Alberta Doctors for NWT COVID-19 Response

Dear Alberta Physician,

I am writing to you as a valued partner in the care of Northwest Territories patients. As a small jurisdiction with limited physician resources, we rely heavily on the expertise and support of our Alberta colleagues.a

Relationship-based, comprehensive primary care - with continuity and cultural safety - is the foundation of NWT’s healthcare system. During the COVID pandemic, we will continue to support this model whenever possible.  We, like Alberta, are enabling virtual care options so patients can continue to receive care during the COVID-19 pandemic and to limit the risk of viral spread. However we will endeavor to do this within a framework that supports the NWT's Primary Care Model. Virtual care is all the more important for our NWT patients as almost always, they must use air travel (and airports) to visit their Alberta Specialists. As elective in-person appointments become restricted, we ask that any Specialists with upcoming appointments with NWT patients consider replacing the in-person visit with a virtual care appointment via phone or video. We will be following up directly with each of these clinics to the best of our ability.

The NWT is currently seeking:

  1. Physicians who are willing to come in person to work as locums (priority areas: FP-EM’s,  internists, Family Physicians, FP-OB, FP-anesthesia, GP-surgery)
  2. Virtual care by Specialists to whom we have previously referred patients for in person assessments
    • Goal: replace medical travel to Alberta and in-person visits with virtual care provided by Alberta Specialists
    • Process:
      • Licensing: NWT Emergency License required: see See "Licensing" below
      • Billing: Alberta Specialists will bill using the new Alberta virtual care code, and will submit it to Alberta Health as with their fee for service billings for their Alberta patients. Submissions for NWT patient will then be reciprocally billed to NWT by Alberta Health
      • Charting: in the Specialist’s own chart, with a consult letter sent back to the NWT referring physician, as per usual
  3. Virtual care by Family Physicians and our regular Visiting Specialists who already have a relationship with the NWT and understand cultural safety and context.
    • Goal: enable our regular locums who cannot travel to the NWT to provide care, to provide virtual care from a distanc:
      • Process:
        • Licensing:  if not currently licensed in the NWT, an NWT Emergency License required: see See "Licensing" below
        • Remote locum contract: enables these  locums to have remote EMR access via VPN for charting directly in Wolf and they will be paid an hourly rate

 

We are not at this point asking for other Family Physicians to provide virtual primary care as it is important that providers know the cultural and community context in the NWT.

To support the above, we will be issuing Emergency Licenses to physician applicants who meet the criteria above in #1 and #2.

For a Family Physician to be eligible for an NWT emergency license, at this point we will require that the Family Physician have access to the NWT EMR through a formal Remote Locum Contract.

 

Licensing

You must obtain an Emergency License in the NWT in order to provide virtual care to NWT patients. The NWT and CPSA Registrars have collaborated to greatly simplify the process for an Emergency License in the NWT. All fees are waived and approval will take less than one day.

The following is required to be sent to megan_livingston@gov.nt.ca and professional_licensing@gov.nt.ca:

  • Your full name and  mailing address
  • Current copy of valid government issued photo identification (example, a driver’s license or passport can be provided).
  • Completed College of Physicians and Surgeons (CPSA) Certificate of Professional Conduct (CPC) consent form at http://www.cpsa.ca/certificates-of-professional-conduct/

Virtual Care Tools and consent

The CPSA has issued a statement to you outlining CPSA Advice to the Profession: COVID-19 Virtual Care (https://mailchi.mp/cpsa/cpsa-advice-to-the-profession-covid-19-virtual-care). The CPSA statement gives explicit instructions on verbal consent and documentation, which are both required to provide virtual care.

While phone is the simplest virtual care solution, it is recognized that video is often required to assess and manage patients. We understand that Alberta Health Services physicians have been asked to preferentially use Zoom.

Billing

The NWT has engaged with Alberta Health to establish a means for Alberta physicians to use Alberta billing codes for virtual care provided to NWT patients, to be billed through Alberta Health to the NWT through reciprocal billing just as you have billed for NWT patients in the past.

As this evolves, Alberta Physicians can refer to this site to find updates related to provision of virtual care for your NWT patients, including billing information.

Thank you again for supporting your northern colleagues and protecting the health and safety of your fellow citizens in the NWT.

 

 

Dr. Sarah Cook,

Territorial Medical Director|Northwest Territories Health and Social Services Authority