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Secure email and e-forms for free
We had a call this morning at Medinet from a clinic whose phone lines have been jamming up, asking if we could set them up with secure email, and maybe some linked web forms they could used for triaging. The answer, of course, is yes! We'll supply anyone in the healthcare system with this package at no charge for the duration. The email is dead simple to use, completely secure (in service at FHA and PHSA for several years) and can be set up in minutes. If you can think of anyone who would find this useful for patient or professional contact, could you please let us know?Be well, Kate
Kate Culter
President & CEO
Medinet
Support@Medinet.ca
Kate@Medinet.ca
or katemedinet@gmail.com
All you need to know about Covid19
For the latest updates and answers to common questions about COVID-19 visit
http://www.bccdc.ca/health-info/diseases-conditions/covid-19
Maze posts data allegedly stolen from PEI in ransomware attack
Howard Solomon @howarditwc Published: March 2nd, 2020 from IT WORLD CANADA
Stolen data purportedly from the government of Prince Edward Island including personal information has been publicly posted on the web site of the ransomware gang known as the Maze group, according to a security researcher.
Brett Callow, a British Columbia-based threat analyst for Emsisoft who has seen the files, said they were posted over the weekend. That’s a week after PEI discovered and stopped a ransomware attack 90 minutes after it started.
Most ransomware attacks only encrypt data before sending a threat notice to victims. The Maze strategy, announced last December, is to first copy as much data as it can before launching ransomware. Then if a victim doesn’t pay it releases some data on its site, as well as the IP addresses and machine names of infected servers, with the threat — implied or direct — that more data will be released if it isn’t paid off.
In the PEI case the posted spreadsheets, PDFs, text and ZIP files are under a headline that reads”Proofs.” Callow says the files he’s seen include person’s names and social insurance numbers, copies of provincial bank statements, audits and budgets.
The PEI data on the public Maze site is one of 10 new victims the attackers allege have been victimized. The sit says “Represented here companies do not wish to cooperate with us, and trying to hide our successful attack on their resources. Wait for their databases and private papers here. Follow the news!”
IT World Canada sent a message to Spencer Lee, a spokesperson for the PEI finance department last night, for comment. As of press time this morning it hadn’t received a reply.
UPDATE: In an email this afternoon Lee said that “the investigation into the attack is ongoing, and we will continue to communicate openly with our citizens in Prince Edward Island, when appropriate and safe to do so. ”
On February 25th Lee issued a statement saying that two days earlier the government discovered malware on its network. At the time he said there was “no reason to believe that Islanders’ personal information” was affected.
The same day John Brennan, the province’s director of business infrastructure services, told the CBC that this was a ransomware attack that was stopped 90 minutes after being detected. Brennan said “a very small amount” of data was encrypted, but it was backed up. He didn’t say if the government knew any data had been copied. But the Maze PEI entry alleges 200 GB of data was stolen.
Brennan told the CBC on Feb. 25th the government hadn’t been in contact with the attackers. Callow said typically attackers get into a network for a week or more before launching malware. That would be enough time to find and copy sensitive data. “PEI has no good options,” he added. “If they don’t pay the ransom more of the data is likely to be published. If they do pay the ransom the criminals still have the data are quite likely to misuse it.”
Posted November 13, 2019 3:30 pm
Updated November 13, 2019 9:20 pm
Canadian experts calling for a greener health care system
Canada’s health care system could be a lot greener, experts say. According to a new report, the health care system is the third-highest-emitting health system per capita in the world — behind Australia and the U.S. — but it represents not quite five per cent of Canada’s total greenhouse gas emissions.
By comparison, Canada’s agricultural sector accounts for about 10 per cent of emissions, the transportation industry 24 per cent and the oil and gas industry 27 per cent, according to government data.
Health care is relatively efficient, though, as it accounts for around 11 per cent of economic expenditure, but only five per cent of emissions, one study found. But that doesn’t mean it can’t do better, the authors say.
“We all have a responsibility to do our fair share,” said Dr. Courtney Howard, an emergency room doctor in Yellowknife and lead author of the 2019 Countdown on Climate Change Briefing for Canadian Policymakers. “It’s like a budget. Five per cent over time adds up,”
The report is part of the Lancet’s annual Countdown on Health and Climate Change Report, released Wednesday. This year’s report found that children around the world were at risk from climate change, including from malnutrition as a result of a changing food supply and infectious diseases that are expected to spread more easily. Canada’s country report suggests that we cut back on emissions in the transportation sector, develop better plans to deal with wildfires, and clean up the health care system itself.
