Medicine & Quality Matters

Fall 2016

News for the Interior Health Medical Community

Fall Update from Dr. Alan Stewart, VP Medicine & Quality

A s we approach the end of another calendar year, I want to thank each and every one of you for your hard work and dedication to providing health care in our communities.

We have seen a tremendous amount of change in the last year – for Interior Health and within the Medicine and Quality portfolio. We have said good bye to a few team members and welcomed others. Our organization faces unique challenges in providing health care across such a large geographic area. You will start to see more technology being developed and implemented to support communication between physicians and medical staff at sites across Interior Health. In this issue of Medicine & Quality Matters newsletter for physicians, there are several physician-specific initiatives that focus on enhancing safety for our patients, clients, and residents. These include influenza vaccinations, new medication reconciliation processes, and facility engagement. You can read more about these on pages 2, 3, and 4. There are also initiatives underway to help support you in your day-to-day practice including the physician invoicing portal, iCommitee, and Medical Staff Impact Analysis. I encourage you to read more about these on p. 5. And, of course, I would like to acknowledge our physicians who have received honours for their contributions to their work in health care: Dr. Richard Hooper and Dr. Norm Lea (p. 6 and 7). In my first few months as Vice President of Medicine & Quality, I have seen firsthand the dedication and effort of our physicians and medical staff. Moving forward, my goal is to actively engage with you and all our physician colleagues. I will share news, updates, and information and I encourage you to reach out with any questions or suggestions. Please feel free to contact me at any time at alan.stewart@interiorhealth.ca. Wishing you a happy and safe holiday season, Alan Stewart MD, FRCPC VP Medicine and Quality

Dr. Alan Stewart, VP Medicine

& Quality.

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Flu season & self-reporting for physicians

As you know, influenza is a serious health problem that causes severe illness and death. Hospitalized patients and seniors in residential care are especially at risk. The IH Influenza Prevention Policy is in place to protect vulnerable patients, clients, and residents from the flu while in our care. During the influenza season, all physicians, employees, volunteers, students, residents, contractors, and other individuals covered by the policy must be vaccinated against influenza or wear a surgical/procedure mask when working in an IH facility or in the community where we are providing services to patients, clients, or residents. Once you have received your flu shot, or have made the decision to mask at all times while in a patient-care area in an IH facility, self-report your decision online at https://medicalstaffhealth.phsa.ca. It’s easy and takes only a minute. Self-reporting is important to ensure there is an accurate report of vaccinated health-care workers in the event of an influenza outbreak. Influenza vaccinations are available from a peer nurse immunizer (PNI) or at any community-based public flu

clinic, pharmacies, or physician offices. Immunize BC provides a list of public flu clinics on their website at: http://immunizebc.ca/clinics/flu. On behalf of Health Authority Medical Advisory Committee (HAMAC) and Medical Affairs, a sincere thanks to all for your ongoing commitment to safeguarding our patients during flu season. Questions or comments? Please send them to physicianinfluenzareporting@interiorhealth.ca or contact your local medical leader.

More on MAiD ... Medical assistance in dying (MAiD) information and resources for physicians are available on the Interior Health website, covering a variety of areas:

Education & training Credentialing & privileging Patient request & assessment forms Standards & guidelines

https://www.interiorhealth.ca/AboutUs/Physicians/PhysMAiD

(Just click on the blue “Physicians” tab at the top of the page!)

Dr. Trevor Corneil, VP Population Health & Chief Medical Health

Officer, gets his flu shot.

Get in touch with us:

MAID@interiorhealth.ca 1-877-442-2001

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NEW medication reconciliation

for safe medication practices

In alignment with Accreditation Canada and Interior Health’s Medication Reconciliation Policy (AK0800), working groups have formed to develop processes to guide staff in community programs in medication reconciliation and obtaining a Best Possible Medication History (BPMH). This includes employees in chronic disease management, home health, primary care, and mental health and substance use. As a physician, you may soon receive facsimiles for clients who are found to have discrepancy(s) with their medication regime. Medication reconciliation is a structured process to communicate accurate and complete information about medications across care transitions and should be considered for all clients when medication management is a component of care. Medication reconciliation begins with generating a Best Possible Medication History (BPMH) that lists all the medications the client is taking including prescription, non-prescription, traditional, holistic, herbal, vitamins, and supplements. The BPMH also details how they are

being taken including the dose, frequency, route of administration, and strength if applicable. The BPMH is collected by IH community staff and involves interviewing the client, family, and/or caregivers at certain points of care. The BPMH is compared with PharmaNet, and when medication discrepancies are identified, a fax will be sent to the most responsible prescriber, either within the team or by referral, for resolution. The prescriber indicates which medication(s) should be continued, discontinued, or modified and the reason(s) why. This new process ensures safe medication practices, prevents adverse medication events, and identifies a process for resolving concerns. The above noted working groups includes representatives from IH community programs including: Mental Health and Substance Use (MHSU), Chronic Disease Management (CDM), Public Health (PH), and Home Health (HH). If you have any questions, please contact medrec@interiorhealth.ca.

