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CMA PolicyBase

Policies that advocate for the medical profession and Canadians


76 records – page 1 of 4.

Industry support for university research programs

https://policybase.cma.ca/en/permalink/policy515
Last Reviewed
2020-02-29
Date
1990-05-26
Topics
Population health/ health equity/ public health
Resolution
BD90-05-215
That the Canadian Medical Association encourage industries to make significant commitments to basic research programs in Canadian universities.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-05-26
Topics
Population health/ health equity/ public health
Resolution
BD90-05-215
That the Canadian Medical Association encourage industries to make significant commitments to basic research programs in Canadian universities.
Text
That the Canadian Medical Association encourage industries to make significant commitments to basic research programs in Canadian universities.
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Continuing medical education funding

https://policybase.cma.ca/en/permalink/policy609
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-84
That the Canadian Medical Association recognize the traditional right of individual physicians to determine the disposition of existing funds negotiated for continuing medical education.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-84
That the Canadian Medical Association recognize the traditional right of individual physicians to determine the disposition of existing funds negotiated for continuing medical education.
Text
That the Canadian Medical Association recognize the traditional right of individual physicians to determine the disposition of existing funds negotiated for continuing medical education.
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Continuing medical education funding

https://policybase.cma.ca/en/permalink/policy610
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-85
That the Canadian Medical Association encourage its divisions to provide maximum flexibility in the use of funds negotiated for continuing medical education to facilitate programs to maintain and enhance professional competence.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-85
That the Canadian Medical Association encourage its divisions to provide maximum flexibility in the use of funds negotiated for continuing medical education to facilitate programs to maintain and enhance professional competence.
Text
That the Canadian Medical Association encourage its divisions to provide maximum flexibility in the use of funds negotiated for continuing medical education to facilitate programs to maintain and enhance professional competence.
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Continuing medical education funding

https://policybase.cma.ca/en/permalink/policy611
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-86
That the Canadian Medical Association encourage its divisions to seek new funds to develop and implement innovative forms of continuing medical education and that these funds be sought from various sources, including but not restricted to ministries of health, education and the private sector (e.g., industry and foundations).
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-86
That the Canadian Medical Association encourage its divisions to seek new funds to develop and implement innovative forms of continuing medical education and that these funds be sought from various sources, including but not restricted to ministries of health, education and the private sector (e.g., industry and foundations).
Text
That the Canadian Medical Association encourage its divisions to seek new funds to develop and implement innovative forms of continuing medical education and that these funds be sought from various sources, including but not restricted to ministries of health, education and the private sector (e.g., industry and foundations).
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Cardiopulmonary resuscitation

https://policybase.cma.ca/en/permalink/policy722
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health care and patient safety
Physician practice/ compensation/ forms
Resolution
GC90-96
The Canadian Medical Association recommends that all physicians ensure that they have the knowledge and skills necessary to provide basic cardiopulmonary resuscitation.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health care and patient safety
Physician practice/ compensation/ forms
Resolution
GC90-96
The Canadian Medical Association recommends that all physicians ensure that they have the knowledge and skills necessary to provide basic cardiopulmonary resuscitation.
Text
The Canadian Medical Association recommends that all physicians ensure that they have the knowledge and skills necessary to provide basic cardiopulmonary resuscitation.
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Heart disease and cardiopulmonary resuscitation skills

https://policybase.cma.ca/en/permalink/policy723
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-101
That the Canadian Medical Association and its members support and encourage public education programs that promote healthy lifestyles, the recognition of warning symptoms and signs of heart disease, and the acquisition of manual cardiopulmonary resuscitation skills, recognizing that these skills are most effective when combined with a pre-hospital advanced life support system.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-101
That the Canadian Medical Association and its members support and encourage public education programs that promote healthy lifestyles, the recognition of warning symptoms and signs of heart disease, and the acquisition of manual cardiopulmonary resuscitation skills, recognizing that these skills are most effective when combined with a pre-hospital advanced life support system.
Text
That the Canadian Medical Association and its members support and encourage public education programs that promote healthy lifestyles, the recognition of warning symptoms and signs of heart disease, and the acquisition of manual cardiopulmonary resuscitation skills, recognizing that these skills are most effective when combined with a pre-hospital advanced life support system.
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Quality Daily Physical Education Program

