PAS FAQs

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Below is a list of detailed FAQs to support you with the Provincial Attachment System (PAS). If after reviewing the FAQs, you still have technical support questions please email PHSA: . For general inquiries email: .

Overview of the PAS 

Why was the PAS being introduced?

PAS is another step in our journey to help revitalize and strengthen family medicine. Its purpose is to connect unattached patients with family doctors who are accepting new patients in a coordinated and seamless way. It will also provide important data that will measure system progress and capacity so that the province and communities can better plan for the future.

What problems are we trying to solve with PAS?

Here are some of the current challenges we need to address:

  • Patients do not have clear guidance on how to find a doctor.

  • Physicians and clinic staff are overwhelmed with inquiries from desperate unattached patients. 

  • Each community has different attachment mechanisms, with inconsistent and different levels of support for patients and providers. Some communities have no attachment programs at all.

  • There is incomplete information on clinic and provider capacity to accept new patients.

How will it benefit patients and doctors?

Patients: Will benefit from a coordinated and equitable approach to attachment. It means less worry and confusion, and once capacity is increased, it will be faster and easier to connect with a family physician. 

Doctors: Will no longer be inundated with calls from unattached patients desperately seeking a family physician, which is adding to your moral distress. You can rest assured that the needs of these patients will be met – you will no longer carry that burden alone. It will significantly help new-to-practice and returning doctors who are building up brand new panels.

For everyone: We need data in order to successfully strengthen our primary care system. And we need to be able to measure progress. Data is the foundational building block to plan for a highly functioning system. The province needs it and so do our communities. If everyone participates, we will better understand what is available in communities now, identify gaps, and measure our progress when solutions are implemented. It will empower communities, regions, and the province to plan more effectively to meet future needs.

Which physicians are expected to participate?

All doctors providing longitudinal care to a panel of patients are asked to participate in the PAS. This includes physicians enrolled in the LFP Payment Model, and those on Fee-for-Service (FFS), and alternate models of payment (for example: group practice contract, population-based funding, AP contract).

Medical directors for clinics with doctors providing longitudinal care are also expected to participate.

Do physicians have a choice in which patients will be attached? Will they be forced to increase their panel size?

Trust and rapport between patients and physicians are critically important and there must be flexibility and choice for both parties.
 
As such:

  • No doctors will be forced to increase their panel size.
  • No doctors will be forced to take on new patients.
  • The final decision on whether a new patient is a good match is left with the physician and the patient. 
How will physicians and patients be matched?

Attachment coordinators will assist in connecting patients and doctors through the Health Connect Registry (HCR) to ensure there is a good "match”. Should either a physician or patient decide that the attachment fit isn’t right, the attachment coordinator will return the patient to the HCR to find a better match.

Will physicians be able to accept a patient outside of the PAS?

Yes, physicians can accept patients outside of the PAS. The goal is to attach as many patients as possible with family doctors. It will be important to ensure that the panel is updated in the PAS to reflect new and departing patients. Information on how to update panel information can be found in the “Ongoing panel updates following your initial panel submission” section here.

What are physicians and medical directors expected to do?

All physicians who provide longitudinal care under the LFP Payment Model, Fee-for-Service, or alternate payment models are asked to:

  1. Log in to the to the Panel Registry, provide or update your practice information and identify if you are able to take on new patients.
  2. Clean up panel lists and submit them into MSP/Teleplan using EMRs (if this option is available) or the third-party service provider Dr.Bill. A few days after uploading lists, the data will appear in the Panel Registry.

Clinic medical directors (or designates) must log in to the Clinic and Provider Registry and verify, update, or add information about their clinics.

How do physicians register and access the PAS?

A step-by-step guide is available here.

How will the data collected by the system be used?

Data is one of the foundational building blocks for a high-functioning primary care system. PAS will help us to:

  • Measure system progress.
  • Understand which clinics and practices are providing care in a community.
  • This information will empower communities, regions, and the province to plan more effectively to meet future needs. In addition, when we understand current gaps, it means that steps can be taken to address these challenges on a short- or medium-term basis, until longer-term solutions are developed.

  • Understand how many and which clinics are accepting new patients. 

  • Identify gaps in care.

Where can physicians go with questions and for technical support?

Detailed information for physicians about the PAS can be found on the Doctors of BC website. A wide range of training supports and resources can be found on this page under the “Resources and support” headline. A step-by-step guide on how to access the PAS is also available.
 
To access technical support through PHSA:
 
Email:

Join Zoom (link for app/browser and phone/dial in option):
https://zoom.us/j/93003034945?pwd=L3lkL0VqdEJvTjZ2cWMxelB3R3ppdz09

Dial: +1778-907-2071
Meeting ID: 930 0303 4945
Passcode: 548989

This service is available Monday-Friday 9am to 7pm PST, excluding stat holidays.

