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Health Law Blog

Interesting Amendments to Independent Health Facilities Clinical Practice Parameters in Chronic Kidney Care Management

November 4, 2010

Extensive revisions and expansion of the College of Physicians and Surgeons Clinical Practice Parameters were released in July 2010 which may very well pave the way for the treatment and care of chronic kidney disease and dialysis patients outside of our public hospitals which is the current model.

While no amendments have been made to the IHF legislation itself or the regulations under the Act, and the process still requires the Government to issue a Request for Proposals, if an IHF license for the delivery of any insured service is contemplated, nonetheless the extent and detail of these practice parameters contemplate the operation of IHF clinics that will provide all aspects of Chronic Kidney Disease Care from education clinic, pre dialysis nutritional issues, psychosocial issues and vascular access all performed in independent facilities owned and operated by nephrologists or by multidisciplinary specialists.

It appears that the aging population and the challenges of our public hospitals to provide chronic care to large segments of society rather than delivering acute care that can only be delivered in hospital may require acknowledgment of the advantages of out sourcing the chronic care in all respects to their staff specialists in an outpatient stand alone but related facility.

Having the IHF clinical parameters in place is the first step to our hospitals being permitted to outsource these services.


Ms. Tremayne-Lloyd was the keynote speaker at the Medical Staff Association 2011 meeting on June 20, 2011. Her presentation was titled: “Hospital Governance: An Indispensable Joint Venture of Medicine and Management and Rights and Responsibilities of the Medical Staff”. The presentation was well received by the Medical Staff and the topic was certainly relevant. We would recommend her and have her back for any further topics.

Hien Ta, M.D., FRCPC Past Medical Staff President, York Central Hospital

Tracey Tremayne-Lloyd Health Law