https://policybase.cma.ca/en/permalink/policy725
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-122
That the Canadian Medical Association support the Quality Daily Physical Education Program as defined by the Canadian Association for Health, Physical Education and Recreation.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-122
That the Canadian Medical Association support the Quality Daily Physical Education Program as defined by the Canadian Association for Health, Physical Education and Recreation.
Text
That the Canadian Medical Association support the Quality Daily Physical Education Program as defined by the Canadian Association for Health, Physical Education and Recreation.
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Code of environmental health

https://policybase.cma.ca/en/permalink/policy731
Last Reviewed
2020-02-29
Date
1990-05-26
Topics
Population health/ health equity/ public health
Resolution
BD90-05-177
That the Canadian Medical Association develop a code of environmental health that would serve as a benchmark to judge all Canadian Medical Association activities, both internal and external.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-05-26
Topics
Population health/ health equity/ public health
Resolution
BD90-05-177
That the Canadian Medical Association develop a code of environmental health that would serve as a benchmark to judge all Canadian Medical Association activities, both internal and external.
Text
That the Canadian Medical Association develop a code of environmental health that would serve as a benchmark to judge all Canadian Medical Association activities, both internal and external.
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Aboriginal health care

https://policybase.cma.ca/en/permalink/policy809
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health systems, system funding and performance
Population health/ health equity/ public health
Resolution
GC90-93
That the Canadian Medical Association encourage physicians to expand contacts with their local aboriginal communities, on both a community and professional level, in order to address aboriginal health care issues.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health systems, system funding and performance
Population health/ health equity/ public health
Resolution
GC90-93
That the Canadian Medical Association encourage physicians to expand contacts with their local aboriginal communities, on both a community and professional level, in order to address aboriginal health care issues.
Text
That the Canadian Medical Association encourage physicians to expand contacts with their local aboriginal communities, on both a community and professional level, in order to address aboriginal health care issues.
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Recruiting Aboriginal people to the health care professions

https://policybase.cma.ca/en/permalink/policy810
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-94
That the Canadian Medical Association urge the federal government to encourage and provide funding for the recruitment of aboriginal people to the health care professions.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Health human resources
Resolution
GC90-94
That the Canadian Medical Association urge the federal government to encourage and provide funding for the recruitment of aboriginal people to the health care professions.
Text
That the Canadian Medical Association urge the federal government to encourage and provide funding for the recruitment of aboriginal people to the health care professions.
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Aboriginal health

https://policybase.cma.ca/en/permalink/policy811
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-95
That the Canadian Medical Association take action to support aboriginal peoples in those areas of social, political and economic life that would improve the health of their communities.
Policy Type
Policy resolution
Last Reviewed
2020-02-29
Date
1990-08-23
Topics
Population health/ health equity/ public health
Resolution
GC90-95
That the Canadian Medical Association take action to support aboriginal peoples in those areas of social, political and economic life that would improve the health of their communities.
Text
That the Canadian Medical Association take action to support aboriginal peoples in those areas of social, political and economic life that would improve the health of their communities.
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Guiding principles for the optimal use of data analytics by physicians at the point of care

