The pilot list of no-cost laboratory services available to patients at community laboratories will continue in 2023-24

To: Ordering Clinicians (Medical Practitioners, Dentists, Midwives, Registered Nurses in the Extended Class, as applicable pursuant to Ontario Regulation 45/22 under the Laboratory and Specimen Collection Centre Licensing Act)
Category: Physician Services, Primary Health Care Services, Dentist Services, Midwife Services, Registered Nurse in the Extended Class
Written by: Laboratories and Diagnostics Branch, Health Programs and Delivery Division
Date issued: March 29, 2023

Overview

The Community Access Pilot for Laboratory Services will be extended to the 2023-24 fiscal year with no changes to the current ordering practices for ordering clinicians.

Any ordering clinician in Ontario (as defined for specimen collection and laboratory testing in Ontario Regulation 45/22 under the Laboratory and Specimen Collection Centre Licensing Act) can request services included in the Pilot by using the existing ordering practices that are currently in-place.

The services that are included are:

  • Category 1 Services: Patients can have their specimens collected at a community laboratory for any genetic tests performed in a laboratory listed in Table 1.
  • Category 2 Services: Patients can have the tests listed in Table 2 performed by a community laboratory.

Participation in the Community Access Pilot for Laboratory Services is voluntary. The ministry encourages providing this pathway to testing for patients when appropriate to help connect patients with care closer to home.

Any specimen collections requiring specialized or complex ordering and/or handling requirements should continue to be collected in the appropriate setting (example: hospital).

Additional details about participating in the Community Access Pilot for Laboratory Services can be found below.

Category 1 Services

There is no change for clinicians or patients.

Clinicians can continue their current ordering practice when completing a requisition form for genetic testing.

Patients needing any genetic testing for that will be tested at a laboratory listed in Table 1 will continue to have the option of taking their requisition form to a community laboratory (or the Specimen Collection Centre it owns or operates).

Please note: patients should be referred to have their specimens collected at a community laboratory only if it is a routine collection with no special collection methodologies.

Table 1: Molecular Genetics & Cytogenetics Laboratories

# Hospital/Program Name
1 London Health Sciences Centre
2 Hamilton Health Sciences Corp
3 Trillium Health Partners
4 University Health Network
5 The Hospital for Sick Children
6 Sinai Health System
7 Sunnybrook Health Sciences Centre
8 Unity Health Toronto
9 North York General Hospital
10 Lakeridge Health
11 Kingston Health Sciences Centre
12 The Ottawa Hospital
13 Children's Hospital of Eastern Ontario
14 Health Sciences North
15 Newborn Screening Ontario (NSO) Molecular Laboratory
16 The National Inherited Bleeding Disorder Genotyping Laboratory
17 William Osler Health System-Brampton Civic Hospital
18 Lakeridge Health Oshawa
19 St. Joseph’s Healthcare

Category 2 Services

There is no change for clinicians or patients.

Clinicians can continue their current practices when completing the requisition for tests listed in Table 2.

Patients will be able to continue to have these tests performed by a community laboratory at no-cost.

The ordering clinician should only refer patients to have their specimens collected at a community laboratory according to the criteria in Table 2.

Table 2: List of Services

Name of Test Collection and/or Testing Clinical Indications for Ordering
Trichomonas – Nucleic Acid Amplification Test (NAAT) Testing Only Polymerase Chain Reaction (PCR) test (NAAT) only-no changes to existing clinical guidance.
Gonorrhea (NAAT) Testing Only PCR test (NAAT) only-no changes to existing clinical guidance.
Chlamydia
(NAAT)		 Testing Only PCR test (NAAT) only-no changes to existing clinical guidance.
C. difficile-EIA stool antigen and Toxin A/B Testing Only Enzyme Immunoassay (EIA) as initial screen. If EIA results for antigen and toxin A/B are concordant, confirmatory NAAT is not needed.
C. difficile-Confirmatory (NAAT) Testing Only NAAT for confirmatory testing only.
Apolipoprotein B Collections and Testing As per the 2021 Canadian Cardiovascular Society (CCS) Guidelines
Lipoprotein a [Lp(a)] Collections and Testing As per the 2021 Canadian Cardiovascular Society (CCS) Guidelines
Celiac tissue Transglutaminase Immunoglobulin A (tTG-IgA) Collections and Testing For the purposes of the Pilot, should be ordered for the diagnosis of celiac disease only with the following criteria:
  • Indicated in clients over 2 years of age.
  • Should only be tested while client is on a gluten containing diet.
If client is IgA deficient (see "serum IgA" test below), additional testing required will not be funded through this Pilot.
Celiac serum IgA Collections and Testing Used alongside Celiac tTG-IgA to determine whether a client is IgA deficient.
N-Terminal-pro hormone B-type Natriuretic Peptide (NT-proBNP) Collections and Testing Clinically indicated only in clients with suspected heart failure.

Additional information

The Community Access Pilot for Laboratory Services will continue from April 1, 2023, to March 31, 2024. The data collected will contribute to healthcare system planning efforts.

The ministry will continue to maintain a Questions & Answers (“Q&A”) document to support the implementation of the Community Access Pilot for Laboratory Services. It will be updated as needed and shared with community laboratories and implementation partners upon request to the ministry at CommunityLabs@ontario.ca.

Keywords/Tags

Community Access Pilot; Community Laboratories; Laboratory Services; Patient Access

Contact information

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