Policies

Policies

Our goal is to provide quality medical care in a timely manner. In order to do so, Open Health has implemented an appointment/cancellation policy. The policy enables us to better utilize available appointments for our patients in need of medical care. Appointments are in high demand, and your early cancellation ensures that another person has the possibility to access medical care in a timely manner. Late cancellations will be considered as a “no show”.

Policies are subject to change, therefore we encourage you to check our website regularly for any updates.

Recommendations when scheduling or cancelling appointments:

  • If you are registered to book online, we encourage you to do so. You can access the patient portal here: https://niverville.inputhealth.com/portal#login
  • If you cannot book online but you have a registered clinician at Open Health, call the clinic and ask the staff if you can book online: 204-388-6626.
  • Please schedule your annual physical exams at least 2 months in advance due to the high demand for these types of appointments.
  • Preventative health visits and prescription renewals are recommended to be scheduled at least two weeks ahead.
  • Open Health requires 24 hours notice to cancel or reschedule an appointment so that your appointment time can be reallocated to someone else. Please keep in mind that our phone lines are open at 9 AM but close over lunch between 12-1 PM.
  • If you are symptomatic, we ask that you do not attend the clinic in-person. Instead, please call to reschedule your appointment to a virtual or telephone visit.
  • It is recommended that you arrive a few minutes before for your scheduled appointment. If you arrive after the half-way point of your scheduled appointment, you may not be able to be seen and the appointment may have to be rescheduled.

Cancelation and No-Show Policy

“No Show” Policy for Regular Appointments

A “no show” is someone who misses an appointment without cancelling within a full working day (24 hours) in advance or who fails to present at the time of a scheduled appointment. Either of these will be recorded in the patient’s chart as a “no show”.

The first time there is a “no show”, the patient will be provided with a verbal reminder about this policy and possibly written notice. The second time, written notice (via email or text message) will be sent out; including a link to or a copy of the cancelation/no show policy. A third failure to present to the scheduled appointment and/or cancel in a timely manner will result in the patient being charged $42 for a regular appointment.

This record is kept in your chart for 12 months and “resets” after this time period. This also resets if you have been billed for your third failed cancellation. Three “no shows” will result in the temporary suspension of services until the fee has been paid. This excludes “same day/next day” appointments or urgently needed care.

“No Show” Policy for Longer appointments

Patients who schedule longer appointments and fail to cancel within the 24 hours period or fail to come to the appointment will be charged $63, even without any previous “offense”. Longer appointments include but are not limited to: Complete Physicals, 1st prenatal visit, Baby Check ups, Child Check ups, Travel health visit, Procedures and private visits such as Driver Medicals.

The patient will be able to reschedule only upon payment of this fee. Niverville is a private clinic, meaning that every time an appointment is not kept, it is a loss for the clinician. First time patients who do not show up for their appointment to meet the doctor will not be given a second appointment.

. Privacy Policy

This Policy is intended to reflect the content of Legislation including the Personal Health Information Act (PHIA) and the Personal Information Protection and Electronic Documents Act (PIPEDA) as well as Guidelines of the College of Physicians and Surgeons of Manitoba and the Canadian Medical Association.
The Staff of Open Health Niverville (OHN) will ensure the protection of the confidentiality of any personal health information (PHI) accessed in the course of providing patient care. We will only collect, use and disclose health information that is required for the purposes of providing care.

Consent is implied for the collection, use, and disclosure of PHI for ourselves and to other health professionals accessed in the routine process of care of patients associated with this clinic.
No consent from the patient is required when the disclosure is mandated by legislation.
Written consent is required for PHI to be shared with a third party for reasons other than care and treatment (i.e. insurance). Consent can be withdrawn at any time.
All staff are required to sign a confidentiality agreement, including persons using the clinic’s electronic medical records (EMR) in the course of providing patient care.

RETENTION OF RECORDS:
Open Health will retain patient records as required by law, and regulation of the College of Physicians and Surgeons of Manitoba. All charts are retained for a minimum of 10 years after the last entry, or 10 years after the patient has reached the age of majority.

DESTRUCTION OF RECORDS:
Open Health will destroy the records only after the requirements for retention have been fulfilled. Destruction will occur in a way that protects patient privacy in accordance with regulations made by the College of Physician and Surgeons of Manitoba.