What will happen to PCNs and divisions that have already started patient waitlists?

The Health Connect Registry team will be working with communities that may already have a waitlist, such as Divisions of Family Practice or a Primary Care Network, to transfer the list to the Health Connect Registry. In this way communities will have one, centralized list to attach from as capacity is available.

How do I update my panel preferences to indicate that I am accepting new patients?

Under the “My Panel” button within the PAS, there is a section at the top where you can update your panel preferences. More information can be found in the Update Panel Preferences and Availability user guide within the PAS. 

Panel Registry 

Can you provide information on what physicians need to do in the Panel Registry?

All physicians providing longitudinal care are to register and enter or update information in the Panel Registry as soon as possible. You will need a OneHealthID in order to log in. Once you gain access, you will be asked to identify if you have capacity to accept new patients and how many. If you are not able to accept new patients, you will enter that information. A step-by-step guide on how to register and participate in the PAS can be found here.
 
Please ensure that you are linked to your clinic as entered into the system by the Medical Director. This must be done to complete the process and claim the $6,500 payment. If you do not see your clinic appear in the dashboard, please speak with your medical director. 

Clinic and provider registry 

What are medical directors expected to do within the Clinic and Provider Registry?

All medical directors (or designates) at clinics where physicians provide longitudinal care need to log in to the PAS using your BCProviderID, generated on the OneHealthID website. A step-by-step guide on how to register and participate in the Clinic and Provider Registry can be found here.

Once logged in, click on the name of the clinic and verify that all members who require access to the PAS have been added. Next, click the "Clinic Details" tab to verify that the clinic information is correct. If you have other types of clinicians that you work with, add them into the "Other Clinical Staff" tab.
 
Once all three steps have been completed, the medical director (or designate) has completed all the required tasks. If you have questions and need technical support, please e-mail PHSA: .

Submitting panel lists 

What is involved in submitting lists of empanelled patients?

All longitudinal physicians are expected to submit panel lists to MSP/Teleplan using your EMR or the third-party service provider Dr.Bill. For more information visit the submission webpage. Guides and resources on the Health Technology Resources webpage can help you do this now. You can also submit a service request for assistance or email .
 
A reminder that full participation in the PAS is an eligibility requirement for the 2023 Community Longitudinal Family Physician (CLFP) Payment and future CLFP Payments. Panel data will be used to calculate future CLFP Payments, to more accurately reflect panel size and complexity. More information on eligibility can be found on the Family Practice Services Committee website.
 
A note for all physicians: A Facility Number is required to submit a patient panel your EMR or Dr.Bill. The Facility Number is used to associate the panel with the physician location of the practice. You must apply for and obtain a Facility Number before submitting your patient panel. If you do not have one, you can request one here.

Once the panel list is submitted, how long will it take before it appears in the Panel Registry?

The data will appear in the Panel Registry in a few days after submitting your panel list.

How do physicians update panel lists once they have been submitted?

Here is information on how to ensure your panel list in the Provincial Attachment System (PAS) is current and accurate:

How to add patients to panel: Send a $0 attachment code 98990 to MSP/Teleplan through your EMR. This will be reflected in the PAS within a few days. 

If you are adding a patient that you have previously removed from your panel within PAS, you will need to contact the PAS support team for assistance. Refer here for contact information.

How to remove patients from panel: Select the patient on your panel and click on the “remove” button in the PAS. Removing a patient in the PAS will not remove them from your EMR, so you will want to ensure the patient has also been removed from your EMR. Work is underway to integrate these systems in the future. 

How often should I update panel lists?

We encourage you to incorporate these steps for adding and removing patients into your daily workflow. We also recommend reviewing your panel list in PAS regularly, and no less than on a quarterly basis, to ensure it is up to date and to correct any possible errors along the way. A note that your PAS password will expire after 90 days from logging into the system, so a quarterly check-in will ensure that you do not need to update your password.

You will be able to see panel lists you submitted within a few days of uploading your panel or providing updates you have made on the Panel Registry through the submission of $0 fee codes. Removals of patients from directly within the PAS are effective immediately. 

Why is updating panel lists important?

Updated panels will help everyone involved in primary care have a better picture of attachment in BC, as we work together to ensure people have access to a primary care provider.

As well, updated panel lists in the PAS will be critical to ensure payments accurately reflect panel size when the new method is developed for calculating CLFP payments, or panel payments under the LFP Payment Model. 