“One of the first things they taught me in med school was ‘do no harm,’” Howard said. “And so we want to be consistent with that in terms of how we’re actually conducting our own operation.” Hospitals and acute care facilities are big contributors to emissions in health care, she said. Aside from basic things like keeping the lights on, what goes on in an operating room can also have a big impact.
A recent study comparing three operating rooms in Vancouver, Minnesota and the U.K. found that anesthetic gases used during surgery contributed significantly to a hospital’s carbon footprint. So, too, did the ventilation systems in the operating room, which completely circulate the air many times a day. They constituted about 52 per cent of an inpatient hospital’s energy use.
Another huge contributor of emissions is the energy used to make, transport and dispose of items used in health care settings, like syringes, medications, bandages and so on. According to a report by the group Health Care without Harm, these account for 71 per cent of emissions attributable to the health care sector.
Another huge contributor of emissions is the energy used to make, transport and dispose of items used in health care settings, like syringes, medications, bandages and so on. According to a report by the group Health Care without Harm, these account for 71 per cent of emissions attributable to the health care sector.“So if anesthetists simply switch from one to the other, it can result in a really big decrease in greenhouse gas emissions.”
The operating room study found that simply turning off the ventilation systems in unused operating rooms at Vancouver General Hospital in the middle of the night or on weekends reduced their energy use by half.
“That’s a lot of wasted energy,” she said. “And when they fixed it, they also saved a lot of money.”
Fixing these problems won’t necessarily be expensive, she thinks. “We anticipate this will actually save money,” she said, by reducing energy use or moving away from certain disposable items — which have to be manufactured and transported — to reusable ones. “I remember when I was a med student at Squamish Hospital, there was one day when the rep came in to extoll the virtues of disposable drapes,” Howard said. Many hospitals in the early 2000s swapped out their surgical drapes, which are placed over the patient during surgery, for a disposable option. Unfortunately, she said, when staff threw out the drapes after the surgery, they often also accidentally threw out a lot of expensive surgical instruments that were caught in them.
Canada wouldn’t be the first country to tackle emissions in health care, either. Between 2007 and 2017, the U.K.’s National Health Service reduced its emissions by 18.5 per cent, despite increasing clinical activity. Howard attributes this mostly to government standards and programs that applied to all public sector activities, including public health. As the Canadian public becomes increasingly aware of the links between climate change and health, she said, she thinks that both health care providers and their patients will increasingly want to take action.
“I think this is just a place where there’s huge win-wins for all of us to be making change that we can all feel good about.”
News
Published on: June 11, 2018 The Globe & Mail
MONTREAL
Why are fax machines still the norm in 21st-century health care?
Two-thirds of Canadian doctors say their primary means of communication with other physicians is by fax.
Medical clinics in this country, on average, send and receive a mind-boggling 24,000 pages of faxed information annually. Only about one-third of family physicians and specialists e-mail their colleagues for clinical purposes, never mind patients.
These data, from a 2017 survey of clinicians by Telus Health, remind us that, in the digital age, health care continues to cling desperately to the facsimile machine, a clunky technology that most industries have long ago relegated to the scrap heap.
There is also an obsession with privacy, one that, time and time again, trumps convenience and even common sense.
Then, there are the practical technological impediments to abandoning the fax.
The majority of primary care physicians – 77 per cent, according to Canada Health Infoway – uses electronic medical records to maintain clinical notes. But the systems they use come from a wide variety of vendors and are often unable to communicate with each other.
That means GPs often can’t send files to specialists, share imaging such as MRIs, or e-prescribe. (Almost half of prescriptions are still written by hand.) Sometimes, two departments within the same hospital can’t even communicate electronically.
Because of this lack of interoperability, most everyone falls back to the tried and true (and flawed) method, the fax. When you send a fax, it can lie around in the machine, which is a privacy issue; fax machines run out of paper, and don’t have much memory. To receive information, it has to be fed manually into a machine.
A new movie, Falling Through The Cracks: Greg’s Story, underscores some of these issues.
Greg Price was an Alberta man who was diagnosed with testicular cancer at age 30 and died of a blood clot a year later in May, 2012, after much bureaucratic bungling, including faxed referrals to specialists being lost and ignored.