PATIENT ACCESS TO RECORDS:
Requests for access or copies of medical records can be made in writing to Open Health Niverville from another health care provider the patient is seeing or their new health care provider. This can be done by faxing a signed consent by both provider and patient. Chart transfers will be done adhering to the Guidelines of the Manitoba Medical Association, within one month after receiving payment of the fee (see fee guidelines for more information).

Refusal of access to medical records will occur in the following circumstances:
If the individual requesting access is someone other than the patient to which the record refers, with the exception being the legal guardian of a minor, unless written consent is obtained from the patient naming the specific designated individual or third party.
If the information could reasonably endanger the mental or physical health or safety of the patient to which the record refers, or any other individual.
If the disclosure would reveal PHI about another person who has not consented to the disclosure.

PATIENT COMPLAINTS:
A patient who feels that Open Health Niverville (OHN) has not provided appropriate access to their PHI, or has handled their PHI in an inappropriate manner is urged to address their concerns to the OHN Office Manager in writing. If the outcome of this process is not satisfactory, a complaint may be forwarded to the College of Physicians and Surgeons of Manitoba.

PROTECTION VIA COMMUNICATION:

ANSWERING MACHINES / MESSAGES: In the event that Open Health Niverville (OHN) needs to contact a patient for any reason and communication is occurring via an answering machine or through another individual via a message, the only information transferred by OHN staff will be a request for a call back. Exceptions to this will include:

  • If the patient is a minor and the telephone contact is made with the legal guardian.
  • If a consent to leave PHI on an answering machine or with another individual has been documented in the patient’s record.
  • If the physician concludes there is a risk to personal health or safety that is grave enough to warrant breach of the patient’s right to privacy.

FAX: The fax machine and copier will be located in a secure, non-patient access area. Any PHI that is sent by Open Health Niverville (OHN) will carry a cover sheet with a disclosure of confidentiality instructing the recipient to destroy the document and contact us in the event that is was sent to a non-intended recipient.

E-MAIL: All computer terminals are kept confidential by use of passwords and any PHI that is sent or received via e-mail will contain a disclosure of confidentiality instructing the recipient to destroy the document and contact us in the event that it was sent to a non-intended recipient. No e-mails will be sent from unsecure accounts unless specifically requested and agreed upon with the patient.

POST / COURIER: All mail, by whatever method, will be sent using sealed envelopes via Canada Post or certified medical carriers.

OFFICE ENVIRONMENT:
The medical records, fax, photocopier and computers will be kept in areas to which the public is not granted access. Computers are password protected.
Patients will be treated only behind closed doors to ensure privacy.
A radio station or other sound will be broadcast at all times in the waiting room to minimize the ability to overhear conversations occurring between staff and patients, either directly or by phone.
Corridor consultation between members of the health care team is discouraged and all verbal communication will occur in a secure area or without the use of names whenever possible.
The office is monitored by alarm in order to prevent break in.

Provider Switching Policy

This Policy is intended to reflect the efforts of the Open Health Niverville at offering the best possible patient care, follow up and continuity for both patient and provider.

The Open Health Niverville (OHN) discourages the switching of primary care providers within the same clinic. However it is understood that in rare circumstances there could be dissension between a patient and care provider. In the case in which a patient wishes to change providers, it is important to remember these following issues before making a request:

– Open Health Niverville is a collaborative centre in which the providers work as a team to provide primary care. If a patient requests to leave the care of one provider, the initial provider may still be involved in providing care for that patient (for example, in the case of “same day” or “walk-in” type appointments).

– Upon switching providers, patients may have an expectation of receiving different care, a different diagnosis or treatment plan, only to learn that the new provider holds the same opinion as the initial provider. In this case, a “switch back” will not be permitted.

– If a patient wishes for a second opinion, it is likely in the best option to seek out a second opinion at a different clinic altogether.

– A care provider may have to make a difficult decision that goes against the patient’s request when the request is potentially unsafe or inappropriate for the patient (such as requests for controlled medications/narcotics). These types of reasons will not be accepted regarding requests for switching providers.

– In the instance where the patient’s primary care provider is NOT available to see them for an urgent matter, and another provider is available, this patient may be allowed to be seen by someone else on a “one time basis”. In the case where there are no providers available to provide urgently needed care, the staff will recommend a different clinic that may be able to provide walk-in care.

