Island Health response to correspondence on North Island Laboratory services

The following is a response sent to community members by Island Health’s Vice President for Clinical Operations for Central and North Island:  

Please be assured that Island Health is committed to retaining pathology labs at the North Island Hospitals.  Key factual information you may find of value is that:  

  • There have been no changes to laboratory service levels at either North Island Hospital campuses since microbiology was moved from Comox in 2017;
  • The Vancouver Island Clinical Pathologists Consulting Corporation is not a private laboratory, please see below for details.
  • There has been no reduction in staff in the towns’ labs;
  • No positions have been eliminated or moved out of the community;
  • Over the past year, 22 medical laboratory assistants and technologists have been recruited to the North Island Hospitals; and, 
  • The majority of clinical pathology samples continue to be processed by local technologists in both communities.  
  • The approach taken to specialist laboratory sample analysis is the best practice standard nationally and internationally, leading to the most optimal outcomes;    
  • The Comox Valley Hospital was selected as the hub based on the principle that the North Island Hospitals is one hospital across two campuses. While both sites have world class laboratories, the Comox Valley hospital campus is somewhat larger based on the population served, its lab has a larger footprint is able to accommodate additional analyzers and instrumentation. As a result, this site was selected as the most appropriate location for the lab hub, aligning with an Island Health wide laboratory medicine ‘hub and spoke’ model that includes collection sites for samples, laboratories for analysis and hub laboratories for specialty services. 
     

In addition, as part of our commitment to continued provision of lab services in the area, Island Health has successfully recruited an anatomic pathologist to replace recent retirements and a hematopathologist who will be based at Comox Valley Hospital, will also wok in Campbell River, and support the North Island beginning in June. This new physician is a highly regarded hematopathologist with particular interest in Transfusion Medicine and will bring a high degree of hematopathology expertise to all North Island communities, providing onsite consultations, helping to expand the North Island bone marrow biopsy service and bringing, for the first time, reporting of complex lab hematology interpretation to the community from which the tests have arisen. 

With respect to turn around times for lab samples, where samples are required to be sent outside the community I can confirm that sample analysis and results are provided in a timely manner. Transport of laboratory specimens does not add any additional transportation costs; Island Health has regular transportation and delivery services travelling the Island every day transporting such things as blood products, medications, and surgical instruments. Running an operation as complex as Island Health in a responsible manner requires that we do this. Laboratory uses this network of couriers to enhance access to specialists for patients of all parts of the Island.

Turnaround times are demonstrated in the charts below.  When interpreting the data in the charts, it is important to know that turnaround times of anatomic pathology and clinical pathology must be considered separately.

Chart 1

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Chart 1 shows anatomic pathology turnaround times in Victoria and in Campbell River have been longer since 2015, but improved considerably in 2019/20 as a result of staff recruitment and moving Campbell River processing from Victoria to Nanaimo.

Chart 2

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Chart 2 illustrates turnaround times for hematopathology from the North Island Hospitals. With one exception (Q1 in 2019), turnaround times are now shorter than prior to the implementation the new specialized model. The reduced turnaround times are a result of technology which allows for 24/7 coverage. 

With respect to the Vancouver Island Clinical Pathologists Consulting Corporation (VICPCC), please be advised that Island Health has contracted with the VICPCC since 2014 to provide specialized clinical pathology. The Citizens for Quality Healthcare has expressed concerns that the VICPCC is a ‘private for profit’ organization. The VICPCC is an entity set up to establish and operate a group contract for pathology services. VICPCC members are physicians who work in Island Health hospitals and provide services to the North Island Hospitals for specific tests. Members of VICPCC reside in Victoria, Nanaimo and Comox. This contract model is similar to contract approaches for many physicians who provide services in a group model in a variety of specialized services. The VICPCC contract model has enabled Island Health to hire a hematopathologist in Comox, resulting in more pathology capacity in the North Island than in the past.

With respect to concerns about conflict, the College of Physicians and Surgeons investigated this specific group contract approach as a potential conflict of interest and determined there was no evidence of conflict of interest. If you have any follow up inquiries on this issue, these should be directed to the College. 

Island Health recognizes the community’s interest and advocacy for local health care services. We are grateful for the opportunity to provide factual information to provide clarification. Clinical pathology services in Island Health operate as a publicly funded, publicly accessible service for all patients. Laboratory turnaround times have improved, and continue to improve and North Island patients are receiving timely access to specialized pathology services.  Additionally, in an environment where physician recruitment is competitive, we are pleased that recruitment of physicians to the North Island Hospitals has been successful. 

Kind regards,

James Hanson
Vice-President, 
Clinical Operations, Central/North Vancouver Island
Island Health

*This post was updated on May 11th, 2021