In the movie, which is designed to teach medical students and practitioners about avoiding medical errors, the camera often zooms in ominously on the fax machine.
It should indeed be looked upon as an object of dread.
One study conducted in Hamilton, Ont., found that one in five faxed requests for consultations – notes sent from doctor to doctor – do not even get a response.
What makes Mr. Price’s story chilling is that it is not at all uncommon. Studies have shown, time and time again, that about half of all medical errors are the result of communication problems.
It is all the more important in an age when many patients have multiple chronic illnesses and a variety of health care providers. Consider that the average frail elderly patient sees two GPs and five specialists in four different clinical settings, and their records are often still paper-based. The fact that their medical files are scattered about like seeds in the wind rather than in one central electronic medical record is unconscionable.
In this country, you can be rushed to the ER, and your family doctor will have no idea you have been there; if the ER wants records from your specialist, they will likely have to get them by fax, during daytime business hours; and, if they want to know your medication history, they likely will have no idea how to contact your pharmacist.
Billions and billions of dollars have been spent creating massive health information systems, but we still don’t have the basics down, such as a single electronic medical record (EMR) with a patient’s medical history, accessible to all appropriate health providers.
The technology exists. It’s affordable, and it’s essential. But to make way for the new, we have to usher out the old. Fax machines belong in a museum, not in 21stcentury medical practice.
Published on: February 18, 2018 The Vancouver Sun
Some facts about B.C.'s PharmaNet as a mother calls for better use of system
VANCOUVER — Some facts about PharmaNet, British Columbia’s unique network that records information about prescription medications:
— PharmaNet was launched by the Health Ministry in 1995 mostly as a billing system, but it became recognized as a valuable tool to access prescription records.
— PharmaNet has been available in emergency departments since the 1990s.
— The College of Physicians and Surgeons of British Columbia made its use compulsory in walk-in clinics and methadone clinics in 2016 after the province declared a public health emergency in response to increasing overdose deaths.
— Doctors say PharmaNet has great potential but an installation fee, monthly charges of about $10, and its time-consuming process are disincentives.
— The Ministry of Mental Health and Addiction says as of December 2017, about 6,500 physicians working in private community practice were eligible for PharmaNet, but only 3,918 have access to the system. It says work is underway to develop an improved prescription monitoring program.
— Beth Sproule, a pharmacist and clinician scientist at the Centre for Addiction and Mental Health, says many provinces now have drug information systems but unlike PharmaNet, they do not provide real-time data to doctors: “The provinces are talking to each other, looking at best practices. There’s a lot of work going on, looking at the prescription monitoring side of things.”
Top 10 tips to protect your inbox, computer and mobile device
To some people, spam messages are simply a nuisance cluttering up their inboxes, but, spam messages can actually pose a real threat to your privacy. They can spread spyware and other types of malware, which can compromise your computer and mobile devices, and collect your personal information without your knowledge. However, there are measures you can take to reduce the risk of:
- Your email address being collected and targeted by spammers in the first place;
- Inadvertently launching malicious software from a spam message in your inbox; and
- Your computer or device being compromised.
Protect your e-mail address from being harvested: Spam starts with a practice called “address harvesting,” where computer programs indiscriminately collect email addresses that are sold to spammers. And so, your first line of defence is protecting your email address. Here are some ways to do this:
- If posting your email address to a website, do not use the “@” or “.” symbols. Instead, use a format such as "jane at myDomain dot com". This can help prevent "spambot" software, often used to seek out and extract email addresses online, from recognizing it.
- Use a primary email address for your trusted contacts and consider creating additional addresses for use in online activities, such as filling out forms or joining communities. These addresses can be easily changed if they are harvested and you start receiving spam.
Protect your inbox from being a launchpad for spyware and other types of malware: While address harvesting leads to spam, spam may spread spyware, which can transmit your personal information to unauthorized parties. In some cases, your key strokes can be monitored, revealing sensitive information like account passwords. To help avoid this:
- First and foremost, don’t open e-mails from an unfamiliar person or organization. Deleting mail from unknown senders can avoid a host of future problems.
- But, if you do, don't reply to spam as that can confirm your address as being active and cause you to receive more spam. For the same reason, never click on a "remove" or "unsubscribe" link in a suspicious spam message. You may be unwittingly “subscribing” to receiving even more spam.