– During our limited “same day or next day” appointments, (which are open to everyone whether you are a patient of the clinic or not), you will be assigned to a provider who has availability that given day (if any). This may end up being different than your regular provider. This appointment does not allow the patient to continue to see that new provider in the future, unless specified by that provider for that issue only. For future care, they would need to continue to see their original provider.

– In an instance where the patient would like to change providers at another clinic altogether and would like their medical file transferred to the new facility, it should be noted that there is a standard fee for this service. The fee covers the cost of the administrative staff to prepare the documents, (whether print or digital USB drive) as well as the cost of secure courier or postage to the new facility. Please see the uninsured services page here for more details. It should be noted that the request must come from the new health care facility with signed consent by both the patient and new provider.

– A request for a new provider may not be able to be fulfilled due to the fact that other providers are not accepting patients.

– It is understandable that discussing a conflict or dissatisfaction can be difficult, however Open Health encourages patients to have open conversations with their providers about their concerns. This can be done at an in-person appointment, however virtual or telephone appointments are also available. It is typical that what is perceived to be a larger issue is simply a misunderstanding and can be resolved with open dialogue.

With all of these above issues being considered, if a patient still feels the need to obtain a different provider, a patient may phone the staff with their request. Their request may be requested in writing and provided to the supervisor or office manager who will review the request.

Please note the following regarding our policy on switching providers:

– Reasons for a switch must be provided in order to review the request and this will be determined on a case-by-case basis. This may involve an additional phone call to the patient by the supervisor or office manager for clarification.

– Please note that depending on the circumstance, the request may be discussed with the original care provider and/or the Medical Director in order to determine best course of action.

– Please note that unless there is an extenuating circumstance that warrants another switch of providers, a request to switch providers will not be reviewed again for 24 months.

– A switch of providers can only be arranged if another provider is accepting patients. If there are no available providers, then the patient would need to consider remaining with their original provider or finding care at another facility altogether.

– This policy is subject to change.

Ending a Provider-Patient Professional Relationship by the Provider

Following the College of Physicians & Surgeons of Manitoba (CPSM) guidelines, Open Health Niverville allows clinicians to end a clinician-patient professional relationship immediately within these parameters:

  • If a patient poses a safety risk to office staff, other patients, or clinicians; or
  • If the patient is abusive to the clinician, office staff or other patients (this includes but is not limited to sexual harassment, physical abuse and aggressive verbal abuse or language); or
  • If the patient does not respect professional boundaries or acts in an inappropriate manner; or
  • If the clinician is leaving medical practice because of personal illness or other urgent circumstances*.

*In this case, best efforts will be made by the clinic to place patients with other Open Health Niverville providers, however this is not guaranteed. Written notice will be provided for any of the above reasons of termination.

Record Management

Electronic Medical Records

Electronic Medical Record (EMR) is essentially an electronic folder which contains all of your consults going back to 2006, as well as any lab results, x-rays and CT scans, and any consultation documents from specialists. We have been using an EMR since February 2006, and in recent years changed our EMR to InputHealth. InputHealth was purchased by Telus Health in 2020-21, but the changeover has been seamless.

InputHealth does a lot more than just store your medical information. We wanted something that would engage you, our clients, more actively in your management towards achieving your wellness goals.

This active engagement with our patients starts by asking if we can store your email and cell phone number. We can text results through the secure EMR and we can also send you copies of reports. Some of you also have been asked to fill out short questionnaires either on your cell phone or computer before your next visit. With your permission, we have the ability to send you questionnaires to be filled regularly through the year to provide us feedback. We need to stress that if you are uncomfortable giving us this access, you can decline.

What happened to your old records? These have been safely stored on a computer with a backup. If ever there is a concern, it can be interrogated and the original record displayed. We have successfully migrated the information from that previous application into this new application and we are happy with the integrity of this transfer.

We believe passionately in keeping the information that you have entrusted to us secure. We work as if this data is yours and we are purely entrusted with its storage. At any time, you can request to look at your own data. There are methods by which you can apply to have information corrected if you disagree with what is in a record of yours. This is covered under the legislation in Manitoba. Please see the “Transferring Records” section below.

Transferring Records
If the time comes to move on to a different provider, you can request a copy of your records.

There is a fee for this service, which covers the administrative time to prepare your records (typically digitally on an USB drive), as well as the cost to securely courier or mail your information.