https://policybase.cma.ca/en/permalink/policy11812
Last Reviewed
2020-02-29
Date
2016-02-27
Topics
Health information and e-health
  1 document  
Policy Type
Policy document
Last Reviewed
2020-02-29
Date
2016-02-27
Topics
Health information and e-health
Text
Electronic tools are now being used more widely in medicine than ever before. A majority of physicians in Canada have adopted electronic medical records (EMRs)-75% of physicians use EMRs to enter or retrieve clinical patient notes, and 80% use electronic tools to access laboratory/diagnostic test results. The increased use of point-of-care tools and information repositories has resulted in the mass digitization and storage of clinical information, which provides opportunities for the use of big data analytics. Big data analytics may come to be understood as the process of examining clinical data in EMRs cross-referenced with other administrative, demographic and behavioural data sources to reveal determinants of patient health and patterns in clinical practice. Its increased use may provide opportunities to develop and enhance clinical practice tools and to improve health outcomes at both point-of-care and population levels. However, given the nature of EMR use in Canada, these opportunities may be restricted to primary care practice at this time. Physicians play a central role in finding the right balance between leveraging the advantages of big data analytics and protecting patient privacy. Guiding Principles for the Optimal Use of Data Analytics by Physicians at the Point of Care outlines basic considerations for the use of big data analytics services and highlights key considerations when responding to requests for access to EMR data, including the following: * Why will data analytics be used? Will the safety and effectiveness of patient care be enhanced? Will the results be used to inform public health measures? * What are the responsibilities of physicians to respect and protect patient and physician information, provide appropriate information during consent conversations, and review data sharing agreements and consult with EMR vendors to understand how data will be used? As physicians will encounter big data analytics in a number of ways, this document also outlines the characteristics one should be looking for when assessing the safety and effectiveness of big data analytics services: * protection of privacy * clear and detailed data sharing agreement * physician-owned and -led data collaboratives * endorsement by a professional or recognized association, medical society or health care organization * scope of services and functionality/appropriateness of data While this guidance is not a standalone document-it should be used as a supplemental reference to provincial privacy legislation-it is hoped that it can aid physicians to identify suitable big data analytics services and derive benefits from them. Introduction This document outlines basic considerations for the use of big data analytics services at the point of care or for research approved by a research ethics board. This includes considerations when responding to requests for access to data in electronic medical records (EMRs). These guiding principles build on the policies of the Canadian Medical Association (CMA) on Data Sharing Agreements: Principles for Electronic Medical Records/Electronic Health Records,1 Principles Concerning Physician Information2 and Principles for the Protection of Patients' Personal Health Information,3 the 2011 clinical vignettes Disclosing Personal Health Information to Third Parties4 and Need to Know and Circle of Care,5 and the Canadian Medical Protective Association's The Impact of Big Data on Healthcare and Medical Practice.6 These guiding principles are for information and reference only and should not be construed as legal or financial advice, nor is this document a substitute for legal or other professional advice. Physicians must always comply with all legislation that applies to big data analytics, including privacy legislation. Big data analytics in the clinical context involves the collection, use and potential disclosure of patient and physician information, both of which could be considered sensitive personal information under privacy legislation. Big data analytics has the potential to improve health outcomes, both at the point of care and at a population level. Doctors have a key role to play in finding the right balance between leveraging the advantages of big data (enhanced care, service delivery and resource management) and protecting patient privacy.7 Background A majority of physicians in Canada have adopted EMRs in their practice. The percentage of physicians using EMRs to enter or retrieve clinical patient notes increased from 26% in 2007 to 75% in 2014. Eighty percent of physicians used electronic tools to access laboratory/diagnostic test results in 2014, up from 38% in 2010.8 The increasingly broad collection of information by physicians at the point of care, combined with the growth of information repositories developed by various governmental and intergovernmental bodies, has resulted in the mass digitization and storage of clinical information. Big data is the term for data sets so large and complex that it is difficult to process them using traditional relational database management systems, desktop statistics and visualization software. What is considered "big" depends on the infrastructure and capabilities of the organization managing the data.9 Analytics is the discovery and communication of meaningful patterns in data. Analytics relies on the simultaneous application of statistics, computer programming and operations research. Analytics often favours data visualization to communicate insight, and insights from data are used to guide decision-making.10 For physicians, big data analytics may come to be understood as the process of examining the clinical data in EMRs cross-referenced with other administrative, demographic and behavioural data sources to reveal determinants of patient health and patterns in clinical practice. This information can be used to assist clinical decision-making or for research approved by a research ethics board. There are four types of big data analytics physicians may encounter in the provision of patient care. They are generally performed in the following sequence, in a continuous cycle11,12,13,14: 1. Population health analytics: Health trends are identified in the aggregate within a community, a region or a national population. The data can be derived from biomedical and/or administrative data. 2. Risk-based cost analysis: Populations are segmented into groups according to the level of risk to the patient's health and/or cost to the health system. 3. Care management: Clinicians are enabled to manage patient care according to defined care pathways and clinical protocols informed by population health analytics and risk-based cost analysis. Care management includes the following: o Clinical decision support: Outcomes are predicted and/or alternative treatments are recommended to clinicians and patients at the point of care. o Personalized/precision care: Personalized data sets, such as genomic DNA sequences for at-risk patients, are leveraged to highlight best practice treatments for patients and practitioners. These solutions may offer early detection and diagnosis before a patient develops disease symptoms. o Clinical operations: Workflow management is performed, such as wait-times management, mining historical and unstructured data for patterns to predict events that may affect care. o Continuing education and professional development: Longitudinal performance data are combined across institutions, classes, cohorts or programs with correlating patient outcomes to assess models of education and/or develop new programs. 