Reevely: Hoping to fix relations with Ontario docs, Tories to leave parents responsible for...

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Ontario’s doctors won’t have to tell local public-health units what shots they’ve given children starting July 1, Premier-designate Doug Ford has told them, putting off indefinitely a rule created by the Liberals that was to kick in two days after he’s sworn in.

It’s part of fence-mending between the province and the Ontario Medical Association, who are returning to negotiations over doctors’ pay after years of dismal relations between the OMA and the outgoing Liberal government.

The plan has been to have doctors or other health professionals who give routine vaccines tell the health units directly when they do it. That’s off, or it will be as soon as the Tories take over on June 29.

“I am taking the necessary steps to pause the implementation of reporting changes for immunization,” Ford wrote to the doctors’ association this week. The association’s president Dr. Nadia Alam followed up with a pleased note to her members, anticipating that a new health minister will negotiate something they’ll like better.


Important update on immunization reporting from @OntariosDoctors President @DocSchmadia: #Onpoli #Onhealth pic.twitter.com/ijHwj5jupO

— Ontario Medical Assoc. (@OntariosDoctors) June 20, 2018


Public-health authorities track vaccinations so they know how well protected people are from spreadable diseases, and specifically so that if there’s an outbreak of something like measles, they have information in hand they can use to try to keep vulnerable kids from getting sick. But the system relies on parents to tell health units what shots their children have had, an archaic practice that doesn’t work very well.

Immunizations aren’t strictly mandatory for Ontario children, but it’s close. When a child reaches pre-school or school age, the schools ask to see his or her vaccination record upon registration. Health units can bar kids from school who don’t have their vaccines or valid explanations of why not.

So as a parent, you go to one part of the government (a publicly funded doctor) to get your kid’s shots and they write down for you what the shots were. Then you’re supposed to call another part of the government (the health unit) to tell it what the first part of the government did. A few years later, a third part of the government (the school board) asks you what the first part of the government did, and then checks with the second part of the government to make sure that you also told the second part of the government.

(They don’t always check, mind you. Earlier this decade, Ottawa’s health unit discovered it had thousands of records showing children here weren’t fully vaccinated and sent out thousands of warnings that kids could be suspended if their records didn’t show they’d had their shots. It started annual reviews of the records in 2015.)

If you’re a parent, this obligation is most intense when your kid is tiny and getting shots every time you leave the house — at two months, four months, six months, 12 months, 15 months and 18 months. It’s easy to forget to do other people’s paperwork when you feel like you’re drowning every day anyway.

We forgot. At some point I had to go to our doctor’s office and sheepishly ask the nurse to fill in a couple of years’ worth of shots we hadn’t recorded on our son’s yellow fold-out card. We didn’t know it mattered and nobody had told us that the third part of the government would be asking for it eventually.

In Ottawa, which has a relatively large and well-resourced health unit, parents have only recently been able to do this online. You had to phone and read the information on your kid’s yellow card to someone, who typed it into a health-unit database. Now there’s an online database health units across the province use.

The Liberals’ solution was to cut out the middleman: doctors’ offices would start telling health units about the routine vaccines they administered. A relief to harried parents but not a joy for harried doctors, especially solo practitioners.

The Liberals made health units responsible for setting up the system for doctors (or others who gave shots) to do the reporting, but even Ottawa Public Health wasn’t fully ready for the July 1 start.

“OPH was awaiting further Ministry of Health and Long Term Care information about the requirements and had initiated consultations with key local health care practitioners on how to assist them with this new reporting requirement,” spokeswoman Donna Casey said Thursday.

The current scheme “introduces more paperwork for doctors as a solution for immunization reporting and surveillance, instead of prioritizing the creation of a fully operable immunization registry that enables the seamless transfer of vaccination information from provider to database,” the OMA objected when the Liberals presented their bill. Even using the health units’ online database involves some work.

“Seamless transfer of vaccination information from provider to database” will require a fully digitized health-records system, including in solo doctors’ offices, something the government reported in 2016 was more than five years away. If that’s what we’re waiting for, parents will be relaying their kids’ vaccination reports for a good long time to come.

dreevely@postmedia.com
twitter.com/davidreevely

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