Manitoba Health

Solutions

The Diagnostic and Surgical Recovery Task Force is finding innovative solutions to address backlogs in health care resulting from the COVID-19 pandemic, by building capacity in Manitoba, with a request for supply arrangement (RFSA) with private and public care providers in Manitoba, and by implementing safe, out-of-province care options for some procedures.

Combined with strategic investments in staffing and health care infrastructure, these measures will continue to ensure that Manitobans have timely access to the care they need.

• Diagnostic Services
• Surgical Services
• Request for Supply Arrangement (RFSA)

Diagnostic Sleep Testing
Manitobans who are currently on a wait list for a diagnostic sleep study may be eligible to have this done at home, at no cost. Diagnostic sleep tests record brain waves, heartbeats, breathing and other information used to diagnose sleep disorders.

These in-home tests are offered by Cerebra Health, a Winnipeg-based company, and are suitable for most people currently on the wait list. The task force's patient navigation team will work with you to ensure it is appropriate for your situation.

The first step is to review the eligibility criteria below. If you meet at least one of these criteria and are willing to complete your sleep test at home, contact the patient navigation team:

• with this eform,
• by email at inprovpatient@gov.mb.ca, or
• by phone at 1-888-600-0108.

Individuals can self-refer, or be referred by their primary health care provider. The patient navigation team will review your information and connect back with you within two weeks.

Colon Cancer Screening
Throughout the pandemic response, the health care system adapted to ensure people continued to have timely access to cancer diagnosis and treatment without delay. In Manitoba, the volume of cancer services being provided, including diagnostics, care planning and treatment, are at or above pre-pandemic levels.

The Manitoba government announced a shift to Fecal Immunochemical Test (FIT) screening as the initial diagnostic tool used for some patients at lower risk for colorectal cancer, rather than a colonoscopy. FIT screening is less invasive, provides accurate results and helps to reduce the need for colonoscopies and other demands on operating room space. This approach will help to reduce the number of follow-up colonoscopies required by Manitoba patients by at least 1,000 annually. FIT screening has now been implemented in all five regional health authorities, diverting more than 1,150 cases from the waitlist, and resulting in an estimated cost saving of more than $1 million.

Virtual Consultations with Specialists
The Diagnostic and Surgical Recovery Task Force is working to expand the availability of the Building Access to Specialist Expertise (BASE™) eConsult service, which enables primary care providers to consult with specialists virtually and without a patient care referral. The BASE™ eConsult service is currently used by 365 primary care providers, who are able to access the expertise of 78 specialists covering 59 specialties. The average response time is currently three days, and participating specialists are asked to complete eConsults within seven days.

The use of eConsult avoids unnecessary referrals to surgical and medical specialists that would otherwise have added to wait lists and larger pandemic backlogs. The Diagnostic and Surgical Recovery Task Force is working to enrol an additional 800 primary care providers over the next three years to increase access to specialists and reduce the pandemic backlog.

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Out-of-Province Medical Referrals
Agreements with out-of-province providers are now creating opportunities for patients who are willing to travel outside Manitoba to access care faster while Manitoba continues to build capacity at home.

• A program for spine surgeries at Sanford Health in Fargo, North Dakota is providing options for Manitobans with conditions such as spinal stenosis and chronic degenerative disc disease.  By the end of 2022 more than  85 individuals have had spine surgery at Sanford in total.
• Hip and knee replacement surgeries are being offered through partnerships with the Cleveland Clinic Lutheran Hospital in Cleveland, Big Thunder Orthopedic Associates in North West Ontario and Sanford Health.

The task force continues to develop partnerships with out-of-province providers, and additional options will be available in 2023.

Learn more about out-of-province options here.

Support for Successful Recovery
The Manitoba government has signed short-term agreements with the Wellness Institute, Elite Sport Injury and Pure Lifestyle to provide post-operative outpatient physiotherapy and rehabilitation support to total hip and knee replacement surgery patients. These agreements will increase access to this important support for patients living in Winnipeg. Patients will receive information in their post-operative packages about how to access care. Patients who travel out of province for surgery can find out more through their patient navigator or through the Diagnostic and Surgical Recovery Task Force's Orthopedic Assessment Unit. Up to six individual physiotherapy sessions or 10 group sessions will be available at one of the three providers contracted to offer services.

Non-Surgical Interventions
More than 1,360  Manitobans are waiting an assessment from the Winnipeg Spine Assessment Clinic. About 90 per cent of patients referred to the Spine Assessment Clinic can be helped through physiotherapy, chiropractic care or other pain management solutions, rather than spinal surgery. In April 2022, the province announced an investment in four new physical therapists at the Spine Assessment Clinic. By the end of 2022, more than 2,270 referrals had been made to the clinic, and 1,671 assessments had been completed.

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Beginning in the summer of 2020, the province began addressing backlogs caused by COVID-19 through a request for supply arrangement (RFSA) with private and public care providers in Manitoba. In 2021, this resulted in nearly 8,000 procedures more than the health care system's usual capacity, with a related investment of more than $7.1 million. This included cataract surgery, echocardiography, hernia surgery, pediatric dental surgery, spine surgery and endoscopy.

In 2022, more than 36,500 cases were contracted through the RSFA process, further reducing Manitoba’s diagnostic and surgical backlog. Quarterly intakes continue to strengthen Manitoba's healthcare system by creating additional capacity for a variety of services, including gynecology procedures, cataract surgery and sleep assessments.

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