Sometimes patients may, often inadvertently, appear on more than one panel list. Early in the new year, we will start a process to resolve situations where patients appear on multiple panel lists. It will be important that panel lists are updated before this process begins to minimize the number of panel conflicts. Watch for more information on deadlines, payment, and the process for resolving panel conflicts in the coming weeks.

Can panel uploads and PAS tasks be completed by my MOA or my director?

While you can allow your MOA or director to manage your panel and profile in the future, you first need to complete the panel upload and the required steps within the PAS.

If physicians want to delegate responsibilities in the PAS to someone in their clinic who is not a doctor or registered nurse practitioner, they must complete the endorsement process in OneHealthID. The endorsement process can be initiated by the endorser or the endorsee. Once the endorsement process has been initiated, the other party will receive an email asking them to confirm the endorsement.
 
Infographics on the endorsement process can be found here: 

You can also contact the OneHealthID Service Desk for support:

How do I transfer my panel to my new clinic?

Within the “My Panel” page, select all patients you wish to transfer, then select "Change Clinic". This can be used whether you are separating your panel into multiple locations, or if you are transferring your panel to a new clinic.

How do I transfer my panel to another physician?

If a provider (A) is leaving practice and transferring their panel to another provider (B), the process is as follows:

  1. Provider A (or delegate) removes all their patients from the Panel Registry within the PAS

  2. Provider A advises Medical Director to remove them from the clinic in the Clinic 
    and Provider Registry

  3. Provider B advises Medical Director to add them to the clinic in the Clinic 
    and Provider Registry (if applicable)

  4. Provider B bulk uploads the patient panel using their EMR or third-party service provider Dr.Bill with the $0 attachment code (98990)

Can I submit my panel in batches?

Your panel should be submitted all at once. This is a one-time process. After submitting panel lists to MSP/Teleplan through your EMR or Dr.Bill, they will show up in the PAS within a few days. It is important to keep your Panel Registry in PAS up to date and in line with your EMR on an ongoing basis. Learn more about this under the “Ongoing panel updates following your initial panel submission” section of this webpage.

I am on the LFP payment model and submitted my panel already. Do I need to submit my panel again for the PAS?

As long as you submitted your panel through your EMR (if supported) or Dr.Bill, you will not need to resubmit.

Is a Facility Number needed for non-LFPs panel upload?

Yes. The Facility Number is important when uploading your panel and is used to associate the panel with the physician’s location practice. This will allow your panel to appear within your clinic on the PAS. If you do not have a Facility Number, you can request one here. If you practice at more than one location, you will need a Facility Number for each one.

Accelerated attachment through the PAS

What steps are being taken to accelerate patient attachment?

A number of enhancements have been made to the Provincial Attachment System (PAS) and the Health Connect Registry (HCR) to streamline and accelerate patient attachment while reducing the burden on physicians:

  • Patients are able to add information on any changes in their health within the HCR.
  • ‘End to end’ supports are in place so that, for the first time, physicians can use the PAS to request, select and confirm attachment of patients online.

The objective of PAS has always been to better support patients and physicians by establishing a clear, consistent, and digitally enabled approach to attachment coordination across the province. This is one of the next steps in the process.The changes were developed based on feedback and engagement with communities since the start of the PAS last year. 

Why is the Ministry of Health reaching out to patients on the Health Connect Registry (HCR)?

Staff are contacting patients registered in the Health Connect Registry (HCR) to determine whether they have found a family doctor, in which case their names can be removed from the registry. They are also asking patients to provide an update on whether there have been any changes in their health status since they first registered. This information will be used by Attachment Coordinators to help prioritize patients for attachment.

What are the factors that will determine priority for attachment?

  • Complexity - Clinical administrative data available to the Ministry will be used to calculate complexity (high/medium/low) of the patients care needs.

  • Stability/New and Recent Diagnoses - Patients will be given the opportunity both at initial registration, and on an ongoing basis, to provide information about their health status either by telephone or online. This may be particularly important for people with new/recent changes to their health status or for people who may be new to the province and whose medical information is not yet available in our administrative data.

  • Time on Registry – Consideration will be given to the length of time people have been on the Health Connect Registry list.

What is the definition of high, medium, and low complexity?

Complexity of patients needs is one of the factors that will be considered in prioritizing patients for attachment. The categories are defined as follows:

High complexity:

Patients with expected highest need and urgency for based on age, diagnostic history (diagnoses, combination of diagnoses, expected duration of diagnoses) and health system utilization.

Medium complexity:

Patients with complex health conditions but do not have the highest need and urgency for immediate attachment to remain stable.

Low complexity:

Patients with potentially complex health conditions but do not have the highest need and urgency for immediate attachment to remain stable OR unknown (no data yet available in BC).

How were these definitions developed?

