The announcement of a Provincial Attachment System (PAS) has been met with many questions from BC’s primary care physicians:
- “How does it work?”
- “Will I be forced to accept new patients?”
- “Will I be compensated for the additional work of uploading my patient panel?”
...and many more.
The Ministry of Health and Doctors of BC have worked quickly to deliver answers, providing an outline of the Provincial Attachment System, the rationale behind its introduction, details on registering a clinic in the system and instructions on how to upload a patient panel.
Here, we consolidate these details into a quick guide you can use to understand the PAS initiative and what physicians need to do to participate.
What is the Provincial Attachment System (PAS)?
PAS is designed to more effectively connect patients who do not have a family doctor with physicians who are accepting new patients. By creating a more connected system of care, PAS seeks to address the following challenges:
- Patients without a family doctor don’t know how to get one and often try multiple avenues in an attempt to secure care
- Physicians and staff field calls daily from patients desperate for care, creating an additional time strain and moral distress
- Significant inconsistencies exist in regional attachment systems and supports, with some areas having no system at all
- Lack of centralized data makes it difficult to identify needs accurately and measure systemic progress
A successful Provincial Attachment System will benefit patients, physicians and the overall system by creating a more connected system of care:
| Patient Benefits | Physician Benefits | System Benefits |
|---|---|---|
| -Easier to find a doctor accepting new patients -A clear & consistent process | -Easy way to build a panel when desired -Fewer direct calls from patients -Physicians always maintain control and choice | -Optimizes current system capacity -Centralized data allows for better reporting and addressing of gaps |
Which practitioners participate in PAS?
PAS applies to any physician, nurse practitioner or clinic providing longitudinal care in British Columbia regardless of payment model. This includes physicians on the LFP payment model, fee-for-service as well as all of the many other alternative payment models throughout the province.
How do patients register for PAS?
Unattached patients can register in the Health Connect Registry to identify that they are seeking a family doctor. Patients are added to a centralized registry of primary care providers within their identified community.
Since primary care provider waitlists at all clinics and community health services in B.C. are transitioning to the Health Connect Registry, patients already waitlisted at a local clinic do not need to re-register. Patients will maintain their original waitlist registration date.
How do physicians participate in PAS?
Physicians and clinics participate in PAS in three steps:
1. Create a OneHealthID
- This will be your username and password for logging in to the Provincial Attachment System. Doctors of BC has created an easy-to-follow infographic to walk you through this process.
2. Complete your Panel Registry
- Physicians must log into the panel registry to verify clinic information and identify any capacity for new patients if it exists.
- To complete this panel registry step, you will also submit your current patient panel to MSP using your EMR or Dr.Bill’s patient panel uploader tool. Not all EMRs support this functionality so Doctors of BC and the Ministry of Health have worked closely with Dr.Bill to create an easy and secure panel uploader tool available to all family practitioners.
Complete your Clinic and Provider Registry
- Medical directors must log into the clinic and provider registry to provide basic clinic information such as address, operating hours, website and physician and clinical staff.
When should practitioners register for PAS?
Physicians on the LFP payment model are working towards uploading their patient panels by October 31, 2023 (or within three months of enrollment in the model, whichever is later). Physicians on all other payment models should register for PAS by December 31, 2023.
Will physicians be compensated for this additional admin work?
The Ministry acknowledges that registering a clinic, providing panel information and updating that information as your clinic evolves takes time. There will be two separate payments to cover your admin time:
For the Panel Registry step, physicians will receive $6,500 to:
- Indicate capacity and if you are accepting any new patients
- Confirm clinic information
- Upload your patient panel
- Commit to keeping your panel updated periodically as it changes
For the Clinic and Provider Registry step, medical directors will receive $2,000 per clinic to:
- Validate and/or update the information for your clinic
- Commit to maintaining up to date information
Important additional compensation notes:
For LFP physicians, submitting a patient panel is required for continuation in the payment model and to receive LFP panel payments.
For non-LFP physicians, participation in PAS will be an eligibility requirement for the Community Longitudinal Family Physician (CLFP) payment.
Where do I go for help?
Doctors of BC offers extensive PAS resources for practitioners. For any additional questions about the PAS initiative, or how to complete any of the steps you can email HealthBcSupport@phsa.ca.
For support specifically with uploading your patient panel with Dr.Bill please visit our Patient Panel Upload page.
Frequently Asked Questions
Will physicians be forced to take new patients?
No. Control of your roster remains with you at all times and PAS will not be used to force providers to increase capacity. If you are at capacity, as many physicians are, simply indicate that when you register your panel.
What if I want to add a patient to my panel who isn’t in the Health Connect Registry?
PAS is not intended to add bureaucracy or to replace your control as a physician over your own roster. If a patient comes to you through other means and you wish to attach them to your practice (for example, when current patients add family members or when patients are discharged from the hospital), you can add them to your roster at any time regardless of if they are in the Health Connect Registry.
Does the Health Connect Registry replace divisional and PCN waitlists?
The Health Connect Registry (HCR) will become the single, central “waitlist.” The process of merging local Primary Care Network and divisional family practice waitlists into the HCR is ongoing. Some mergers have already happened and others are planned or in progress. Original registration dates on these lists will continue to be respected and patients that were on a divisional or PCN list do not have to register again for HCR to stay in the queue.
What if we share patients at my clinic? How do we attach shared patients to a single provider?
If you have a practice share or another team-based situation where patients are shared, it’s up to you to decide which provider’s panel to attach each patient to. Attaching a patient to one provider will not mean the patient can’t see another and attachment will not impact care delivery.
What if two or more practitioners submit the same patient?
While those who share care should attach patients to one physician (while still sharing care), the Ministry expects instances where multiple physicians will unknowingly submit the same patient. Reasons for this will be varied. For instance, patients often move and change providers without notifying their previous provider or must seek care from multiple physicians if they work or spend time in multiple communities. Once panels are submitted, the Ministry will have a better line of sight into attachments and may be able to support physicians in these instances if needed.
If I note that I have capacity, can I control the number and complexity of patients from the Health Registry?
Absolutely. As a physician, it’s critical that you maintain control over your panel and practice. You will be able to indicate the number of patients you have capacity for and can liaise with a health attachment coordinator to add best-fit patients to your practice.
What patient information needs to be submitted?
No detailed health information will be required. Practitioners only need to supply each patient’s first name, last name, date of birth and PHN.
Is there a cost to using Dr.Bill’s patient panel uploader?
No. The Dr.Bill panel upload service is complimentary. You will not be prompted to provide any payment information.
Where can I get more information on PAS?
Visit the Doctors of BC PAS resources page or email your questions to HealthBcSupport@phsa.ca.
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