March Messenger 2018

Dina Baras CPSA


Get a refund on your 2018 Annual Renewal Fee!

Check your email March 22nd and share your feedback.

Complete the 2018 CPSA physician survey and you could win a prize worth nearly $2000!

The survey will take 15-20 minutes of your time and will remain open until April 16, 2018. Responses are anonymous, and all feedback will help us improve CPSA programs and services.

If you complete the survey and choose to submit your name (separate from your survey responses), you could win a refund of your 2018 Annual Practice Permit renewal fee (value = $1960).

Look for an email from the CPSA March 22nd. You’ll find more details and a link to the survey.

We look forward to your feedback.


Family Doctor charged with incomplete medical record submission to the College

He returns to practice following a two-week suspension and must cover the cost of the investigation.

During a College of Physicians & Surgeons of Alberta (CPSA) investigation of Dr. Stanley Fu’s management of a diabetic child, Dr. Fu submitted incomplete patient records. Specifically, the records submitted for the investigation truncated his sign-off for a particular patient visit. Dr. Fu acknowledged he did not sign off the clinical record until approximately three months post-visit.

In addition, investigators learned Dr. Fu billed the Alberta Health Care Insurance Plan (AHCIP) for seeing a patient on a date when, in fact, he did not. That date only included a conversation with the patient’s mother.

The Hearing Tribunal accepted a joint submission by each party, which included Dr. Fu’s acknowledgement of his misconduct. Dr. Fu will receive a two-week suspension from practice, and had to pay the costs of the investigation and hearing ($10,692.41).

Commentary

The CPSA and the Canadian Medical Protective Association (CMPA) both advise physicians to ‘sign off’ on a clinical record as soon as possible after the encounter. This avoids the appearance of later altering medical records. Equally important: physicians should never truncate or edit patient records they are submitting to the College for an investigation.

The inappropriateness of billing AHCIP for a service not provided is self-evident.

Family Doctor charged with inappropriate use of Netcare

Inappropriate use of Netcare to access a romantic partner’s personal information requires Dr. Yuliya Kolodenko to complete privacy training.

Between 2013 and 2015, Dr. Yuliya Kolodenko used Netcare to access the personal health information of a physician she was romantically involved with (“Dr. AB”). Dr. Kolodenko also shared her Netcare login credentials with Dr. AB, who used them to access confidential records.

At her hearing, Dr. Kolodenko identified 10 distinct occasions where she used Netcare to access Dr. AB’s information. Despite having done so at his request, she acknowledges her use of Netcare in these cases was inappropriate.

To avoid a 30-day suspension, the Hearing Tribunal directed Dr. Kolodenko to complete additional privacy training[i] and practise for 12 months without any further privacy incidents. She must also change her Netcare login credentials, and reimburse the College for the costs of the investigation and hearing ($10,706.24).

Commentary

Ask yourself; am I in the circle of care for this patient? Do I need to access this information to provide care?

Always consider why you’re accessing patient information before you log in to Netcare. The privacy of a patient record, whether electronic or paper-based, is absolute. Guidance to the profession has been consistent over time: a physician should never access the personal health information of an individual where there is no physician-patient relationship or professional consultation. In the context of a personal relationship with another healthcare provider, accessing this information is in conflict with the CMA Code of Ethics. Similar cases have resulted in suspension of a member’s practice permit and prosecution in the courts.

OBGYN found guilty of unprofessional medical records documentation

Case prompts change in College’s complaints process

Background

A patient complaint was made against Dr. Paul Henning over the placement of an intra-uterine contraceptive device and his management of post-procedure care. Although an investigation did not find concerns with the care Dr. Henning provided, there were deficiencies with his medical records and coordination of follow-up care. The Complaints Director (CD) sought to resolve this issue informally.[ii] Dr. Henning was willing to take continuing professional education in medical record keeping, and was actively making changes to his office processes to improve the coordination of post-procedure care.

The complainant rejected informal resolution; therefore, the CD dismissed the original complaint[iii] and informally directed Dr. Henning to improve his chart documentation and office processes. The complainant then appealed the decision to the Complaint Review Committee (CRC). After reviewing all findings, reports and submissions, the CRC referred the case to a formal Hearing since the complainant did not agree to the resolution.

At the Hearing, the College and Dr. Henning’s legal counsel made a joint submission. Dr. Henning acknowledged his medical records did not meet the profession’s standard on Patient Record Content. Both parties proposed Dr. Henning should receive a caution and pay 50% of the Investigation and Hearing costs ($6,013.65). The Hearing Tribunal accepted the joint submission.

Commentary:

In this case, concerns with Dr. Henning’s medical records came from the investigation – not from the original complaint. In the future, Investigation Findings that go beyond the original submission will likely be treated as a separate complaint initiated by the CD.[iv] This will allow a member in a similar situation to manage the complaint informally (rather than in a formal disciplinary hearing).

[i] This was in addition to the privacy training the Office of the Information and Privacy Commissioner (OIPC) and Covenant Health (her employer at the time) required Dr. Kolodenko to complete following their own investigation.

[ii] Provided under Section 55 (2)(a.1) of the Health Professions Act

[iii] The‘de facto’ direction without an informal resolution

[iv] Provided under Section 56 of the Health Professions Act


Help guide your colleagues through the College’s new practice review programs

We’re looking for members in good standing to take the lead. Positions are now available for GPR and MSF+ facilitators. Submit your resume today!

Group Practice Review (GPR) Facilitators guide their medical colleagues through the results of a review* that identifies how well their group practice is meeting the CPSA Standards of Practice, identifies group practice quality indicators and shares best practices with other clinics and physicians Facilitators meet in-person with clinic physicians to identify the group’s strengths and opportunities for improvement, and to provide resources to the clinic.

Multi-Source Feedback Plus (MSF+) Facilitators work from home or their clinic and guide their medical colleagues by teleconference through the results of the MSF+ program. MSF+ uses the Medical Council of Canada’s MCC360 survey tool** and data from the College’s Renewal Information Form (RIF) to provide a comprehensive overview of a physician’s practice.

Learn more about GPR and MSF+

Qualifications & Time Commitment: We would love to hear from you if you are in good standing with the College and are available for facilitator training. The time commitment depends on the complexity of the review session but generally ranges from 60- 90 minutes per session and includes facilitating reviews, and the time involved in producing summary reports for the College.

Applications & Questions:  Submit your questions or resume to GPR & MSF+ Program Manager Tanya Northfield, via tanya.northfield@cpsa.ab.ca or 780-969-5005

* This is called a Standards of Practice Implementation (SOPI) review and is conducted by Registered Nurse reviewers.

** MCC360 takes feedback from physician colleagues, non-physician co-workers and patients to provide physicians with a comprehensive look at their abilities as collaborators, communicators, and professionals.