- And don’t click on links or attachments in an e-mail if the message is suspicious. They may be harbouring malware, which, if unleashed from your inbox, can jeopardize your privacy or compromise your device.
- Malware can even come from the accounts of your friends or other known sources if their computers have been hijacked. So, if you are in doubt about an attachment, don’t reply to the email itself and before opening it check with the sender by phone or in person. In other words, if an email from a trusted source seems out of character it may indeed be from an altogether different character.
- Report unsolicited e-mail containing suspicious attachments or content to the Spam Reporting Centre at www.fightspam.gc.ca. By analyzing accumulated reports and identifying trends gathered by the Centre, the Office of the Privacy Commissioner of Canada is working with its enforcement partners to identify address harvesters and sources of spyware for investigation.
Protect your device or computer: Think of these next steps as a sort of insurance policy for your device in the event your first two lines of defence fail:
- Install security software from a reliable company on your computer. Security software should include features like anti-spam, anti-virus, anti-malware and a firewall.
- Ensure your operating system and other software suites, including security software, are set to automatically update. If you’re not sure how, use your “Help” function and search for “Automatic Updates.”
- Don’t acquire security software in response to unexpected calls, messages or pop-ups. This type of marketing is commonly used for malicious purposes. Instead, only download security software from web sites you know and trust. Free software might sound appealing but can hide malware. In the same vein, apps for your mobile device should only be downloaded from reputable marketplaces.
To find out more about the Office of the Privacy Commissioner of Canada’s responsibilities under Canada’s anti-spam legislation or “CASL”, Canada’s law against spam and other electronic threats, visit www.priv.gc.ca/casl
For information about CASL overall, visit www.fightspam.gc.ca.
April 3, 2017
Man arrested in relation to PharmaNet privacy breach
One man has been arrested in connection to a series of PharmaNet breaches that may have compromised the personal medical information of about 20,500 British Columbians.
Vancouver police executed a search warrant at a home in Richmond on March 23 and arrested a suspect. Investigators believe the man gained unauthorized access to the provincial online prescription-medication information system and used patients’ personal data for fraudulent purposes.
The man, who hasn’t been identified, faces a number of identity-theft-related charges, said police. Charges haven’t been laid.
The Health Ministry characterized the breach as a product of “cybercrime” that targeted doctor and medical clinic offices and PharmaNet service vendors.
“Through forensic analysis, we have learned that several breaches, which have occurred since July 2016, are connected,” said spokeswoman Lori Cascaden.
In February, the Health Ministry sent out letters to about 7,500 people affected by the breach, which officials became aware about after users and vendors reported incidents of “suspicious access.”
Since then, another 13,000 people may have had their PharmaNet information accessed, said the ministry Monday.
In the majority of cases, the suspect is believed to have accessed patients’ profiles, which contain their name, address, gender, date of birth and personal health number. In some cases, information such as the patient’s medication history for the last 14 months was also viewed.
To mitigate the risk of identity theft, the government said it will provide free credit monitoring to affected individuals. People who had their personal information compromised should expect a letter on how to access this service.
The ministries of Health, Finance, and Technology, Innovation and Citizens’ Services have launched an investigation and taken immediate steps to stop the breaches, and is working to implement “more robust security measures” with PharmaNet vendors, said the health ministry.
An independent security review of PharmaNet and an overall modernization of the system, which would include security enhancements, are also underway.
Read the full Vancouver Sun story
February, 2017
BCCLA says government should tell all PharmaNet patients how to avoid data breaches.
“You go into your pharmacy and say you want to lock down your records with a key word,” BCCLA policy director Micheal Vonn said Thursday. “With a key word, you have to give it to them every time you fill a prescription, but you know that only the people who are attending to your health care have access to your records.”
The PharmaNet system links all B.C. pharmacies to a central set of data systems and logs every prescription dispensed in the province.
February, 2017
Your password: The key to your personal information.
Think of your password as a guard that stands between your personal information and potential online risks. Given the best protective armour, the chances of anything getting through are greatly minimized.
When you create passwords with combinations of letters and numbers that are unique for every one of your online accounts, you'll make it more difficult to unlock your identity – keeping your information safe and secure. You should password-protect all your devices: computer, laptop, tablet, smartphone, etc.