We require written consent signed by the patient from the new care provider to request your medical information.

We do not destroy your records, however there is legislation that allows us to destroy paper records after 7 or 10 years, depending on the type of information. However, within an Electronic Medical Record there should be no need for destruction, as space is never an issue. We already have records on many of our clients that go back over 10 years on our EMR.

If you are new to our clinic and you wish to have your previous medical history transferred to us, please see the reception desk where a consent form will need to be signed. We can then fax this request to your previous physician’s office. We would also ask you to contact their office as they may request a fee from you to initiate the transfer.
We scan into our system copies of consultations and diagnostic results. We do not typically scan handwritten notes. Unless the documents are requested to be returned to the original clinic (at their expense only), the documents are securely shredded after they have been scanned in.

As healthcare in general moves to a province-wide data system that stores diagnostic results, the transfer of medical records will become less and less a necessity. It really is only important if you, the client, have an exceptional medical history that needs to be provided for relevant past information for our records. If you had not seen your previous provider for years or only had gone for the odd cough or cold, it is likely not worth the expense to transfer your medical records. Your new provider will review a thorough history with you on your first visits and can always request information on your behalf at a later time, if needed.

Communication

Traditionally, information was passed between the patient and the clinician in two ways. One would be a telephone call – typically from the receptionist – and the other would have been face-to-face in the clinic room. Until recently, we had been limited from using many modern techniques due to privacy concerns.

Now, there is a secure way of contacting you through text messaging (SMS) and email. Both of these are generated within our EMR. With this, you will receive a message that has a link and a five-figure, one-time access number. Upon clicking the link, a page either on your smartphone or computer will open. You will be prompted to enter in the five-digit code which will take you to a secure page that has the message as well as any attachments/results.

You can also visit the patient portal on our website, enter in your identifying numbers as prompted, and enter into your portal which will have all your messages stored. We hope in the future that this portal will have access to more of your clinical results.

There are also virtual appointments available as generated securely within the EMR, and has a similar setup as our SMS and email messaging. The link sent to you requires entering a one-time unique code which opens to the EMR system. The virtual visit is run through the EMR and you can speak to your provider via video over your cell phone or home computer!

Additionally, you now have the possibility of booking your own appointments on the patient portal (on a limited basis based on the provider’s availability). You will receive a confirmation text and/or email, as well as a reminder on the day of or day before your appointment. Your total clinical notes are always secure and cannot be accessed by other means.

There is an Open Health Niverville Facebook page in which we use for clinic announcements, office closures, snow days, and general information about our clinic and community. This is not used as a two-way communication tool between the clinic and patients. We will never communicate with our patients directly through Facebook, Instant Messaging, etc. regarding anything relating to appointments or personal medical information. We also ask that patients use our phone lines and/or patient portal in order to communicate with our clinic. Requests, questions, and other communication via Facebook or any future social media outlets will not be answered/viewed.

Zero Tolerance Policy

Open Health Niverville is committed to providing a safe, secure and respectful environment for all patients, visitors, providers and staff.

Words or actions that make others feel threatened or demeaned will not be tolerated and decisive action will be taken to protect patients and staff.

There is zero-tolerance for any conduct that causes any individual to feel at genuine risk of harm. In these situations, the offending individual will be asked to leave the premises. Patients exhibiting this conduct may be discharged from the practice with no option of returning in the future.

In circumstances of aggression involving physical contact, such as spitting, grabbing, striking, pushing or otherwise, a police report will be filed.

Generally speaking, the zero-tolerance policy extends to conduct which can be considered unacceptable in nature. This includes interactions in person, by phone, and/or in writing.

Examples of unacceptable conduct include (but not limited to): Violence, Intimidation, Throwing objects or damaging property, Inappropriate, demeaning, or abusive language, Discriminatory remarks, Threats or threatening behavior, Bulling or yelling, Sexual harassment

In limited extenuating circumstances, we may exercise our discretion to excuse a single lapse in judgment. In this case, the offending party will receive a written letter noting the circumstance, unacceptable conduct, zero tolerance policy and resolution expectations. This letter will be kept on file at minimum 24-months. Even with the one-time satisfactory resolution being met, no further warnings will be given and any future abusive conduct on the offending individual’s part will be grounds for immediate discharge from Open Health Niverville.

Open Health Niverville