Doctors technology office

Doctors Technology Office (DTO) is seeking physicians to join in a series of upcoming webinars on information management and information technology (IMIT) related initiatives at the regional and provincial level. The webinars are designed to help ensure closer linkages and provide opportunities for physicians to provide input and feedback. DTO advocates on behalf of and facilitates clinician engagement at a provincial level to ensure that there is a strong physician leadership voice in the design and implementation of IMIT solutions for the health system, particularly those that impact clinical decision-making and clinical workflow.

Physicians that are interested or would like more information can contact DTO at dtoadmin@doctorsofbc.ca. www.doctorsofbc.ca/doctors-technology-office

4

Facility engagement initiative

Participating Hospital City MSA President Facility Engagement Physician Lead(s)

Vernon Jubilee Hospital Vernon Dr. Scott Ainslie Dr. Chris Cunningham

Kelowna General Hospital Kelowna Dr. Bruce Povah Dr. Bruce Povah; Dr. John Falconer; Dr. Michael Humer; Dr. Cara Wall; Dr. Jan McIntosh

Penticton Regional Hospital Penticton Dr. Jacqueline Stewart Dr. Jacqueline Stewart

East Kootenay Regional Hospital Cranbrook Dr. Charles Casselmann Dr. Charles Casselmann

Kootenay Lake Hospital Nelson Dr. Rodica Janz Dr. Rodica Janz; Dr. Martha Wilson

Kootenay Boundary Regional Hospital Trail Dr. Scot Mountain Dr. Scot Mountain

South Okanagan General Hospital Oliver Dr. Juan Venter Dr. Juan Venter

Boundary Hospital Grand Forks Dr. Robert Lewis Dr. Robert Lewis; Dr. David Merry

Golden & District Hospital Golden Dr. Bruce McKnight Dr. Bruce McKnight

Princeton General Hospital Princeton Dr. Tim Van Der Heide Dr. Tim Van Der Heide

Queen Victoria Hospital Revelstoke Dr. Victoria Haines Dr. Victoria Haines

Elk Valley Hospital Fernie Dr. Shayne Soetart Dr. Shayne Soetart

Lillooet Hospital & Health Centre Lillooet Dr. Ian Routley Dr. Ian Routley

Shuswap Lake General Hospital Salmon Arm Dr. Guy De Wet Dr. Guy De Wet

Cariboo Memorial Hospital Williams Lake Dr. Glenn Fedor Dr. Glenn Fedor

The goal of the Facility Engagement Initiative is to give physicians who work in hospitals and acute care facilities across B.C. a meaningful voice to address issues that affect them. It is meant to generate more opportunities for physicians and health authority leaders to work together on issues with the intent of improving patient care, the physician experience, and the cost effectiveness of the health-care system. The Doctors of BC Specialist Services Committee (SSC) provides funding to the medical staff of a facility through the medical staff association (MSA). This initiative allows the MSA to allocate funding to support any number of initiatives, opportunities or projects with a view to improving physician involvement in the decision-making within a facility.

The funding can be used to: Pay for physicians’ time; and, Hire expertise to support the physicians or the

MSA (e.g., a coordinator to provide administrative support; an analyst to track issues, develop business cases and manage projects; a physician-lead to support engagement activities).

To date, Interior Health has 14 facilities actively engaged in the Facility Engagement Initiative. For more information, or to get involved, contact your Specialist Services Committee representative, Dr. Mike Ertel, Executive Medical Director, at Michael.Ertel@interiorhealth.ca.

5

physician initiatives to watch for

Physician Invoicing Portal The claims portion of the Physician Invoicing Portal (PIP) is currently being rolled out across IH allowing physicians to submit meeting, Rural Continuing Medical Education (RCME), Reverted RCME, and locum claims directly to Physician Compensation.

The system allows physicians to track their current and historical claim payment through the process. Training information will be shared via email as areas are added – watch your personal email for more information in the coming weeks. Or, if you have a claim and you would like to use the online system, please email Chelsea Martinick at Chelsea.Martinick@interiorhealth.ca for access and assistance.

The second phase of the PIP implementation will include physician invoicing for specific contracted services including: administrative contracts, sessionals, Medical On-Call Availability Program (MOCAP), and diagnostic imaging (DI). The implementation will begin with administrative contracts in January 2017 with the remainder scheduled to go live early in the new fiscal year.

Training information, including instructions and how-to videos, will be circulated and posted to the Physician section of the IH website at www.interiorhealth.ca/aboutus/physicians as they become available.

iCommittee iCommittee is one of the modules of the Cactus credentialing and privileging software platform. iCommittee is a paperless, secure, and flexible centralized solution that streamlines the committee review process. iCommittee tracks meetings and invites reviewers to electronically participate in the review process.

