It's back to the drawing board as MRI wait

times soar again in Champlain LHIN

DON BUTLER, OTTAWA CITIZEN
Published on: May 26, 2016 | Last Updated: May 26, 2016 5:34 PM EST

Two years ago, it looked as if hospitals in Eastern Ontario

had finally licked their annoyingly persistent problem with
MRI wait times.
After they starting co-operating and redistributing patients to hospitals with shorter
waiting lists, wait times fell by two-thirds. By December 2013, 90 per cent of nonurgent patients needing an MRI were able to get one within 52 days.
Since then, though, the tide has turned. According to the most recent data, it now
takes up to 132 days for 90 per cent of Champlain LHIN patients with the leasturgent need to get MRI scans the second-longest wait in the province and far
above the Ontario governments 28-day target.
The problem isnt unique to the Champlain LHIN. In a presentation this week to the
LHINs board, Jack Kitts, the president and CEO of The Ottawa Hospital, said MRI

wait times have more than doubled in each of Ontarios 14 health districts in the
past two years. Everybody is struggling with meeting the growing volumes of
demand with the capacity they have, he said.
There are no easy fixes, admitted Kitts, who chairs a steering committee of
hospital executives charged with finding answers.
I wish I could tell you weve found a solution, he told board members. But I can
tell you were pretty clear on what the challenges are and what the diagnosis is.
Though redistributing patients among the six hospitals with MRIs helped initially,
those improvements slowly petered out, Kitts said, partly because the growing
demand for MRI scans is outstripping the capacity of the regions 12 MRI
machines.
Hospitals in the Champlain LHIN did more than 82,000 MRI scans in 2015-16, and
demand is projected to grow by three per cent annually going forward.
In 2012, the hope was that an electronic central intake and triage system, which
would funnel all MRI requisitions to one location for processing, would be a key
part of the solution.
But the cost of implementing that was prohibitive more than $6 million. We
cant justify spending (that much) on a piece of equipment over patient care, said
Chantale LeClerc, the Champlain LHINs CEO.
Now the six participating hospitals Ottawa Hospital, Montfort, Queensway
Carleton, CHEO and the hospitals in Cornwall and Pembroke are forging ahead
with plans for central intake and triage, but done manually, using faxes. Kitts said
he hoped such a system could be in place within six months.
Once implemented, central intake should equalize wait times across the region,
which Kitts said is critical to providing equity to everyone within the LHIN. At
present wait times vary widely, ranging from a low of 57 days at CHEO to 188 days
at the Queensway Carleton.
Those numbers apply to so-called P4 scans, done on people who have injuries or
degenerative conditions that arent life-threatening.
But that doesnt mean the long wait for P4 scans is no big deal, LeClerc said.
They certainly have an impact on peoples quality of life and their ability to be
productive in society.
Scans for the most urgent patient categories are done within 48 hours, though P3
scans, which are overwhelmingly done on patients with suspected or diagnosed
cancers, typically take between 10 and 20 days more than the provinces 10day target.
Thats a serious issue, LeClerc said. Every day that you delay a diagnosis is a
day that you could have started treatment.
Central intake should also help clinicians identify and weed out inappropriate MRI
requisitions. Anecdotally, Kitts said, radiologists believe five to 10 per cent of scans
are unnecessary.

Though Champlain LHINs efficiency in dealing with MRIs is above the provincial
average, were not at peak efficiency, Kitts said. So there is room to improve.
But it wont be easy to make improvements because of inherent inefficiencies
built into the system, he warned.
While Kitts hopes those measures will stabilize MRI wait times and prevent them
from worsening, it will take more funding from the province to actually reduce
them.
Without more resources, Kitts told the board, I dont want to leave you with any
misconception that going from 132 (days) to 28 is realistic.
While LeClerc described the lengthy wait times for MRI scans as a critical issue,
she said public complaints to her focus more on access to home care services or
primary care.