Getting involved.

In keeping with one of our strongest core beliefs, that active participation is essential to ensuring that all Canadians continue to have access to affordable healthcare, Green Shield Canada recently provided the Ontario Ministry of Health and Long-Term Care with commentary regarding recommendations made by the Health Professionals Regulatory Advisory Council (HPRAC) report:

Critical Links: Transforming and Supporting Patient Care
A Report to the Minister of Health and Long-term Care on Mechanisms to Facilitate and Support Interprofessional Collaboration and a New Framework for the Prescribing and Use of Drugs by Non-Physician Regulated Health Professions

As the HPRAC states, “Building on HPRAC's previous advice to the Minister over the last two years, this report focuses on interprofessional collaboration, and the prescribing and use of drugs by non-physician regulated health professions and scope of practice reviews for the professions of medical laboratory technology and medical radiation technology.”

Being responsive.

Green Shield Canada recommends topics for further discussion.
Green Shield Canada applauds the HPRAC for developing the Critical Links report based on the admirable principle of improving access to healthcare. Although we support in principle many of the HPRAC recommendations, we suggest the following topics for further discussion:

• Financial impact of regulatory changes – any regulatory changes should not impact employers and other benefit plan sponsors in Ontario, nor should these regulatory changes impact Ontarians currently lacking supplemental health benefits. If the service is currently being paid for from the public purse, it should continue to be covered publicly regardless of the health professional delivering the service.
• Training regarding safe, effective and affordable use of products and services
– within their respective scopes of practice, each health professional will need to learn safe, effective and affordable practices in accordance with accepted treatment guidelines for each disease state.
• Full and complete collaboration between all healthcare providers – as additional disciplines become able to prescribe and dispense drugs, mechanisms need to be put in place to avoid the inappropriate and potentially harmful interactions that may arise (e.g., drug-to-drug and/or drug-to-disease) due to multiple prescribers and lack of an accessible and comprehensive Electronic Health Record.
• Cost benefit scenarios – although reduced costs may be achieved as other health professionals provide similar services at potentially lower costs, improved access may increase the costs associated with the treatment of minor conditions that would otherwise have been untreated or self-treated.
• Conflict of interest issues – although expansion of the scope of practice of various health professionals may be beneficial, strategies will need to be put in place to address any conflict of interest concerns and, when necessary, respond to potential conflicts (i.e.,
  between traditional dispensing role versus potential prescribing role).
• Effectiveness, efficiency and patient satisfaction – the new models of care will require ongoing evaluation to ensure they are benefiting patient care.

View the complete Green Shield Canada submission. The Critical Links report is available at hprac.org.