Reviewers access the applicant’s credentialing information, interact with other reviewers, post comments, and make their recommendations all within the module. The administrator advances the applicant on to the next review until the process is completed.

Implementation of iCommittee is scheduled to begin in December – stay tuned for a schedule of information and training sessions.

Medical Staff Impact Analysis The Medical Staff Impact Analysis (MSIA), formerly known as the Physician Impact Analysis (PIA), provides comprehensive resource/costing information to senior level acute care administrators (both clinical and non-clinical) to support decision making when adding a new specialized medical staff position.

The Medical Staff Impact Analysis considers all of the impacts to the acute site including the types of services the practitioner will both offer and require support for (e.g., lab, diagnostic imaging, medical records, operating room time, specialized equipment, etc.).

Implementation of the MSIA will begin in early December and will be rolled out in phases to all of the acute sites that routinely hire specialist medical staff positions.

Chelsea Martinick (L), Physician Trainer, and Neeta

Tapper, Physician Compensation Accounts

Payable Clerk.

3

6

In early July, the lobby in the Interior Heart and Surgical Centre (IHSC) was named the Dr. Richard Hooper IHSC Lobby, in recognition of Dr. Hooper’s vision and significant contributions to Interior Health (IH) over the past 20 years. Dr. Hooper was born and raised in Vancouver, where he also attended medical school at the University of British Columbia. After completing his residency training in internal medicine and cardiology at McGill University in Montreal, Dr. Hooper returned to Vancouver to join the cardiology department at St. Paul’s Hospital. It did not take long for Dr. Hooper to become aware that patients from rural locations in the B.C.’s south and central Interior needed improved access to cardiac services closer to where they called home. “I remember working in the cardiology department at St. Paul’s Hospital in Vancouver and our rural patients were waiting far too long to get here for treatment,” said Dr. Hooper. “Unfortunately, some of those patients not only suffered; some of them died while waiting. I knew something needed to change.” In the summer of 1990, Dr. Hooper left St. Paul’s Hospital and moved to Kelowna, with the intent of bringing the cardiology programs used in the Lower Mainland to the B.C. Interior. With the support of his wife and their five children, Dr. Hooper began advocating to all levels of government for the creation of a more comprehensive cardiac centre in the Okanagan and to open a cardiac transition program for IH. In 2009, nearly 20 years after arriving in the Okanagan, Dr. Hooper’s efforts paid off when KGH became the first hospital outside of the Lower Mainland and Victoria to perform percutaneous coronary interventions, or angioplasties.

In 2012, other breakthroughs occurred, as construction began on the IHSC at the KGH campus and the first open heart surgery procedure was completed at Kelowna General on Dec. 3. “On behalf of Interior Health, I’d like to thank Dr. Hooper for his many service contributions,” said Interior Health Board Chair Erwin Malzer. “Interior Health’s cardiac programs have saved thousands of lives to date thanks to the efforts of dedicated, compassionate, and hardworking physicians like Dr. Hooper.”

Dr. Richard Hooper honoured Naming Recognition for Vision & Contribution

Dr. Richard Hooper (L) with IH Board Chair Erwin Malzer.

Medicine & Quality Matters 7

IH Executive Medical Leadership

Dr. Alan Stewart, VP Medicine and Quality: 250-862-4010

Dr. Mike Ertel, Executive Medical Director, IH Central: 250-862-4068

Dr. Sue MacDonald, Executive Medical Director, IH East: 250-870-4633

Dr. Malcolm Ogborn, Executive Medical Director, IH West: 778-214-4657

Dr. Curtis Bell, Executive Medical Director, Primary Care: 250-870-5899

Dr. Ron Collins, Executive Medical Director, Quality Improvement & Patient Safety: 250-862-4309

Dr. Harsh Hundal, Acting Executive Medical Director, Residential & Community: 250-469-7070 ext.12245

Dr. Douglas Kingsford, Executive Medical Director, Chief Medical Information Officer: 250-862-4325

Dr. Peggy Yakimov, Executive Medical Director, Physician Support and Practice Enhancement: 250-870-4735

Dr. Norm Lea recognized with RCCbc Award in Excellence in Rural Medicine

Dr. Norm Lea, physician at Arrow Lakes Hospital in Nakusp, recently received one of the Rural Coordination Centre of BC’s (RCCbc) Awards in Excellence in Rural Medicine for 2016. The award honours rural physicians whose contributions to the practice of rural medicine have improved the health and well-being of their community. Norm is the Continuing Professional Development lead for the Kootenay Boundary Division. He moved to Nakusp in 1988 intending to stay for one year, and 28 years later is still practising rural medicine in the community. Norm is also a recipient of the Queen’s Diamond Jubilee medal (2012) for his dedication in ensuring that residents in the community have access to medical coverage and services—specifically, his efforts to ensure the emergency room stays open to provide immediate care when needed. Congratulations, Norm! We are lucky to have you on our team. Find out more on the Divisions of Family Practice website at divisionsbc.ca.