4. Performance analytics: Metrics for quality and efficiency of patient care are cross-referenced with clinical decision-making and performance data to assess clinical performance. This cycle is also sometimes understood as a component of "meaningful" or "enhanced" use of EMRs. How might physicians encounter big data analytics? Many EMRs run analytics both visibly (e.g., as a function that can be activated at appropriate junctures in the care pathway) and invisibly (e.g., as tools that run seamlessly in the background of an EMR). Physicians may or may not be aware when data are being collected, analyzed, tailored or presented by big data analytics services. However, many jurisdictions are strengthening their laws and standards, and best practices are gradually emerging.15 Physicians may have entered into a data sharing agreement with their EMR vendor when they procured an EMR for their practice. Such agreements may include provisions to share de-identified (i.e., anonymized) and/or aggregate data with the EMR vendor for specified or unspecified purposes. Physicians may also receive requests from third parties to share their EMR data. These requests may come from various sources: * provincial governments * intergovernmental agencies * national and provincial associations, including medical associations * non-profit organizations * independent researchers * EMR vendors, service providers and other private corporations National Physician Survey results indicate that in 2014, 10% of physicians had shared data from their EMRs for the purposes of research, 10% for chronic disease surveillance and 8% for care improvement. Family physicians were more likely than other specialists to share with public health agencies (22% v. 11%) and electronic record vendors (13% v. 2%). Specialists were more likely than family physicians to share with researchers (59% v. 37%), hospital departments (47% v. 20%) and university departments (28% v. 15%). There is significant variability across the provinces with regard to what proportion of physicians are sharing information from their EMRs, which is affected by the presence of research initiatives, research objectives defined by the approval of a research ethics board, the adoption rates of EMRs among physicians in the province and the functionality of those EMRs.16 For example, there are family practitioners across Canada who provide data to the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The CPCSSN is a multi-disease EMR surveillance and research system that allows family physicians, epidemiologists and researchers to understand and manage chronic care conditions for patients. Health information is collected from EMRs in the offices of participating family physicians, specifically information about Canadians suffering from chronic and mental health conditions and three neurologic conditions, including Alzheimer's and related dementias.17 In another example, the Canadian Partnership Against Cancer's Surgical Synoptic Reporting Initiative captures standardized information about surgery at the point of care and transmits the surgical report to other health care personnel. Surgeons can use the captured information, which gives them the ability to assess adherence to the clinical evidence and safety procedures embedded in the reporting templates, to track their own practices and those of their community.18 The concept of synoptic reporting-whereby a physician provides anonymized data about their practice in return for an aggregate report summarizing the practice of others -can be expanded to any area in which an appropriate number of physicians are willing to participate. Guiding principles for the use of big data analytics These guiding principles are designed to give physicians a starting point as they consider the use of big data analytics in their practices: * The objective of using big data analytics must be to enhance the safety and/or effectiveness of patient care or for the purpose of health promotion. * Should a physician use big data analytics, it is the responsibility of the physician to do so in a way that adheres to their legislative, regulatory and/or professional obligations. * Physicians are responsible for the privacy of their individual patients. Physicians may wish to refer to the CMA's policy on Principles for the Protection of Patients' Personal Health Information.19 * Physicians are responsible for respecting and protecting the privacy of other physicians' information. Physicians may wish to refer to the CMA's policy on Principles Concerning Physician Information.20 * When physicians enter into and document a broad consent discussion with their patient, which can include the electronic management of health information, this agreement should convey information to cover the elements common to big data analytics services. * Physicians may also wish to consider the potential for big data analytics to inform public health measures and enhance health system efficiency and take this into account when responding to requests for access to data in an EMR. * Many EMR vendors provide cloud-based storage to their clients, so information entered into an EMR may be available to the EMR vendor in a de-identified and/or aggregate state. Physicians should carefully read their data sharing agreement with their EMR vendor to understand how and why the data that is entered into an EMR is used, and/or they should refer to the CMA's policy on the matter, Data Sharing Agreements: Principles for Electronic Medical Records/Electronic Health Records.21 * Given the dynamic nature of this emerging tool, physicians are encouraged to share information about their experiences with big data analytics and its applications with colleagues. Characteristics of safe and effective big data analytics services 1. Protection of privacy Privacy and security concerns present a challenge in linking big data in EMRs. As data are linked, it becomes increasingly difficult to de-identify individual patients.22 As care is increasingly provided in interconnected, digital environments, physicians are having to take on the role of data stewardship. To that end, physicians may wish to employ conservative risk assessment practices-"should we" as opposed to "can we" when linking data sources-and obtain express patient consent, employing a "permission-based" approach to the collection and stewardship of data. 2. A clear and detailed data sharing agreement Physicians entering into a contract with an EMR vendor or other third party for provision of services should understand how and when they are contributing to the collection of data for the purposes of big data analytics services. There are template data sharing agreements available, which include the basic components of safe and effective data sharing, such as the model provided by the Information and Privacy Commissioner of Ontario.23 Data sharing agreements may include general use and project-specific use, both of which physicians should assess before entering into the agreement. When EMR access is being provided to a ministry of health and/or regional health authority, the data sharing agreement should distinguish between access to administrative data and access to clinical data. Physicians may wish to refer to the CMA's policy on Data Sharing Agreements: Principles for Electronic Medical Records/Electronic Health Records.24 3. Physician-owned and -led data collaboratives In some provinces there may exist opportunities to share clinical data in physician-owned and -led networks to reflect on and improve patient care. One example is the Physicians Data Collaborative in British Columbia, a not-for-profit organization open to divisions of family practice.25 Collaboratives such as this one are governed by physicians and driven by a desire to protect the privacy and safety of patients while producing meaningful results for physicians in daily practice. Participation in physician-owned data collaboratives may ensure that patient data continue to be managed by physicians, which may lead to an appropriate prioritization of physicians' obligations to balance patient-centred care and patient privacy. 