The pilot list of no-cost laboratory services available to patients at community laboratories will continue in 2024-25

To: Ordering Clinicians (Medical Practitioners, 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, Registered Nurse in the Extended Class
Written by: Laboratories and Diagnostics Branch, Health Programs and Delivery Division
Date issued: May 6, 2024
Bulletin Number: 240501

Overview

The Community Access Pilot for Laboratory Services will be extended through March 31, 2025 with no changes to the current ordering practices for ordering clinicians or the tests funded under the Pilot.

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.

Services included in the Community Access Pilot 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 below.
  • Category 2 Services: Patients can have the tests listed in Table 2 (please see below) performed by a community laboratory.

Participation in the Community Access Pilot for Laboratory Services is voluntary. The ministry encourages providing this testing option where appropriate to help connect people with care faster and closer to home.

Any specimen collections requiring specialized or complex ordering and/or handling requirements should continue to be collected in the appropriate setting such as a 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 that will be performed by 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 and Cytogenetics Laboratories

#Hospital/Program Name
1LONDON HEALTH SCIENCES CENTRE
2HAMILTON HEALTH SCIENCES CORP
3TRILLIUM HEALTH PARTNERS
4UNIVERSITY HEALTH NETWORK
5THE HOSPITAL FOR SICK CHILDREN
6SINAI HEALTH SYSTEM
7SUNNYBROOK HEALTH SCIENCES CENTRE
8UNITY HEALTH TORONTO
9NORTH YORK GENERAL HOSPITAL
10LAKERIDGE HEALTH
11KINGSTON HEALTH SCIENCES CENTRE
12THE OTTAWA HOSPITAL
13CHILDREN'S HOSPITAL OF EASTERN ONTARIO
14HEALTH SCIENCES NORTH
15NEWBORN SCREENING ONTARIO (NSO) MOLECULAR LABORATORY
16THE NATIONAL INHERITED BLEEDING DISORDER GENOTYPING
17WILLIAM OSLER HEALTH SYSTEM-BRAMPTON CIVIC HOSPITAL
18LAKERIDGE HEALTH OSHAWA
19ST. 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 TestCollection and/or TestingClinical Indications for Ordering
Trichomonas – Nucleic Acid Amplification Test (NAAT)Testing OnlyPolymerase Chain Reaction (PCR) test (NAAT) only-no changes to existing clinical guidance.
Gonorrhea (NAAT)Testing OnlyPCR test (NAAT) only-no changes to existing clinical guidance.
Chlamydia (NAAT)Testing OnlyPCR test (NAAT) only-no changes to existing clinical guidance.
C. difficile-EIA stool antigen and Toxin A/BTesting OnlyEnzyme 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 OnlyNAAT for confirmatory testing only.
Apolipoprotein BCollections and TestingAs per the 2021 Canadian Cardiovascular Society (CCS) Guidelines
Lipoprotein a [Lp(a)]Collections and TestingAs per the 2021 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 IgACollections and TestingUsed alongside Celiac tTG-IgA to determine whether a client is IgA deficient.
N-Terminal-pro hormone B-type Natriuretic Peptide (NT-proBNP)Collections and TestingClinically indicated only in clients with suspected heart failure.
Antineutrophil Cytoplasmic Antibodies (ANCA): PR3 and MPOCollections and Testing
  • Canadian Vasculitis Network Guidelines; as per disease activity.
  • Ordering Clinicians are restricted to clinicians practising Pediatrics and all its subspecialties, Internal Medicine and all its subspecialties, Dermatology, Neurology, Otolaryngology and Ophthalmology.
Anti-Cyclic Citrullinated Peptide Antibodies (ACPA)Collections and Testing
  • If negative, do not repeat within 1 year.
  • If positive, do not repeat.
  • Ordering Clinicians are restricted to clinicians practising Pediatrics and all its subspecialties, Internal Medicine and all its subspecialties, and Dermatology.

Additional Information

For further information about the Community Access Pilot for Laboratory Services, please email CommunityLabs@ontario.ca or call 416-326-2158.

Keywords/Tags

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

Contact information

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