What makes a strong password
Many people choose a password that's easy to remember – like an address, pet's name or special date – and use it over and over again. The thing is, attackers try these first because they're pieces of information that are easy to obtain.
To protect your passwords online, follow these tips:
- Make sure it's a minimum length of eight characters.
- Use a combination of upper and lower case letters and at least one number.
- Include at least one character that isn't a letter or number.
- Be creative. Use the first letter of each word of a memorable sentence or phrase, then make it even tougher by changing some of the letters to numbers (e.g. use a "3" to replace an "e").
- Try a mix of your pet's name, your favourite numbers, the street you grew up on or other combinations.
June, 2016
College of Physicians and Surgeons of BC adopt new professional standard on safe prescribing.
“Currently, physicians are required to have PharmaNet access in methadone clinics, and walk-in and urgent care settings. The College Board endorses the concept of mandatory use of PharmaNet for BC physicians at all points of clinical care.”
June 2, 2016
Vancouver Sun, Health Issues Reporter, Pamela Fayerman
B.C. doctors have become the first in Canada to be legally bound by strict new standards for prescribing opioids and other addictive drugs.
The mandatory prescribing program of the College of Physicians and Surgeons of B.C., which took effect Wednesday, comes about because of an epidemic of narcotic addictions and deaths. Doctors who don’t follow the mandatory, professional standards could face complaint hearings and disciplinary actions like fines and licence suspensions.
The standards replace guidelines that were only recommendations on proper and safe prescribing of pain medications, sedatives, stimulants and other addictive medications. The guidelines allowed for some discretion; the new standards do not.
“It’s not a matter of if, when or maybe,” said Dr. Ailve McNestry, deputy registrar of the College, referring to the new standards.
“Unsafe prescribing needs to stop,” said Dr. Gerry Vaughan, president of the College’s board. “The new document clearly states what our registrants must and must not do when prescribing certain classes of drugs, especially if there is a risk of misuse or diversion.”
Last year, up to 200 doctors were ordered by the College to take educational programs to learn how to properly prescribe opioids and other addictive drugs.
Under the standards, doctors must now have discussions with patients about alternatives to opioids, especially for conditions like low back pain, headaches and other ailments that don’t require such medications. Doctors must take careful patient histories and do a risk-benefit analysis to consider if opioid therapy is safe.
McNestry said some mental health patients may be vulnerable to addiction, as are patients who have abused alcohol or come from families where addiction is a problem. Doctors must review PharmaNet records to see if a patient has taken such medications, because some individuals doctor-shop in order to collect more pills to either use themselves, give to others or sell on the street. If doctors do end up prescribing such medications, they are now required to start with the lowest dose, for a short time period, and monitor patients frequently.
While some opioids like fentanyl are illegally imported into B.C. or manufactured here by organized crime networks, the College says doctors have also had a role through inappropriate prescribing of opioids and other medications.
Dr. Perry Kendall, the provincial health officer, said a few months ago that B.C. has “a public health emergency” and as many as 800 people may die from opioids in 2016, almost double the number in 2015.
McNestry said B.C. is unique in introducing standards. Provinces have historically taken only an educational approach to prescribing recommendations.
“We are now calling these legally enforceable standards. Our mandate is public protection and if education doesn’t (achieve) that, then we need to do something more,” she said. While chronic pain doctors and their patients may have “valid”concerns about how the changes will affect them, McNestry said the College must do more to stop the overuse of such medications.
“There’s just too many people suffering from the side effects of high dose opioid therapy. There are people who are being prescribed dangerous combinations of drugs (opioids and sedatives), leading to people stopping to breathe.”
According to IMS Brogan, which monitors pharmaceutical sales, Canadian doctors have been heavy prescribers of opioids, writing 53 prescriptions for every 100 people. McNestry said one doctor who came to the attention of the College recently had prescribed 80,000 opioid tablets in a three-month period.
The new standards are based on a set published in March by the U.S. Centers for Disease Control and Prevention. The B.C. College and its board adopted them because they didn’t want to wait any longer for proposed new Canadian standards. The current national guidelines are six years old.
McNestry said coroner’s reports, which are reviewed by College officials, showed that a disturbing number of people who died of overdoses were never prescribed the medication that killed them, which means they had obtained drugs illegally. A Vancouver Sun series earlier this year showed that some health professionals steal opioids from hospitals for their personal use or sell them on the streets.