4. Endorsement by a professional or other recognized association or medical society or health care organization When considering use of big data analytics services, it is best to select services created or endorsed by a professional or other recognized association or medical society. Some health care organizations, such as hospitals, may also develop or endorse services for use in their clinical environments. Without such endorsement, physicians are advised to proceed with additional caution. 5. Scope of services and functionality/appropriateness of data Physicians may wish to seek out information from EMR vendors and service providers about how big data analytics services complement the process of diagnosis and about the range of data sources from which these services draw. While big data analytics promises insight into population health and practice trends, if it is not drawing from an appropriate level of cross-referenced sources it may present a skewed picture of both.26 Ultimately, the physician must decide if the sources are appropriately diverse. Physicians should expect EMR vendors and service providers to make clear how and why they draw the information they do in the provision of analytics services. Ideally, analytics services should integrate population health analytics, risk-based cost analysis, care management services (such as point-of-care decision support tools) and performance analytics. Physicians should expect EMR vendors to allocate sufficient health informatics resources to information management, technical infrastructure, data protection and response to breaches in privacy, and data extraction and analysis.27,28 Physicians may also wish to consider the appropriateness of data analytics services in the context of their practices. Not all data will be useful for some medical specialties, such as those treating conditions that are relatively rare in the overall population. The potential for new or enhanced clinical practice tools informed by big data analytics may be restricted to primary care practice at this time.29 Finally, predictive analytics often make treatment recommendations that are designed to improve the health outcomes in a population, and these recommendations may conflict with physicians' ethical obligations to act in the best interests of individual patients and respect patients' autonomous decision-making).30 References 1 Canadian Medical Association. Data sharing agreements: principles for electronic medical records/electronic health records [CMA policy]. Ottawa: The Association; 2009. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD09-01.pdf 2 Canadian Medical Association. Principles concerning physician information [CMA policy]. CMAJ 2002 167(4):393-4. Available: http://policybase.cma.ca/dbtw-wpd/PolicyPDF/PD02-09.pdf 3 Canadian Medical Association. Principles for the protection of patients' personal health information [CMA policy]. Ottawa: The Association; 2010. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD11-03.pdf 4 Canadian Medical Association. Disclosing personal health information to third parties. Ottawa: The Association; 2011. Available: www.cma.ca/Assets/assets-library/document/en/advocacy/CMA_Disclosure_third_parties-e.pdf 5 Canadian Medical Association. Need to know and circle of care. Ottawa: The Association; 2011. Available: www.cma.ca/Assets/assets-library/document/en/advocacy/CMA_Need_to_know_circle_care-e.pdf 6 Canadian Medical Protective Association. The impact of big data on healthcare and medical practice. Ottawa: The Association; no date. Available: https://oplfrpd5.cmpa-acpm.ca/documents/10179/301372750/com_14_big_data_design-e.pdf 7 Kayyali B, Knott D, Van Kuiken S. The 'big data' revolution in US health care: accelerating value and innovation. New York: McKinsey & Company; 2013. p. 1. 8 College of Family Physicians of Canada, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada. National physician survey, 2014. National results by FP/GP or other specialist, sex, age and all physicians. Q7. Ottawa: The Colleges and Association; 2014. Available: http://nationalphysiciansurvey.ca/wp-content/uploads/2014/08/2014-National-EN-Q7.pdf 9 Anonymous. Data, data everywhere. The Economist 2010 Feb 27. Available: www.economist.com/node/15557443 10 Anonymous. Data, data everywhere. The Economist 2010 Feb 27. Available: www.economist.com/node/15557443 11 Canada Health Infoway. Big data analytics in health. Toronto: Canada Health Infoway; 2013. Available: www.infoway-inforoute.ca/index.php/resources/technical-documents/emerging-technology/doc_download/1419-big-data-analytics-in-health-white-paper-full-report (accessed 2014 May 16). 12 Ellaway RH, Pusic MV, Galbraith RM, Cameron T. 2014 Developing the role of big data and analytics in health professional education. Med Teach 2014;36(3):216-222. 13 Marino DJ. Using business intelligence to reduce the cost of care. Healthc Financ Manage 2014;68(3):42-44, 46. 14 Porter ME, Lee TH. The strategy that will fix health care. Harv Bus Rev 2013;91(10):50-70. 15 Baggaley C. Data protection in a world of big data: Canadian Medical Protective Association information session [presentation]. 2014 Aug 20. Available: https://oplfrpd5.cmpa-acpm.ca/documents/10179/301372750/com_2014_carmen_baggaley-e.pdf 16 College of Family Physicians of Canada, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada. National physician survey, 2014. National results by FP/GP or other specialist, sex, age and all physicians. Q10. Ottawa: The Colleges and Association; 2014. Available: http://nationalphysiciansurvey.ca/wp-content/uploads/2014/08/2014-National-EN-Q10.pdf 17 Canadian Primary Care Sentinel Surveillance Network. Available: http://cpcssn.ca/ (accessed 2014 Nov 15). 18 Canadian Partnership Against Cancer. Sustaining action toward a shared vision: 2012-2017 strategic plan. Toronto: The Partnership; no date. Available: www.partnershipagainstcancer.ca/wp-content/uploads/sites/5/2015/03/Sustaining-Action-Toward-a-Shared-Vision_accessible.pdf 19 Canadian Medical Association. Principles for the protection of patients' personal health information [CMA policy]. Ottawa: The Association; 2011. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD11-03.pdf 20 Canadian Medical Association. Principles for the protection of patients' personal health information [CMA policy]. Ottawa: The Association; 2011. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD11-03.pdf 21 Canadian Medical Association. Data sharing agreements: principles for electronic medical records/electronic health records [CMA policy]. Ottawa: The Association; 2009. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD09-01.pdf 22 Weber G, Mandl KD, Kohane IS. Finding the missing link for big biomedical data . JAMA 2014;311(24):2479-2480. doi:10.1001/jama.2014.4228. 23 Information and Privacy Commissioner of Ontario. Model data sharing agreement. Toronto: The Commissioner; 1995. Available: www.ipc.on.ca/images/Resources/model-data-ag.pdf 24 Canadian Medical Association. Data sharing agreements: principles for electronic medical records/electronic health records [CMA policy]. Ottawa: The Association; 2009. Available: http://policybase.cma.ca/dbtw-wpd/Policypdf/PD09-01.pdf 25 Physicians Data Collaborative. Overview. Available: www.divisionsbc.ca/datacollaborative/home 26 Cohen IG, Amarasingham R, Shah A, Xie B, Lo B. The legal and ethical concerns that arise from using complex predictive analytics in health care. Health Aff 2014;33(7):1139-1147. 27 Rhoads J, Ferrara L. Transforming healthcare through better use of data. Electron Healthc 2012;11(1):e27. 28 Canadian Medical Protective Association. The impact of big data and healthcare and medical practice. Ottawa: The Association; no date. Available: https://oplfrpd5.cmpa-acpm.ca/documents/10179/301372750/com_14_big_data_design-e.pdf 29 Genta RM, Sonnenberg A. Big data in gastroenterology research. Nat Rev Gastroenterol Hepatol 2014;11(6):386-390. 30 Cohen IG, Amarasingham R, Shah A, Xie B, Lo B. The legal and ethical concerns that arise from using complex predictive analytics in health care. Health Aff 2014;33(7):1139-1147.
Documents
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Supporting the enactment of Bill C-14, Medical Assistance in Dying

