Medical conditions and driving: Changes from RoadSafetyBC

Issue: BCMJ, No. 2, March 2018, Page 131 Council on Health Promotion
By: Helen Thi, BA Chris Rumball, MD

RoadSafetyBC is responsible for assessing and determining driver medical fitness to ensure the safety of all road users. Through the Driver Medical Fitness Program, RoadSafetyBC ensures drivers are provided the maximum licensing privileges possible, while considering the effects that medical conditions may have on the functions necessary for driving.

Family physicians are familiar with forms such as the Driver’s Medical Examination Report, which patients may have received with a requirement to be completed within 45 days. Additionally, physicians may become concerned about a patient’s medical fitness to drive, prompting them to submit a Report of a Condition Affecting Fitness and Ability to Drive. The issue of assessing a patient’s ability to drive may be challenging for physicians and can impact the relationship they have with patients and their families. However, physicians also play an important role in ensuring that their patients remain medically fit to drive, for their own safety and the safety of others.

Introduction of the Enhanced Road Assessment
As of 1 March 2018, RoadSafetyBC will be using a new Enhanced Road Assessment (ERA) administered by ICBC to evaluate drivers of any age who may have a cognitive, motor, or visual deficit that could impair their ability to drive safely. The results of the ERA will be reviewed by RoadSafetyBC, along with all other information related to the individual’s medical fitness to drive, in order to make a licensing decision.

RoadSafetyBC may require individuals experiencing one or more medical or functional impairment issues to complete an ERA as part of the process of making a Driver Medical Fitness determination. The requirement to complete an ERA is based on the driver’s medical or functional condition, not age. The ERA is an on-road assessment and will only be provided to drivers with a Class 5 or Class 7 licence, not commercial drivers. The ERA will be used to assess drivers currently referred for an ICBC road test re-examination, as well as drivers who would have previously been assessed by DriveABLE.

RoadSafetyBC and ICBC have been in consultation to develop and implement the ERA, which will include the following changes:

•    ICBC’s existing 75 minute re-exam will be extended to 90 minutes and will include new components to assess driving errors that may result from cognitive impairment and other areas of medical concern.
•    A mid-assessment feedback component will be incorporated to allow drivers an opportunity to improve their driving for the remainder of the assessment.
•    The ERA will be delivered by ICBC Driver Examiners (DEs) at approximately 70 ICBC locations throughout the province.
•    The enhanced assessment will not include an in-office (computer-based) component.
•    The ERA will be conducted in the driver’s own vehicle.

Impact on clinical practice
With the change to the ERA, DriveABLE assessments will no longer be used by RoadSafetyBC to make licensing decisions. Physicians who think a patient requires a driving assessment due to cognitive impairment or other medical condition may recommend that RoadSafetyBC refer the patient for an ERA.

Additionally, any DriveABLE assessments completed after 28 February 2018 will not be reimbursed and the results will not be used to make a licensing decision. 
RoadSafetyBC requests that medical professionals continue to provide detailed information by completing and submitting the updated Report of a Condition Affecting Fitness and Ability to Drive form, which no longer lists DriveABLE as a recommendation, or when a patient brings a Driver’s Medical Examination Report for completion. 

Drivers who reach age 80 will continue to be required to have their physician complete a Driver Medical Examination Report every 2 years. This does not mean they will be required to take an ERA, or other assessment. RoadSafetyBC will review the information provided in the Driver Medical Examination Report, along with all other relevant information on file, and determine whether further information or assessment is required. Referrals to the ERA will be made based on the entirety of the information on a driver’s file, which may include information from medical professionals, police, and the individual’s driving record.   
For additional information on the ERA, visit RoadSafetyBC’s website (https://www2.gov.bc.ca/gov/content/transportation/driving-and-cycling/dr...).
—Helen Thi, BA
—Chris Rumball, MD

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This article is the opinion of the Emergency and Public Safety Committee, a subcommittee of Doctors of BC’s Council on Health Promotion, and is not necessarily the opinion of Doctors of BC. This article has not been peer reviewed by the BCMJ Editorial Board.

Helen Thi, BA, Chris Rumball, MD. Medical conditions and driving: Changes from RoadSafetyBC. BCMJ, Vol. , No. 2, March, 2018, Page(s) 131 - Council on Health Promotion.


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