PAS FAQs

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.

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.

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 distress levels. You can rest assured that there is a system in place to address the needs of these patients–you will no longer carry that burden alone. The coordinated approach to attachment 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. Data is the foundational building block to plan for a highly functioning system. As each physician and clinic participates, we will better understand services available in communities and across the province, 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.

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.

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 as to whether a new patient is a good match is left with the physician and the patient.

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 a patient decide that the attachment fit isn’t right, the attachment coordinator will return the patient to the HCR to find a better match.

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 you use the 98990 attachment code through MSP/Teleplan to ensure the panel is updated in the PAS to reflect new patients. Information on how to update panel information for new and departing patients can be found in the “Ongoing panel updates following your initial panel submission” section.

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 Panel Registry, provide or update your practice information, and identify whether 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.
3. Keep your panel information up to date by billing the attachment code for new patients, removing patients through PAS, and periodically reviewing your list of empanelled patients. Starting May 28, 2024, you can see a new ‘MRP Status’ column displayed within the Panel Registry. If you have patients with the Not the MRP status, you may wish to remove them from your panel in the PAS. Once that has occurred, an MRP status of Removed will be displayed.

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

A step-by-step guide on how to register and access the PAS is available.

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

• Measure system progress.
• Understand which clinics and practices are providing care in a community.
• 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.
• Have accurate panel information on longitudinal family physicians.

Find detailed information for physicians on the PAS. 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 how to access the PAS is also available.

To access technical support through PHSA:

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

Dial:1 778 907-2071
Meeting ID: 930 0303 4945
Passcode: 548989

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

The Health Connect Registry team is 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.

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.

All physicians providing longitudinal care need to register and enter or update information in the Panel Registry. You will need a OneHealthID in order to log in. Once you gain access, you will be asked to identify whether you have capacity to accept new patients and how many. If you are not able to accept new patients, you will enter that information. 

• You can find a step-by-step guide on how to register and participate in PAS.

Please ensure that you are linked to your clinic as entered into the system by the Medical Director. If you do not see your clinic appear in the dashboard, please speak with your medical director.

All medical directors (or designates) at clinics where physicians provide longitudinal care need to log in to the PAS using the BCProviderID, generated on the OneHealthID website. 

Step-by-step guide on how to register and participate in the Clinic and Provider Registry.

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: HealthBcSupport@phsa.ca.

All longitudinal physicians are expected to submit panel lists to MSP/Teleplan using their 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. 

A reminder that full participation in the PAS is an eligibility requirement for CLFP Payments. When new methodology is developed, 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 to 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.

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

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. This code and process is only to be used after your full panel is submitted.

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

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 updates you have made on the Panel Registry through the submission of $0 fee codes. Removal of patients from directly within the PAS is effective immediately.

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 appear on more than one panel list. In PAS we want to ensure as much as possible that patients are only identified on the panel for the FP or NP they visit as their regular source of care. There is now an MRP confirmation process underway, using billing data, to help resolve situations where patients appear on multiple panel lists

The ministry has been using a process through analyzing MSP data.

• Patients that have had more than five visits and all their visits with a single provider over the past three years will be assigned to that provider.
• Patients that have had fewer than five visits, but where 80% of visits, including their most recent visit, have been with one provider, will be assigned to that provider.

Plans are underway for patients to be contacted to confirm their attachment in situations where the MRP remains unconfirmed after the data analysis is complete. Patients will be able to call 811 or use a new secure patient portal to confirm their MRP.

A new column in the panel registry will identify the patient’s MRP status.

Starting May 28, 2024, FPs and NPs can see the results of the above process for each patient reflected in a new ‘MRP Status’ column displayed within the PAS Panel Registry. The column will indicate the following:

• Confirmed–The patient is confirmed as attached to the FP or NP (i.e., they are on the panel).
• Not the MRP–The patient is confirmed as attached to a different FP or NP, or the patient has indicated they are not attached to the FP or NP (i.e., they are not on the panel).
• Pending–The patient’s attachment status remains unresolved at this time.
• Removed–The FP or NP has removed the patient from their panel.

In the future, as patients clarify their MRP through 8-1-1 or the secure patient portal, the MRP Status column in the PAS Panel Registry will continue to be updated by the Ministry.

Please note that work is underway for EMR integration with the PAS, with the goal of automating addition and removal of patients in the Panel Registry through EMRs. However, in the interim, FPs, NPs, or their delegates will need to remove patients from the PAS Panel Registry manually. 

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. Learn about the steps.

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.

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)

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.

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

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. If you practice at more than one location, you will need a Facility Number for each one.

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

• A new system to prioritize patient attachment that includes the ability for patients to provide information on any changes to their health within the HCR.
• Improvements to the PAS that provide ‘end to end’ supports 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 FPs/NPs 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.

• 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.

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 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 who do not have the highest need and urgency for immediate attachment to remain stable.

Low complexity:

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

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.

Attachment Coordinators will 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 will be 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.

Practitioner Capacity: 
Practitioner advises capacity (if accepting, and max # patient request) in Panel Registry

+

Patient Selection:
Practitioner receives notification an attachment coordinator has recommended patients for consideration, and selects patients for intake in Panel Registry > Pending Selection 

+

Patient Intake: 
Practitioner completes intake for selected patients, and confirms successful (or not) attachment in Panel Registry > Pending Intake

=

Attached:
Practitioner views list of accepted patients following intake in Panel Registry > Accepted

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

Access the detailed FAQ pdf that includes much more information on deadlines and process.