February 2016
From ISMP Canada
Five Questions to Ask About Your Medications
Patients are at high risk of fragmented care, adverse drug events, and medication errors during transitions of care. Ensuring safe medication transitions is complex. It requires patients to be an active partner in their health to ensure that they have the information they need to use their medications safely.
ISMP Canada, the Canadian Patient Safety Institute, Patients for Patient Safety Canada, the Canadian Pharmacists Association and the Canadian Society for Hospital Pharmacists have collaborated to develop a set of 5 questions to help patients and caregivers start a conversation about medications to improve communications with their health care provider.
It may be particularly helpful for patients to ask these questions at transitions of care. Examples include:
- doctor's appointment (e.g. family physician or specialist, dentist)
- interaction with a community pharmacist
- discharge from hospital to home
- visit by home care services
November 2015
Drug safety tool being ignored by B.C. doctors
Make PharmaNet check mandatory, report urges
Forcing doctors to register with B.C.’s prescription database would help ensure patients are not receiving too many of the dangerous opioids behind fatal overdoses, addiction and other serious problems, according to a new report.
Less than a third of British Columbia’s physicians are using PharmaNet, the provincial system that records all prescriptions, according to a report released
Check these links
The Centre for Excellence
in HIV/AIDS
CBC News
Vancouver Sun
Globe & Mail
PharmaNet records data such as the drug name, dose, quantity, prescribing doctor and duration for all prescriptions dispensed in B.C.’s pharmacies. All pharmacists can access it and physicians working in B.C.’s methadone clinics or transient-care settings, such as hospital emergency departments or walk-in clinics, must be able to use it. But many other physicians have been reluctant to sign up and pay the $8 monthly fee to access PharmaNet, according to Evan Wood, co-director of the Urban Health Research Initiative at the B.C. Centre for Excellence in HIV/AIDS.
That’s a huge problem, he said, because more than 70 per cent of the province’s doctors may be writing opioid prescriptions without knowing their patient’s history with the drugs or whether they are already being prescribed the dangerous form of pain medication from another doctor.
Without access to PharmaNet, doctors may also be unsure whether someone is receiving benzodiazepines, the risky pharmaceutical class of tranquilizers like valium or ativan that are often linked to opioid-related deaths in B.C., Dr. Wood added.
Globally, Canadians are the second-largest per capita consumer of opioids, a family of pain medications that includes oxycodone, hydromorphone, morphine and fentanyl. Deaths tied to the synthetic opioid fentanyl have spiked across the four largest provinces in recent years, with fatal overdoses increasing nearly seven times in B.C. from 13 in 2012 to 90 last year, according to a national network of drug researchers.
Dr. Ailve McNestry, deputy registrar for the College of Physicians and Surgeons of B.C., said her agency’s board will likely review and approve new guidelines this January mandating all clinicians use PharmaNet, and it could take up to a year for doctors to make the technological change.
“Most younger physicians, who have no technological challenges, would just say ‘Of course [I use PharmaNet],’” Dr. McNestry said. “It’s mostly about the hassle factor: so it would be physicians who are more of my generation who would have to read the instruction manual and figure out how to connect with PharmaNet through their electronic medical records.
“We’re the only province in Canada, I think, that has access to such an informative database and not using it is not justifiable any more.”
The experts’ report also called on the college to impose a maximum dose for opioid prescriptions, to cut down on supplying of the black market and abuse of the drugs, and for more investment in addiction care and education.
In 2013, more deaths in British Columbia were linked to opioids other than heroin (about 3.5 deaths per 100,000 people) than to motor vehicle accidents involving alcohol (just over 1 death per 100,000 people), according to Tuesday’s report.
Charles Webb, president of the association representing B.C.’s doctors, was unavailable for an interview before press time, but said in an e-mailed statement that his organization supports the use of PharmaNet “to ensure the safe prescription of opioids, particularly for patients unfamiliar to physicians at the point of prescription.”
Provincial Health Minister Terry Lake said he was surprised so few doctors reported using the database. He said he was committed to talking with the provincial medical association and college to increase participation in the system – something he said might be inevitable in coming years as all patient records are digitized.
Mr. Lake welcomed the new report, stating the province has made significant progress on the issue, through cracking down on pharmacies dispensing methadone illegally, and investing $3-million last year into new ways of treating substance addiction and Dr. Wood’s research at the centre.
