IMPROVEMENTS/SOLUTIONS

Palliative Care Training for Paramedics
Aug 22, 2019
With this new training, paramedics can now potentially care for patients at home if it’s the patient’s wish, work with their palliative care team and assist them with taking their already prescribed medications after consultation.

Doctors and health providers treat loneliness by prescribing yoaga and crochet lessons
Aug 13, 2019
Research out of the United Kingdom, an early adopter of social prescription programs, has showed promise on this front. A review of UK projects found that these referrals led to a 28 per cent drop in demand on GP services and a 24 per cent drop in emergency room visits, according to the same report. 

Two private MRI outpatient clinics purchased by Fraser Health
2019, May 2
At the start of this year, 10 of B.C.’s 33 MRI machines were running around the clock, compared to one in August 2017.
Residents of Terrace, Fort St. John, Fort St. James and Vanderhoof can now expect the same service they would receive in Victoria or the west side of Vancouver, Dix says.

https://enews.rccbc.ca/2018/10/24/codi-is-live/
CODI is a secure iOS smartphone app that provides ER physicians in rural and remote BC with instant support and collaborative assistance in the ER. It directly connects a rural physician to an intensivist using technology similar to a FaceTime call.  Enhanced patient outcomes and reduced out-of-community transfers are potentially positive outcomes. CODI’s virtual, 24/7 presence in the pocket of a physician will lessen anxiety, build confidence, enhance quality of life and positively impact recruitment and retention in rural and remote BC (and ultimately, all of Canada). Enhanced patient outcomes and reduced out-of-community transfers are other potentially positive outcomes of CODI.

BC to improve access to dental care with $3.6 million to non-profit clinics.
2019, March 20
Minister of Social Development and Poverty Reduction Shane Simpson announced a commitment of $3.6 million in funding over three years, which will be distributed by the British Columbia Dental Association to the province’s 24 dental clinics.
“Poverty requires a multitude of solutions and too many people are denied opportunities because of physical, social, financial and structural barriers,” Simpson said at the Mid-Main Community Health Clinic on Wednesday. “Dental care can be one of those barriers.”

B.C. government’s primary health-care strategy focuses on faster, team-based care
Thursday, May 24, 2018
The B.C. government is launching a new primary health-care strategy to deliver faster and improved access to health care for British Columbians in all parts of the province, Premier John Horgan has announced.
Initial priority will be on addressing the shortage of general practitioners in the province by:
– Providing funding for up to 200 new general practitioners to work in the new team-based care model.
– Offering opportunities for every family medicine resident to work in a renewed primary care system that allows them to focus their time and energy on practising patient-centred medicine.
The government will be putting in place: primary care networks, urgent primary care centres, and community health centres.

UBC Master of Occupational Therapy program expands to northern BC
May 25, 2019
The occupational and physical therapy programs at UBC’s Faculty of Medicine, in partnership with the University of Northern British Columbia (UNBC) are expanding, thanks to $3.3 million from the provincial government.
The addition of new training seats will ensure more patients get access to care that will improve their quality of life, while more students can train closer to home.

Action plan to provide faster care for people with Parkinson’s
Beginning April 1, 2019, people with Parkinson’s disease whose symptoms can no longer be controlled with medication will have improved access to deep brain stimulation (DBS). DBS uses electrical impulses to stimulate a target area in the brain. The stimulation affects movement by altering the activity in that area of the brain. The procedure does not destroy any brain tissue and stimulation can be changed or stopped at any time. Surgery is required to implant the equipment that produces the electrical stimulation. 

Health Workers Celebrate Repeal of Bill 29 and Bill 94 
Nov. 19, 2018
16 years ago, the BC government passed two bills that opened the gate to an era of privatization in the health-care sector.
Bill 29 made it easier to contract out services to companies and removing provisions that protected workers who were laid off.
Bill 94 was intended to “facilitate development and implementation of public-private partnerships in the health sector, enabling improved delivery of cost effective non-clinical services to the public.”

Thunder Bay’s Rapid Access Clinic for hip, knee conditions cuts wait times from years to weeks
Cathy Alex · CBC News · Posted: Oct 14, 2018
Patients are referred by their family doctor to the clinic, which then acts as a one-stop shop for consultations with orthopedic specialists and ultimately surgery if required.
Once enrolled in the program, the patient is assessed and then agrees to be cared for by the next available doctor from a pool of orthopedic surgeons, who also take turns working in Dryden, Fort Frances and Kenora.
Putting aside the natural competitive instinct between surgeons was key to developing the program, said Puskas.

