News

01 Mar

Does telemedicine need stricter rules for engagement?

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 article

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20 Jan

Electronic Signatures on Prescriptions

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.

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. 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.”

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21 Nov

Pharmacy Audits

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

 

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12 Oct

Provincial Privileging Project

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:

  1. A description of the discipline
  2. Criteria for initial privileges including current experience
  3. Criteria for renewal of privileges
  4. Core privileges
  5. Core privilege list
  6. Non-core privileges
  7. Context specific privileges
  8. 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:  
http://privileging.typepad.com/privileging_project/

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10 Oct

Billing Tip: Reminder not to bill MSP for services provided to family members

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 practitione

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01 Jul

New Executive Director

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.

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