Advocacy and Initiatives

Doctors of BC is working with health care partners to inform, guide, and influence work underway to develop and implement digital health solutions in BC. The project lifecycle below outlines the various stages of development we use to track and indicate the status of the various initiatives underway.

Digital health project lifecycle

  • Initiating 
  • Planning/Collaboration 
  • Implementing 
  • Evaluating 
  • Learning 

 

Doctors of BC supported initiatives

Digital Referrals and Orders Program

The Digital Referrals and Orders program (DRO) is a provincial platform that enables care teams to electronically exchange, track, and manage referrals, medical order requisitions, and consults (advice requests) in a more effective and efficient way.

Through various member engagements, Doctors of BC is committed to ensuring the physician voice is elevated and reflected throughout the development and implementation of the PHSA-led DRO program. This has included defining clinical needs and data sharing requirements for the provincial Request-for-Proposal (RFP) issued in 2022 and sharing member feedback during PHSA’s selection of the OceanMD vendor, to current ongoing design and implementation aspects of the DRO platform.
 
Benefits of the program include:

  • Care teams using an interactive visual Healthmap to search for providers and clinics by keyword, locations, and health service offering.

  • Clinics auto-populating data and attachments directly from integrated clinical systems into their referral, order, and consult requests to streamline data entry and reduce administrative burdens.

  • Clinics receiving and sending patient messages, pre-appointment questionnaires, and appointment reminders to improve communication and transparency.

  • Patients and their referring providers receiving real-time updates about the status of their referrals throughout the process.

Implementation timeline

Initial implementation of OceanMD will begin in the Lower Mainland in Spring 2024 with the distribution of eReferrals to care providers that use the OceanMD web portal and/or the following integrated EMRs:

  • QHR Accuro

  • TELUS Med Access

  • WELL Health OSCAR Pro

The Digital Referrals & Orders team is also actively working on adding more clinical system integrations and eOrders for medical imaging requisitions at select sites in 2024. The implementation of eOrders for lab requisitions and eConsults (advice requests) will occur in a future phase of the project.

Additional information

Further information on the DRO program, including patient benefits and a link to a short video, can be found in these resources:

If you have any questions specific to the Digital Referrals and Orders program, please contact the PHSA DRO team at .
 
If you are interested in being involved in this work or would like to learn more, please contact Doctors of BC’s Digital Health team at .

Other active initiatives

EMR Inter-operability

In collaboration with the Ministry of Health and other stakeholders, Doctors of BC’s Digital Health Strategy team is working towards enabling connection and communication across BC's health care system.

Recently, Doctors of BC completed an EMR Survey to understand our members' needs. Doctors of BC will use these findings to inform development of a provincial EMR Strategy. They will also guide our advocacy approach and our collaboration with provincial partners. We will continue to seek member input to understand BC doctors' evolving priorities, including seeking more information from them on central supports for EMR contract negotiations and pricing.

Care
Connect

CareConnect is British Columbia’s secure, view-only Electronic Health Record (EHR) that offers authorized care providers access to an integrated, provincial view of patient-centric information available 24/7 to support the delivery of patient care.

Gain access to encounters, provincial and community lab results, diagnostic imaging, clinical documents from both non-health authority and health authority sources, and provincial immunization records for patients within BC.

Doctors of BC’s Digital Health Strategy team has been working collaboratively with the CareConnect team to ensure all doctors’ needs are met and ensuring that doctors’ voices are heard in regards to the use of CareConnect.

Health Gateway

Health Gateway is a website that provides British Columbians with access to their health information, and currently provides access to:

  • Medication history
  • Immunization records
  • Health visits billed to BC MSP
  • Special authority request status
  • COVID-19 test results
  • COVID-19 proof of vaccination
  • Lab results *NEW as of June 2022*

Health Gateway is a provincial patient portal that provides patients with access to their health records for health care received anywhere in the province.