A welcome second chance for BC medicare protection
April 10, 2018
Colleen Fuller – health policy researcher
Seth Klein – B.C. Director of the Canadian Centre for Policy Alternatives.
In 2003, the B.C. government brought in the Medicare Protection Amendment Act (Bill 92) to prevent unlawful extra billing as required by the federal Canada Health Act. These provincial and federal laws ban doctors and private clinics from charging patients for medically necessary surgeries and other procedures covered by our public health care system.  
Last week’s announcement by health minister Adrian Dix that Bill 92 will finally be proclaimed is welcome news.
Doctors found to have unlawfully billed patients can be fined up to $20,000 and multiple violations could mean de-enrolment from the public system, meaning no more public funding. Patients who believe they have been inappropriately billed can apply to the provincial government to recover those costs.
B.C. is the only province that Ottawa has repeatedly fined for unlawful extra billing. Bill 92 aligns us with the rest of the country.
Doctors remain able to leave medicare entirely and charge patients who are able and willing to pay.

Government expanding coverage for insulin pumps, eliminating age restriction
June 12, 2018 The provincial government is expanding insulin pump coverage, so any British Columbian requiring one to manage diabetes will have access under PharmaCare, announced Adrian Dix, Minister of Health.

Victoria increases respite care for home caregivers by $75 million
June 18, 2018
Respite care: caregivers will be able to take the person they’re caring for to a residential care facility (nursing home) for a day or several days. A day program is where someone with dementia can spend a day getting health-care and personal services such as nursing and bathing, have lunch and take part in group activities.
Dix said the $75 million over three years will go to help reduce stress experienced by family members and friends who provide unpaid caregiving at home.
Kevin Griffin. Vancouver Sun

How Ontario’s next government could relieve overcrowded hospitals
By THERESA BOYLE Health Reporter Sun., June 3, 2018
The number of patients who occupied hospital beds even though they no longer required hospital care hit a record level in Ontario this past winter, the Star has learned.
As a result, emergency room wait times also hit an all-time high.
Almost 5,000 patients, most of them frail and elderly, were stuck in hospital beds because long-term-care homes were full or because it was unsafe for them to return home without more support, according to newly audited data from the Ontario Hospital Association (OHA) and the province’s Health Ministry.
Dr. Danielle Martin, vice-president of Women’s College Hospital, says Ontario’s health system is built upon a “20th-century model” and requires “21st-century solutions” to work better.
She said there are many demonstration projects and areas of excellence that should be scaled up. They achieve the triple aim of reducing costs, improving patient outcomes and enhancing patient experiences, she said. One solution to improving hospital wait times is, interestingly, not investing in hospitals but instead building community resources such as “transitional spaces” for patients who no longer require hospital care and are waiting to move into long-term-care homes or other settings.

B.C. doctors working to improve care for residential-care patients – Dr. Eric Cadesky
June 30 – 2018
Through non-profit organizations called Divisions of Family Practice (also funded by Doctors of B.C. and the provincial government), family doctors are creating local, grassroots residential-care solutions that reduce unnecessary hospital transfers, improve care experiences for patients and providers and reduce costs to the system while improving quality of care. 
Providing patients with regular physician visits in local facilities has reduced unnecessary hospital transfers significantly in many regions. For example, transfer rates have been reduced in Mission by 33 per cent, in Kootenay Boundary by 34 per cent and 31 per cent in Salmon Arm.

B.C. should allow physician assistants
May 27, 2018 
PAs work independently under the supervision of a physician and are able to diagnose, develop treatment plans and work closely with patients throughout their care. PAs practice in Alberta, Manitoba, Ontario, New Brunswick and in our Canadian Armed Forces. They are also critical members of the health-care team in the U.K., the Netherlands, the U.S. and elsewhere.
They’re used in all of these jurisdictions because evidence proves that PAs reduce wait times, improve care and save money. It’s time for B.C. to introduce PAs so that patients and families can benefit from their skills as part of the health care team.
Trevor Stone, President Canadian Association of Physician Assistants

North Vancouver’s HealthConnection Clinic lauded for its innovative approach in treating vulnerable patients
In its most recent national newsletter, the College of Family Physicians of Canada highlights the innovative work of North Vancouver’s HealthConnection Clinic and how it cares for vulnerable patients.
Established in 2013, the clinic is a unique partnership between VCH and the North Shore Division of Family Practice. Its goal when it opened was to improve the care for high-needs, medically complex and vulnerable clients who were unattached, difficult to serve and who had high rates of hospital admissions by providing team-based primary care.
Highlighted in the College’s article was the clinic’s addition of a team-based learning site for all associated disciplines and the creation of the Complexity Assessment Tool, also known as AMPS (Attachment, Medical, Psychiatric, Social determinants), which is helping improve patient care.