https://policybase.cma.ca/en/permalink/policy13693
Last Reviewed
2019-03-03
Date
2016-05-02
Topics
Ethics and medical professionalism
  1 document  
Policy Type
Parliamentary submission
Last Reviewed
2019-03-03
Date
2016-05-02
Topics
Ethics and medical professionalism
Text
In this submission to the House of Commons Standing Committee on Justice and Human Rights, the CMA’s feedback is focused on three of the legislative objectives of Bill C-14, given their relevance to the CMA’s Principles-based Recommendations for a Canadian Approach to Assisted Dying. On behalf of its more than 83,000 members and the Canadian public, the CMA performs a wide variety of functions. Key functions include advocating for health promotion and disease/injury prevention policies and strategies, advocating for access to quality health care, facilitating change within the medical profession, and providing leadership and guidance to physicians to help them influence, manage and adapt to changes in health care delivery. i) Robust Safeguards First, the CMA supports the legislative objective of ensuring a system of robust safeguards to the provision of medical assistance in dying. The safeguards proposed by Bill C-14 include: patient eligibility criteria, process requirements to request medical assistance in dying, as well as monitoring and reporting requirements. The CMA is a voluntary professional organization representing the majority of Canada’s physicians and comprising 12 provincial and territorial divisions and over 60 national medical organizations. ii) Consistent, Pan-Canadian Framework Second, the CMA supports the legislative objective that a consistent framework for medical assistance in dying in Canada is desirable. In addition to robust safeguards, key measures proposed by Bill C-14 support the promulgation of a consistent framework across jurisdictions include legislating definitions for “medical assistance in dying” and “grievous and irremediable condition.” The CMA’s Principles-based Recommendations reflect on the subjective nature of what constitutes “enduring and intolerable suffering” and a “grievous and irremediable condition” as well as the physician’s role in making an eligibility determination. iii) End-of-Life Care Coordination System Thirdly, the CMA supports the objective to develop additional measures to support the provision of a full range of options for end-of-life care and to respect the personal convictions of health care providers. The fulfilment of these commitments with federal non-legislative measures will be integral to supporting the achievement of access to care, respecting the personal convictions of health care providers, and developing a consistent, pan-Canadian framework. The CMA encourages the federal government to rapidly advance its commitment to engage the provinces and territories in developing a pan-Canadian end-of-life care coordinating system. It will be essential for this system to be in place for June 6, 2016. At least one jurisdiction has made a system available to support connecting patients with willing providers. Until a pan-Canadian system is available, there will be a disparity of support for patients and practitioners across jurisdictions. iv) Respect Personal Convictions Finally, it is the CMA’s position that Bill C-14, to the extent constitutionally possible, must respect the personal convictions of health care providers. In the Carter decision, the Supreme Court of Canada emphasized that any regulatory or legislative response must seek to reconcile the Charter rights of patients wanting to access assisted dying and physicians who choose not to participate in medical assistance in dying on grounds of conscientious objection. The CMA’s Principles-based Recommendations achieves an appropriate balance between physicians’ freedom of conscience and the assurance of effective and timely patient access to a medical service. From the CMA’s significant consultation with our membership, it is clear that physicians who are comfortable providing referrals strongly believe it is necessary to ensure the system protects the conscience rights of physicians who are not. While the federal government has achieved this balance with Bill C-14, there is the potential for other regulatory bodies to implement approaches that may result in a patchwork system. The CMA’s position is that the federal government effectively mitigate this outcome by rapidly advancing the establishment of the pan-Canadian end-of-life care coordinating system. CMA Supports Cautious Approach for “Carter Plus” The CMA must emphasize the need for caution and careful study in consideration of “Carter Plus”, which includes: eligibility of mature minors, eligibility with respect to sole mental health conditions, and advance care directives. The CMA supports the federal government’s approach not to legislate these issues, rather to study them in greater detail. Word count: 750
Documents
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Summary of federal legislation/regulations

