- A description of the discipline
- Criteria for initial privileges including current experience
- Criteria for renewal of privileges
- Core privileges
- Core privilege list
- Non-core privileges
- Context specific privileges
- Criteria for returning to currency
An expert panel of physicians works together to develop the dictionary for their particular discipline. For General Practice, there will be dictionaries for GP Anaesthesia ; GP Surgery; and General Practice (including obstetrics, community ER and residential care.)
The results of this work will have significant and lasting implications for all family physicians. SGP is working with the BCCFP, the Rural Issues Committee, and the Joint Standing Committee on Rural Issues to ensure the expert panel members represent the broad geographic and scope of practice diversity of BC. We will keep you updated with news on our website, and welcome your input.
For further information about the project see:
The Preamble States:
C.19 Services to Family and Household Members
1. Services are not benefits of MSP if a medical practitioner provides them to the following members of the medical practitioner’s family:
a) a spouse,
b) a son or daughter,
c) a step-son or step-daughter,
d) a parent or step-parent,
e) a mother-in-law or father-in-law,
f) a grandparent,
g) a grandchild,
h) a brother or sister, or
i) a spouse of a person referred to in paragraph (b) to (h).
2. Services are not benefits of MSP if a medical practitioner provides them to a member of the same household as the medical practitioneRead More
Dr. Jean Clarke took the reins of SGP July 1, 2013. A family doctor in Vancouver for the past 25 years with privileges at St. Paul’s Hospital. For those who have worked with her, it is hard to imagine anyone more honourable, or practical. She is the embodiment of the principles of family practice.Read More