Two methodologies were used:

Adjusted Clinical Groups (ACG) - ACG is derived from diagnostic codes submitted to the Ministry of Health, either through MSP billings or hospital records. It considers diagnoses, expected duration and intensity of healthcare resources, severity, diagnostic certainty, age and sex in its complexity scoring.

John Hopkins and Resource Utilization Bands (RUB) - ACG disease groupings are combined with MSP utilization data to generate RUB. RUB includes six categories ranging from non-users and healthy users to patients with very high morbidity.

What do these changes mean for physicians?

Attachment Co-ordinators are now able to use the new data to recommend a list of patients for possible attachment with physicians who have capacity to expand their panels, taking into account complexity, any recent changes, and length of time on the Health Connect Registry.

Physicians are now able to build a panel with varying degrees of complexity and health care needs. For the first time, physicians will be able to receive, select and attach patients entirely through the PAS. 

How will the process work for physicians?

What happens if a patient is not selected?

If the patient is not selected, they will remain on the Health Connect Registry until a suitable match is found. Later this spring, the Ministry will start directing complex, high needs patients to interim, virtual supports while waiting for attachment. 

Reducing Duplication of Patients on Panel Lists 

Why is the Ministry of Health taking steps to reduce the number of patients who appear to be on more than one panel list?

 

Based on the information collected in the PAS, we know that just over 500,000 patients appear to be on more than one physician's panel list (or have more than one Most Responsible Provider).  The Ministry of Health wants to maximize the number of patients who have one MRP so that more patients may obtain access to a family doctor for their longitudinal care.

How does the process work?

Step one

For patients who appear on more than one panel list and have received care from one physician 100% of the time over the last three years, with a minimum of five visits:

The Ministry of Health is automatically assigning these patients to the panel of the physician they have been seeing. There is no notification to patients or physicians, but physicians can view their patients’ status in a column marked 'MRP Status' in the PAS. Automatic assigning of these patients and access to the MRP Status column started May 2024.

Information on next steps will be provided as soon as possible. 

What changes will doctors see in the PAS?

Physicians can view the status of their patients in a new ‘MRP Status’ column in the PAS Panel Registry. The column provides the following information:

  • Confirmed – This means the patient is confirmed as attached to you.

  • Pending – This means the patient’s attachment status remains unresolved at this time, and awaits patient confirmation of who the MRP is.

  • Not the MRP – This means the patient is confirmed as attached to a different physician or the patient has indicated they are not on anyone’s panel. 

  • Removed – This appears when a physician removes a patient from their panel in the PAS.

Will I be notified if a patient is no longer on my panel list?

Physicians will not receive direct notification but will be able to view the status of patients in the PAS.

A new column entitled “MRP Status” will tell you whether your patient is confirmed (which means the patient is on your list), pending (which means the patient is on multiple lists and their MRP has not yet been determined), or not the MRP (which means the patient is confirmed as attached to a different physician or nurse practitioner or does not have an MRP).

What should I do if I see that I am not the patient’s MRP?

You may choose to remove the patient from your panel list in the PAS, and they will show up as “removed” in that column on the PAS. Any updates that are made to your panel registry in the PAS should also be reflected in your EMR.

Once you have removed the patient from your panel list in the PAS, you may assess whether the removal creates capacity for you to add new patients to your panel by updating your availability in the Panel Registry. This will engage the services of your local Attachment Coordinator who can provide you with prospective new patients you may wish to consider for your practice.

What if a patient that is on my list as ‘Pending’ confirms with my clinic that I am their MRP – can I update the status in PAS to ‘Confirmed’?

No. Patients will have an opportunity to confirm their MRP through 8-1-1 or on a new patient portal that will be hosted by the Ministry of Health. Physicians cannot change the status within PAS themselves or request it to be changed on behalf of the patient. Once a patient confirms their MRP, that choice will update the PAS.

Does this mean patients can only visit their own family doctor (Most Responsible Provider or “MRP”)?

Patients can see other doctors, nurse practitioners, specialists and doctors at walk-in clinics. The goal is to ensure that patients appear only on the panel list of the physician who is their MRP.

Can doctors continue to provide care for patients for whom they are no longer the MRP?

It will be up to individual doctors whether they continue seeing a patient who is confirmed on another panel. Ideally, they will take the opportunity to add new patients who are waiting for attachment.

Did the Ministry of Health consult with doctors?

Doctors of BC provided input into the approach as it was being developed and it is represented within the governance of the PAS and its related implementation. We made every effort to minimize administrative burden and make this transparent. Note that planning is underway to integrate EMRs into the PAS to make updating panel lists much easier in the future. 

Where can I get more information?

Additional information is available in a Ministry of Health memo and/or you can e-mail .