https://policybase.cma.ca/en/permalink/policy11922
Last Reviewed
2018-03-03
Date
2016-08-24
Topics
Physician practice/ compensation/ forms
Resolution
GC16-46
The Canadian Medical Association will create an up-to-date summary of federal legislation/regulations that impacts physician practice.
Policy Type
Policy resolution
Last Reviewed
2018-03-03
Date
2016-08-24
Topics
Physician practice/ compensation/ forms
Resolution
GC16-46
The Canadian Medical Association will create an up-to-date summary of federal legislation/regulations that impacts physician practice.
Text
The Canadian Medical Association will create an up-to-date summary of federal legislation/regulations that impacts physician practice.
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Medical assistance in dying education

https://policybase.cma.ca/en/permalink/policy11941
Last Reviewed
2018-03-03
Date
2016-08-24
Topics
Ethics and medical professionalism
Resolution
GC16-48
The Canadian Medical Association supports the inclusion of education and the development of Canadian accreditation elements related to medical assistance in dying for all medical students and resident physicians.
Policy Type
Policy resolution
Last Reviewed
2018-03-03
Date
2016-08-24
Topics
Ethics and medical professionalism
Resolution
GC16-48
The Canadian Medical Association supports the inclusion of education and the development of Canadian accreditation elements related to medical assistance in dying for all medical students and resident physicians.
Text
The Canadian Medical Association supports the inclusion of education and the development of Canadian accreditation elements related to medical assistance in dying for all medical students and resident physicians.
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Provincial health advisory councils

