Toolkit and PSP waste, complex care kudos

Kudos to the SGP, BCMA, and MSP for the chronic disease management, complex care, and other new billing codes that have significantly improved remuneration and encouraged good care in family practice.

In complete contrast, the Practice Support Program (PSP), on which millions will be spent for imaginary returns, needs to be reconfigured now. This program has groups of physicians enticed away from family and practice to sit about for up to 4 hours with their MOAs for retainers of $370 and $80 respectively, to be walked through some barely conceived no­tions that amount to a complete waste of time and an insult to our intelligence.

I attended a 4-hour session on the infamous ministry toolkit to learn precisely nothing of value, except that as a Wolf EMR user I have no need for the toolkit because what it adds is decidedly unwanted. Wolf already populates the CDM fields automatically, and curiously Clinicare does not, and yet is chosen by PITO (Physician Information Technology Office), necessitating hours of data input with Clinicare if you did decide to demonstrate how much hopeless hoop hopping you will willingly endure (I have been informed that the 6.4 version of Clinicare will populate the CDM fields).

I fail to understand how PITO can recommend, at the taxpayers’ potentially huge expense, a software program that would appear to be dead in the water, and yet exclude open-source EMR such as OSCAR, which works very well at a mere fraction of the cost. Why is PITO cowing to corporate pressure to the detriment of common sense? Why not seek competition from the free-spirited open-source EMR leaders who are developing novel software options to balance the power of big vendors?

The practice management inherent in the ministry toolkit is the epitome of guideline medicine gone astray. Physicians complying are encouraged to do needless testing and measurements to a recipe without regard to age, needs, or informed consent, to the further detriment of good medical care as judged appropriate to individuals followed in longitudinal care.

Now I want to believe that the in­tentions were better than my above analysis, but unchecked, the outcome will be dismal. Family physicians should have guidance and assistance to computerize with a robust, user-friendly EMR. 

Family physicians also need trained practice nurses, possibly shared between practice groups, to monitor and survey CDM and complex care patients and others to be identified, recalling when appropriate, ensuring appropriate testing and delivery of care. That money spent would translate into improved care of these identified populations, in line with what was requested at the first PQID meeting in Vancouver, already years past. 

In the meantime we can all extract and manage the necessary data from a good EMR or paper chart system if we have enough time, help, and energy. I will use the freed-up time of my MOAs since we computerized to fine-tune current methods. I will not take any more currently flavored PSP dollars and do not expect PITO dollars anytime soon, or ever, but sincerely hope we can have some meaningful family practice support and collaboration, soon. 

—Rick Potter-Cogan, MD

Rick Potter-Cogan, MB BCh BAO. Toolkit and PSP waste, complex care kudos. BCMJ, Vol. 50, No. 1, January, February, 2008, Page(s) 12 - Letters.

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