As new features are added regularly, input from patients, physicians, and other clinicians and providers will help to inform future expansion of information currently under consideration by the Health Gateway team (e.g., diagnostic imaging reports).

Pharmanet

The Ministry of Health and Doctors of BC are working to support the development and deployment of the provincial prescription management solution to community-based prescribers that enables real-time, closed loop prescription management via the PharmaNet system, enhanced interdisciplinary communication, and supports team-based care (the “PPM Project”).

Pharmanet is a secure network linking community pharmacies and other authorized clinical users in British Columbia. It records all medication dispensed in community pharmacies and gives health care providers controlled access to their clients' dispensing history. It protects against dangerous medication interactions, prescription fraud, and drug abuse.

Connection is provided by software vendors. Their software, installed at a single community medical practices, is called a site. Practices using more than one vendor for PharmaNet access have more than one site.

As of December 1, 2020, all new PharmaNet users must enroll in PRIME to request Ministry of Health approval to access PharmaNet.

Medical Imaging Reports

Doctors of BC’s Digital Health Team has been working closely with Fraser Health to find solutions to medical imaging (MI) reports distribution issues. The Fraser Health team will be using a phased approach for resolution to the issues raised around MI reports distribution. The approach will encompass four phases. The first two phases for resolution will be implemented as a priority to resolve the immediate concerns. The third and fourth phases will require further conversations and would be considered medium to long term solutions.

These solutions were in part supported through meeting with the physician representatives from divisions within the Fraser Health region, where they were able to provide their feedback and preferences for solutions – including in which order they prefer the phases to be carried out. Doctors of BC's Digital Health Team and Doctors Technology Office are continuing to support doctors by ensuring their voice is heard and working to find solutions to help reduce their administrative burden.

The four phases for resolution are:

Phase 1: Filter out select repeating exam results 

  • Filters out duplicate exam reports 
  • Solution moved into testing and estimated timeline for completion in production is the end of July 2022

Phase 2: Revert to single report (not split up multi-orders) 

  • Removes repeated report content and uses generic name for multi-orders
  • No EMR conformance required
  • Go-Live Dec 15th 2022

Phase 3: Rename to Medical Imaging Terminology Set

  • Provide more accurate naming for reports
  • Requires manual mapping from Excelleris
  • Estimated Timeline: around five months ongoing for full mapping completion. Once an approach is finalized, we will look to prioritize the most used codes first with Excelleris.

Phase 4: Map to SNOMED or LOINC to align with BC Document Ontology

  • Timeline: long term – this requires alignment with the province

Should you have additional concerns related to electronic reports distribution please contact the Doctors Technology Office at . Concerns that require ongoing advocacy and escalation are transitioned over to the Digital Health Team ().

Virtual care

Virtual care, also referred to as telehealth, aims to create a more accessible and sustainable health care system throughout BC. Doctors of BC continues to collaborate with stakeholders to develop standardized approaches to addressing and implementing solutions that reflect and address physician needs and concerns.

Real time virtual support

Doctors of BC, through the JSC and RCCbc, is working with partners to develop a platform and support pathways that help rural healthcare providers looking for immediate support with their patients. A Collaborative Centre of Excellence in Virtual Health was established to enable this work. The Centre is supported by RCCbc, the First Nations Health Authority, and Providence Health, and is working to enable rural providers to connect in a timely and simple fashion with peers and specialist colleagues (e.g., rural general intensivists, emergency medicine physicians, and dermatologists). For more information visit: https://rccbc.ca/rtvs

More information on virtual care solutions is available in the Doctors Technology Section of our website.

Access the Doctors of BC, Doctors Technology Office virtual care toolkit.

Canada Health Infoway (Infoway) and Healthcare Excellence Canada (HEC) announced that a Clinician Change Virtual Care Toolkit was available to support health care providers in their implementation and use of virtual care.

The Clinician Change Virtual Care Toolkit (the Toolkit) was developed in collaboration with clinicians, virtual care experts and patient partners to give care providers the tools they need to provide safe, high quality virtual care to their patients. It is intended for clinicians and support staff who are new or experienced users of virtual care.

