Whereas there has been a noticeable increase in delays in treatment and testing for all British Columbians, with a particularly significant impact on residents in rural areas; And whereas there is an expectation of a standard of practice that every individual should be able to rely on, ensuring that test results are promptly reviewed; however, delays in testing and review processes are causing undue stress and potential health risks, especially in rural communities; And whereas the discrepancy in wait times for test result reviews, such as heart halter monitors, between urban and rural locations can lead to adverse health outcomes, including increased mortality rates: Therefore be it resolved that the UBCM jointly lobby the provincial government to compel the Health Authorities to review and address the discrepancies in the standard of care, particularly in wait times for test result reviews, across the province, with a specific focus on addressing the disparities between rural and urban areas; And be it further resolved that UBCM advocate for shared patient records between health authorities.
Ministry of Health Laboratory Services: Laboratory services in British Columbia are delivered through a combination of public providers and publicly funded private organizations. LifeLabs is responsible for delivering approximately two-thirds of outpatient laboratory services, while the Health Authorities account for the remaining share. LifeLabs delivers services under the framework of a tripartite Master Laboratory Services Agreement MLSA with the Ministry of Health and the Provincial Health Services Authority PHSA, which includes specific obligations around performance monitoring and reporting. A central component of LifeLabs contractual responsibilities involves the ongoing reporting of key standards and performance indicators to ensure equitable access and high-quality laboratory testing across the province, including in many rural and remote communities. This includes detailed tracking and reporting on critical metrics such as patient wait times, which support broader objectives of accountability and continuous improvement in patient outcomes and experience. Furthermore, to ensure system-wide alignment and enhanced service delivery, the MLSA requires LifeLabs to monitor and report its performance against predefined targets and key performance indicators, as well as historical baselines. In 2018, the Provincial Laboratory Medicine Services PLMS within PHSA was established to enable a single clinical and administrative structure with a mandate for operational planning and clinical policy implementation, service monitoring and reporting, and budgeting processes, to ensure patients have timely access to high-quality, appropriate, and cost-effective laboratory services. In accordance with its provincial mandate, PLMS is currently spearheading cross-sector planning initiatives with the Health Authorities aimed at identifying opportunities to expand and harmonize standards of care throughout the province, with the goal of fostering a more consistent and integrated approach to laboratory service delivery. Diagnostic Imaging: In British Columbia, patients are referred for medical imaging by a referring practitioner based on their clinical judgement and should be in alignment with clinical guidelines for appropriate and evidence-based use of medical imaging. The requisition for medical imaging is received by a hospital or community imaging clinic and patients are prioritized based on the level of care a patient requires. The priority levels and recommended wait times in BC are based on guidelines from the Canadian Association of Radiologists CAR. The CAR priority levels were further adopted by B.C. Guidelines to provide clinical decision support in the published MRI Prioritization Guideline. Patients with the most urgent and immediately life-threatening symptoms are booked for their appointments sooner than those with non-urgent symptoms. Recognizing the growing demand on medical imaging services, the Ministry of Health, the Provincial Medical Imaging Office PMIO in partnership with the health authorities and medical imaging professionals are working together to improve delivery, build a standardized, equitable, and integrated approach to medical imaging across the province to improve access and patient care. Enhanced access to medical imaging is supported by four key strategies including, building further capacity, increasing essential personnel, optimizing business processes and improving waitlist management. Diagnostics: Diagnostic services in British Columbia are delivered through a combination of publicly and privately owned facilities. The Medical Services Commissions the Commission Advisory Committee on Diagnostic Facilities ACDF, under the authority of the Medicare Protection Act and the Medical and Health Care Services Regulation the Regulations, is responsible for reviewing and approving applications from facilities wishing to bill the Medical Services Plan MSP for the following restricted outpatient services: ultrasound, radiology, nuclear medicine, polysomnography, pulmonary function, electromyography, and electroencephalography. The ACDF assesses applications in accordance with the Regulations to ensure there is sufficient medical need, the quality of the proposed diagnostic services is sufficiently high and there is reasonable utilization of existing approved diagnostic facilities which provide the same services. As a condition of approval, diagnostic facilities wishing to bill MSP for outpatient diagnostic services must obtain accreditation by the College of Physicians and Surgeons of British Columbias Diagnostic Accreditation Program. The Commission has established wait time benchmarks for polysomnography, bone densitometry, echocardiography and urgent, non-emergency ultrasound and is actively monitoring polysomnography wait times to ensure service needs are met. The Commission has recently made policy changes that have resulted in the accreditation and approval of 145 stand-alone Home Sleep Apnea Testing HSAT facilities across the province and permits the provision of remote HSAT in underserved, ruralremote communities. The ACDF has policy that considers future plans for construction or significant physical expansion of public diagnostic facilities i.e., new hospital builds, major renovations to a hospital in the catchment area or any other geographic area defined by the ACDF, when considering an application. However, similar applications will not be considered or approved if there is a firm plan in place to implement a new or substantially expanded public diagnostic facility within the next five years. The ACDF has implemented policy that may, on a case-by-case basis, recommend the Commission grant approval under exceptional circumstances for applications where outpatient diagnostic services are required in direct support of a Ministry of Health priority initiatives, i.e. service provision directly related to Primary Care Networks, including Urgent Primary Care Centres, or Specialized Community Service Programs for target populations. The Committee has a policy in place to allow both public and privately-owned facilities to apply for Distance-Reading Diagnostic Ultrasound Telemetry approval for ultrasound services they are approved to perform. Thus, allowing patients to remain in their communities for ultrasound scans, which are in turn read off-site at another ACDF approved ultrasound facility.