Wednesday’s Wait Times Reduction Task Force report included a number of areas that could directly impact rural Manitoba.

The report emphasizes the interdependencies of emergency departments (EDs) and emergency medical services (EMS) as well as between EDs and timely access to primary care or family doctors.  It found that small EDs with frequent suspensions or closures are essentially serving as primary care sites where staff may feel ill-equipped to deal with emergency situations requiring specialized skills.

The report does not recommend specific changes to rural health facilities, but concludes it is not reasonable for rural residents to memorize the hours of EDs that are not open 24-7 or are subject to inconsistent service.  Nearly every site and many health-care providers consulted mentioned the need for a provincial on-call consultation service.  The report states such a resource would allow rural health-care practitioners to consult with dedicated emergency physicians via phone on treatment options as well as the need and urgency of transfer to another site.

The report also analyzed the waits and delays for hip and knee replacements, cataract surgery and magnetic resonance imaging (MRI) and makes recommendations on ways to reduce wait times and improve access.  Recommendations focus on better education for providers on the appropriate ordering of tests, implementing standardized referral processes, increasing capacity, making use of distance communications options such as Telehealth for follow-up appointments, and undertaking analysis to determine the best options for future investments.

The report also concludes there's no need for additional MRI machines in the province at this time.

Instead, the report recommends maximizing the use of the ones we already have by running them 16 hours per day, every day, where appropriate.

The report says an analysis done in January of this year shows maximizing what we have currently could eliminate MRI wait times by May 2019.

Dr. Brock Wright, CEO of Shared Health, says there's an opportunity to better use the MRIs we have. He says it will take some time, and it's up to the provincial government to determine whether there's any value in adding machines in the meantime.

The report also says there may come a time when further analysis should be done into whether an MRI is needed in northern Manitoba.

Both Dauphin and Niverville have been after MRI machines. Earlier this year, Niverville proposed a public-private partnership to get one. Dauphin was promised one under the previous NDP administration, but the current government put it on hold, pending the release of this report; Dauphin has already had a building constructed and trained staff.

Meanwhile, Winnipeg was set to lose two emergency departments at the same time next year, but now the Winnipeg Regional Health Authority will stagger the changes.

Concordia's emergency department will close and Seven Oaks will have its ER turned into urgent care, as part of the WRHA's second phase of "Healing our Health System." Both of those moves were supposed to happen simultaneously in the spring or summer of next year, but a new report suggests "de-coupling" the two. According to the WRHA's Lori Lamont, that's a recommendation they're on board with, through their own analysis.

"What we've seen as we've been planning for phase two, and is reinforced by the recommendation by the Wait Times Task Force, is that we will in fact de-couple those changes. So the changes will occur at one site and then at a later date at the second site," says Lamont.

She says they're currently in the planning stage of figuring out which of the upcoming changes will happen first, and when. She says they're aiming for spring 2019 for the completion of phase two.

The Wait Time Reduction Task Force report released today says if the Seven Oaks emergency department were to close at the same time as Concordia's, it would put a "monumental burden" on the remainder of Winnipeg's emergency departments.

In October, Victoria's emergency department became urgent care, and the urgent care centre at Misericordia was closed.