The Toolkit focuses on three priority areas identified by clinicians:

Appropriateness: Considerations for determining whether virtual care can be used, and which modality (phone, video, secure messaging or remote patient monitoring) is most appropriate for the particular circumstance Use and optimization of virtual care services: Information to help address issues and challenges associated with enabling and delivering virtual care services, including technology, privacy and security considerations Quality and safe virtual care interactions: Resources to enhance the quality and safety of virtual care delivery, including virtual relationship building and conducting physical examinations

 

Currently, the PHSA Office of Virtual Health has embarked on an RFP process with Canada Health Infoway to find new Remote Patient Monitoring solution(s) to better meet clinical needs, and have an ability to scale and expand.

Doctors of BC’s Digital Health Strategy team will continue to collaborate with PHSA and Canada Health Infoway to ensure our member voices are heard during the process. If you are interested in being involved for this project, visit our Get Involved page.

In addition, feedback from the Virtual Care Together Design Collaborative, an initiative that brought together 25 teams in 10 provinces and territories, helped refine information in the Toolkit. The teams included representatives from primary care practices and organizations, community-based health centres and non-profit organizations, as well as patient partners. The teams collectively serve more than 400,000 Canadians.

See below for information on current projects/initiatives and their status.

Remote patient monitoring

Telehomecare, or remote patient monitoring, enables health care providers to electronically monitor patients outside of conventional clinical settings, such as in a patient’s home.

Patient Summaries

 A patient summary is a standardized set of basic clinical data that includes the most important health and care related facts required to ensure safe and secure health care. It’s comprised of a standardized collection of patient information - the necessary minimum and sufficient data to inform a patient’s treatment at a point of care. These include:

Medications Allergies/Intolerances Problems Immunizations Results Procedures

 

BC patient summaries

In early 2021, the Shared Care Committee (SCC) funded a Patient Summaries Pilot Project in the Victoria and the South Island regions. A key objective of the project was to improve communication between community- and hospital-based doctors in their shared care of in-hospital patients. The project successfully met this objective.

Related work is underway at a national level through Canada Health Infoway’s Patient Summaries project. Recognizing the need to build on BC-based lessons and for physician input on digital health solutions, Doctors of BC advocated for and facilitated physician participation in key review stages of Health Infoway’s work.

The below diagram shows the Doctor’s of BC’s roadmap of BC Patient Summaries.

BC PATIENT SUMMARIES 2022 June National Physician Engagement (Canada Health Infoway) Planning for BC Patient Summary Implementation 2022 April Patient Summaries Workshop: Review Quantified Benefits 2022 March Patient Summaries Workshop: Capture Decision Criteria and Evidence 2022 January - February Patient Summaries Follow-up: - Review use cases - Clinical priorities - Data quality - Constraints 2015-Present Victoria & South Island Patient Summaries Pilot 2021 October - December Review Pan-Canadian Patient Summary: - Use cases & requirements - Data elements & semantic interoperability BC PATIENT SUMMARIES 2022 June National Physician Engagement (Canada Health Infoway) Planning for BC Patient Summary Implementation 2022 April Patient Summaries Workshop: Review Quantified Benefits 2022 March Patient Summaries Workshop: Capture Decision Criteria and Evidence 2022 January - February Patient Summaries Follow-up: - Review use cases - Clinical priorities - Data quality - Constraints 2015 - Present Victoria & South Island Patient Summaries Pilot 2021 October - December Review Pan-Canadian Patient Summary: - Use cases & requirements - Data elements & semantic interoperability

For more information on the National Patient Summaries Project, visit Canada Health Infoway.

Clinical uses of patient summaries may include:

Medical emergencies Unfamiliar provider at the point of care Coordination/transitions of care

Patient summaries can help improve:

Coordination of care and clinical workflow efficiencies Health outcomes and patient safety Patient and provider experiences Cross-jurisdictional patient flows