Scottish inventor Alexander Bain received the first patent for a fax machine in 1843. Over a century later, in 1964, the Xerox Corporation introduced and patented what many consider to be the first commercialized version of the modern fax machine.
In the 1970s and 1980s, faxes became, and remain, the mainstay for exchanging information between family physicians and specialists in the patient referral process. There’s always been a yin-and-yang as to how to improve the process, with each group offering advice to the other on how it should do its job.
Reconfiguring the patient referral process may not have a significant financial impact on the sustainability of Medicare but, depending on what occurs, it could align with one of the values of the Association of Canadians for Sustainable Medicare, Your Voice for Patient Choice™ – “timely access to quality care.”
Now, the College of Physicians and Surgeons of Alberta [CPSA], which is the medical profession’s regulator body, has introduced new rules for “acknowledging and responding to referral requests.”
As of January, 2017, a physician who is asked to provide a consult on a patient has:
- 7 days to acknowledge receipt of the request for the referral.
- 14 days to inform the referring physician “whether you can accept the referral.”
- 14 days to contact the patient “to schedule an appointment or to confirm the status of the referral.”
- 30 days to provide the referring physician “with a written report after your first appointment with the patient.”
Will the college’s decision be the demise of fax machines in physician offices? One Edmonton company that hopes so is ezReferral. According to Edmonton family physician Dr. Denis Vincent, his company’s specialized web-based program captures all communications between the physicians and the relevant contact with the patient. In other words, there’s a complete log.
- Date the family physician requested a consult for a patient.
- Content for the consultation
- Date the consultant responded
- Accept/do not accept the consult
- If accept, details for an appointment
- Date the patient informed about the appointment
- Date the consultant provided a report to the family physician
- Date the family physician informed the patient
Dr. Vincent became involved in this venture because “a patient, a young mother passed away as a result of the tragic shortcomings in the current referral process.” Our company “solves the problem of lost referrals. We are the only service that can ensure that your referral to a medical specialist never falls through the cracks.”
He believes that the private sector can very effectively bolster a publicly funded health-care system. “We consider ourselves a social enterprise. We want to solve a serious problem in our health care system by turning it into an opportunity, and offer a real solution that doesn’t burden our health care system and doesn’t cost the taxpayer any more money.”
ezReferral includes alumni from Saville Systems. “Our project has attracted an experienced team of business people and IT experts who have committed themselves to launch a viable venture that will prevent suffering and save lives. As a lean startup, we apply sound business practices to ensure success,” according to Dr. Vincent.
Companies currently providing electronic health records [EHRs] and electronic medical records [EMRs] and others with expertise in health-care information management are undoubtedly determining if they will enter into this niche market.
But, what happens after the referral? What happens to a person requiring so-called “elective” surgery? For example, someone who requires cataract surgery and falls outside the quota that the government imposes to restrict how many surgeries each ophthalmologist can perform.
Canadians for Sustainable Medicare believes Canadians deserve to have a choice to receive their care in Canada outside the straitjacket of the Medicare monopoly.
- The right to have a choice as to when, where and from whom you can receive your health care.
- The right to choose a hospital, in either the public or the private sector.
- The right to choose a physician, in either the public or the private sector.
In 2015 the Supreme Court of Canada recognized the power and importance of “choice” in its ruling on a person’s autonomy, specifically a person’s right to choose to die without undue pain and suffering. We commonly know it as assisted suicide.
But, what about a person’s right to live without undue pain and suffering? For example, not being on a waiting list for months, even years.
The College of Physicians and Surgeons of Alberta may have taken an important step to streamline the referral process and to expedite medical consults. But, will it all be naught if Medicare can’t or won’t provide timely access to quality care? Will it all be for naught if Canadians don’t have choice? And, will the fax machine suffer the fate of the typewriter?