Free up money to solve doctor shortage – Perry Kendall
August 1, 2018
Re: “Weighing the value of family physicians,” comment, July 29. In B.C., we are facing the prospect of significant numbers of family practitioners entering the retirement-aged cohort. Pengilly is one such. The outcome will likely be even more British Columbians who are unable to find a primary-care attachment.
We also see that these retiring physicians are unable to sell their practices and recruit successors. As Pengilly notes, most newly graduating family-medicine specialists do not, on the whole, wish to be small-business owners. They would prefer alternative ways of being remunerated; they would also prefer to work in team-based practices. I also agree that the Doctors of B.C. (formerly the B.C. Medical Association) needs a fundamental change of heart.
Government and the Doctors of B.C. should get together to agree that the fee-for-service dollars that are “freed up” as older family practitioners retire should be “retired” from the fee-for-service “pot” and redirected to a variety of alternative payment plans that can be used to support new family-practice specialist graduates and ancillary health-care professionals entering the primary-care arena.
Dr. Perry R.W. Kendall served as B.C.’s provincial health officer.

Vancouver health authority ends contract with private surgery centre over patient-pay issues
PAMELA FAYERMAN Updated: August 30, 2018
Vancouver Coastal Health is ending a contract with False Creek Healthcare Centre, and as of next week 115 surgeons and anesthesiologists with privileges at regional public hospitals won’t be able to use the operating rooms at the Vancouver clinic.
The change comes a month before new legislation comes into effect imposing harsh penalties on private clinics and physicians where medically necessary services are paid for directly by patients seeking faster treatment. Private clinics have gone to court seeking an injunction to block the bill that will be effective as of Oct. 1.
Other health authorities are not severing contracts with private clinics and health minister Adrian Dix told Postmedia that “a significant role for private surgical clinics” remains, as long as they don’t charge patients for surgeries that are typically publicly funded. 

Government adds pharmacists into primary and community care
June 5, 2018
The Ministry of Health is adding 50 new clinical pharmacists as part of primary-care network teams around the province. The ministry is supporting this new developmental program, with $23 million over three years, and is working with University of British Columbia’s faculty of pharmaceutical sciences to manage the program.

Pharma companies could be forced to reveal payments to B.C. doctors
Bethany Lindsay

CBC News – Jun 25, 201
Ministry of Health launching consultations on a health sector payment transparency program. If it goes ahead, the province’s proposed health sector payment transparency program would cover payments and services handed out by pharmaceutical companies and equipment manufacturers.
“I think what it does is it puts the patient more at the centre of health care, so the patient has knowledge and responsibility,” Health Minister Adrian Dix told CBC.

Legislation will prohibit payment for blood and plasma collection
April 26, 2018 
Health Minister Adrian Dix today introduced the Voluntary Blood Donations Act, which will help preserve the integrity of Canada’s public blood and plasma collection system by preventing payment for blood and plasma collection in British Columbia.
Currently in Canada, there are private for-profit organizations paying individuals for plasma, and then selling that plasma on the global market. By preventing these businesses from operating in B.C., this legislation will ensure that blood and plasma collected in B.C. stay as part of the national supply system run by Canadian Blood Services (CBS). 

Universal Pharmacare and Federalism
August 12, 2018
Canada is the only OECD country with universal health insurance that does not include coverage of prescription pharmaceuticals. Some provinces have taken steps to provide drug insurance coverage for the poor, the elderly and people facing catastrophic costs (there are some 70 drug funding programs across the country).
 It is estimated that approximately 20 percent of Canadians have no drug insurance. 

Premier John Horgan opens door to including dental coverage within B.C.’s health care system
December 13, 2018 
The plan would cover basic procedures such as dentures, exams, X-rays, fillings, cleanings and restorative work.
“It would take pressure off of our doctors’ offices, and off of our hospitals, where people are now forced to go when they’re in absolute crisis when it comes to their mouth and their oral health and their dental needs,” NDP leader Andrea Horwath said during the election campaign.
Richard Zussman, Global News, December 13, 2018

New UBC chair to advocate for rural health care in B.C.
November 15, 2016
Health Minister Terry Lake announced a $5-million endowment to establish a new chair at the University of British Columbia (UBC) to help enhance the delivery of rural health-care services throughout the province. The $5-million endowment is funded through the Joint Standing Committee on Rural Issues, a partnership between the Ministry of Health and Doctors of BC that advises the Province on matters related to rural medical practice.
Dr. Dave Snadden has been appointed as the founding rural doctors’ UBC chair in Rural Health. Based out of Prince George, Dr. Snadden will provide academic leadership in rural affairs, establish relevant research, and address rural physician recruitment and retention.
The chair was created following a proposal by the Rural Coordination Centre of BC, which works on behalf of the Joint Standing Committee, and seeks to improve rural health education and advocates for rural health in British Columbia.

The B.C. government will be implementing strategies that will increase access to surgeries such as hip and knee replacement.
B.C.’s wait times for some key surgeries are among the longest in the country – and have grown in recent years.
The provincial surgical strategy includes:
• Funding for 4,000 more hip and knee surgeries this year. Ongoing targeted funding of $75 million starting in 2018-2019 and increasing to $100 million in 2019-2020.
• Five specialized hip and knee replacement programs throughout the province designed to support increased surgical volumes, reduce wait times, and improve continuity of care for patients.
Centralized intake, assessment, and triage with a single point of access so that people have the option of seeing the first available surgeon.