Polysomnography Application Assessment Process

The Medical Services Commission has updated the process for assessing polysomnography applications. The updated assessment process is consistent with the Medical and Health Care Services Regulation S 40(1) which states that the Commission must not issue a certificate of approval for a new, expanded or relocated diagnostic facility unless it is satisfied that there is sufficient medical need to warrant the proposed services and that there is reasonable utilization of existing approved facilities which render the services for which approval is sought. 

A Data-Informed Approach

Since April 2021, the Ministry of Health has gathered wait time and utilization data from all adult polysomnography facilities in British Columbia through a formal wait time reporting program.

This has helped to inform the Commission concerning:

• A population-based target service level for polysomnography beds
• Patient wait time and priority level to be used
• Addressing polysomnography utilization when assessing applications 

To address regulatory requirements when assessing polysomnography applications, the Commission has adopted the criteria outlined below.

1. Sufficient Medical Need

The Commission’s Advisory Committee on Diagnostic Facilities (ACDF) will consider both service level and patient wait times when assessing sufficient medical need and may recommend denial of applications where the one or both of these criteria have not been met.

For polysomnography, sufficient medical need will be assessed based on:
(1) a population-based model that describes the polysomnography service level determined to be sufficient, and (2) patient wait times.

Target polysomnography service level

1. For polysomnography catchment areas (Health Service Delivery Area/HSDA), a service level of 1.7 to 1.9 beds per 100,000 people is considered appropriate.
2. the Ministry has calculated the  service level (beds per 100,000 people) considered appropriate for each HSDA in British Columbia.

For further detail see Polysomnography Target Service Level Calculation

Wait times

1. For polysomnography, only the wait following patient consultation with a specialist (i.e., when a diagnostic facility receives a requisition) to the time of the diagnostic study (Wait 2), during the preceding 12, 6 and 3-month periods, will be considered in reference to Commission-endorsed benchmarks for polysomnography.
2. the Commission-endorsed wait time for Priority 1 patients will be the primary wait time benchmark used when assessing applications. If warranted, other priority benchmarks may be considered (in descending order).

2. Reasonable Utilization of Existing Facilities

To inform a determination of “reasonable utilization” when assessing applications, the ACDF will consider HSDA-specific data on:

1. average monthly utilization at each existing approved facility during the preceding 12, 6 and 3-month periods, and
2. the Commission-endorsed utilization benchmark for each facility, based on the approved number of polysomnography beds in the facility.

Underutilized Facilities

If a facility within a catchment area under consideration is found to be operating significantly below the benchmark for reasonable utilization, operational leaders will be asked to prioritize polysomnography to achieve, within a prescribed time, a utilization level that is considered reasonable, as per the Commission-endorsed benchmark.

Generally, if a facility fails to achieve reasonable utilization, the ACDF may consider approving additional/new capacity in that catchment area.

In addition, the Commission has determined that priority consideration for publicly owned facilities, as detailed in the ACDF’s Use of Existing Facilities policy (PDF, 633KB), be provided only to those publicly owned facilities that are achieving reasonable utilization of their existing polysomnography capacity.

Conditions

As a condition of approval, all approved polysomnography facilities are required to provide patient wait time reports as specified by the Ministry.

For further detail regarding assessment of polysomnography facility applications, see:

Service Level Calculation
Current and Target Service Levels
Patient Priority and Wait Time Benchmarks