https://policybase.cma.ca/en/permalink/policy700
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Health systems, system funding and performance
Resolution
GC73-63
That in each province there be established a health advisory council to advise government in matters relating to health facilities and provision of health care services throughout the province, and that on this council there be representation from the provincial division of the Canadian Medical Association.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Health systems, system funding and performance
Resolution
GC73-63
That in each province there be established a health advisory council to advise government in matters relating to health facilities and provision of health care services throughout the province, and that on this council there be representation from the provincial division of the Canadian Medical Association.
Text
That in each province there be established a health advisory council to advise government in matters relating to health facilities and provision of health care services throughout the province, and that on this council there be representation from the provincial division of the Canadian Medical Association.
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School health programmes

https://policybase.cma.ca/en/permalink/policy779
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Population health/ health equity/ public health
Resolution
GC73-40
The Canadian Medical Association and provincial/territorial medical associations shall lend support in stimulating initiation and improvement of school health.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Population health/ health equity/ public health
Resolution
GC73-40
The Canadian Medical Association and provincial/territorial medical associations shall lend support in stimulating initiation and improvement of school health.
Text
The Canadian Medical Association and provincial/territorial medical associations shall lend support in stimulating initiation and improvement of school health.
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Programmes for drug addicts

https://policybase.cma.ca/en/permalink/policy780
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Population health/ health equity/ public health
Resolution
GC73-43
That the Canadian Medical Association favours the availability of multi-modal programmes to aid in dealing with the many faceted needs of the drug dependent population and taking into account the multi-drug use problem.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Population health/ health equity/ public health
Resolution
GC73-43
That the Canadian Medical Association favours the availability of multi-modal programmes to aid in dealing with the many faceted needs of the drug dependent population and taking into account the multi-drug use problem.
Text
That the Canadian Medical Association favours the availability of multi-modal programmes to aid in dealing with the many faceted needs of the drug dependent population and taking into account the multi-drug use problem.
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Psycho-active substances and the operation of motor vehicles and industrial equipment

https://policybase.cma.ca/en/permalink/policy781
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Population health/ health equity/ public health
Resolution
GC73-50
That the membership of the Canadian Medical Association clearly inform its patients, and the general public at large, of the hazards associated with the operation of motor vehicles, industrial equipment, etc., while under the influence of psycho-active substances, especially alcohol and antihistamines, and particularly the combination of such substances.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1973-06-16
Topics
Pharmaceuticals/ prescribing/ cannabis/ marijuana/ drugs
Population health/ health equity/ public health
Resolution
GC73-50
That the membership of the Canadian Medical Association clearly inform its patients, and the general public at large, of the hazards associated with the operation of motor vehicles, industrial equipment, etc., while under the influence of psycho-active substances, especially alcohol and antihistamines, and particularly the combination of such substances.
Text
That the membership of the Canadian Medical Association clearly inform its patients, and the general public at large, of the hazards associated with the operation of motor vehicles, industrial equipment, etc., while under the influence of psycho-active substances, especially alcohol and antihistamines, and particularly the combination of such substances.
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Protective systems for passengers in motor vehicles

https://policybase.cma.ca/en/permalink/policy794
Last Reviewed
2017-03-04
Date
1980-09-15
Topics
Health care and patient safety
Resolution
GC80-27
That the Canadian Medical Association strongly support continued research by industry and government in the design of protective systems for passengers in motor vehicles.
Policy Type
Policy resolution
Last Reviewed
2017-03-04
Date
1980-09-15
Topics
Health care and patient safety
Resolution
GC80-27
That the Canadian Medical Association strongly support continued research by industry and government in the design of protective systems for passengers in motor vehicles.
Text
That the Canadian Medical Association strongly support continued research by industry and government in the design of protective systems for passengers in motor vehicles.
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