“There’s a lot of blame going on in terms of prescribing practices, but I remember distinctly in the late ’80s, early ’90s, people said that physicians weren’t treating pain well enough, that people were going without good pain medication because of physicians’ fear or antipathy toward using opioids,” said Mr. Lake. “What we saw was the pendulum swung and it swung too far, so we’re seeing a lot of prescription opioid abuse and dependence.
“Now it’s time to bring it back into balance and use opioids appropriately.”
© Copyright (c) The Globe & Mail
July/August 2015
Walk-in clinics in B.C. told to offer continuing care to patients
Under new rules, clinic doctors must offer to be primary-care physician for patients who do not have a family doctor
The walk-in or urgent care clinic that you visited just once is obliged to be your “medical home” if that’s what you need and want, according to new standards set by the College of Physicians and Surgeons of BC.
Formerly, there was an expectation that such clinics became your primary care clinic of record after three visits.
Under beefed-up guidelines, walk-in clinics will be held to the same high standard as those where patients book appointments. That means doctors at walk-in clinics must keep excellent medical records, contact patients with lab or other diagnostic test results, send copies of reports to other doctors who need them, offer to be the primary-care clinic for patients who need a regular place to go, and schedule periodic screening and prevention checkups.
Dr. Heidi Oetter, CEO and registrar of the College, said professional standards and guidelines were updated with stronger language to let doctors and patients know there aren’t different standards of care for traditional medical clinics and walk-in clinics.
If patients have no other place to go, then walk-in clinic doctors must offer to be the patient’s primary care physician through a “verbal invitation.” They can no longer consider a patient’s visit as a one-off, she said,.
Oetter said the College hears regular complaints from the public that walk in clinics “cherry pick” the easiest cases. But even patients with complex or chronic illnesses should be able to depend on walk-in clinics for continuing care, she said. If it’s not offered, patients should feel comfortable demanding “what they need.”
The College also expects every walk-in clinic to have a medical director who is a doctor, not a business person, so the College can communicate “doctor to doctor.” The medical director must ensure compliance with College standards. Doctors at such clinics can’t delegate followup of medical care and lab tests to staff who are non-physicians.
The College is also insisting walk-in clinics provide after-hours coverage and have access to PharmaNet so they know what prescriptions patients are taking. Oetter said the latter rule arose after investigations which found evidence of prescription fraud throughout the Lower Mainland. One person got more than 250 prescriptions, from multiple physicians, and filled them at 34 different pharmacies from 2007 to 2013. The College found fault with 46 physicians who had deficient prescribing practices.
“This case serves to remind physicians of the important role they play in mitigating this public health problem, which starts with prescribing medication to patients according to current prescribing standards and principles. This includes taking the time to conduct an appropriate exam, asking the right questions, and checking the patient’s PharmaNet profile before issuing a prescription — especially for a narcotic.”
January 2015
BC Law Firms get caught with a ransom virus, stemming from bad email...is healthcare next?
We find it interesting that the authorities quoted in the article, and not the software experts, seem to think that no damage was done—even though the hackers obviously had full access to the client machines.There seems to be a strong wish to deny the danger that comes from email hacking.
Here's the litmus test: Would you be okay sending your personal VISA number, expiry date and CRC code by email?
Read the full story.
November 2014
New Research
The New York Times on November 12, 2014 reported that a Pew Research Center study released the same day indicates a majority of adults feel that their privacy is being challenged along such core dimensions as the security of their personal information and their ability to retain confidentiality.
September 2014
BC Women's Hospital celebrates one year communicating with patients by secure email and eForms.
The Comprehensive Abortion and Reproductive Education (CARE) program at BC Women’s Hospital & Health Centre offers counseling and abortion services to women who are experiencing unplanned pregnancies or to those who require an abortion for genetic or medical reasons.
The CARE clinic takes its appointments by telephone. Concerns included significant time on hold, averaging up to 45 minutes, patients desiring to make appointment outside of regular office hours and on weekends, and patients’ desire to use Internet services for appointments and medical information.
September 2014
Medinet Launches Rejection Management Service for Medical Billing.
Service takes off as doctors realize the thousands of dollars of income lost in rejected claims. Doctors are busy, and our Rejection Management package recovers lost income and helps keep the practice accounting up to date.