Mark Roseman
@markroseman.com
Fierce independent advocate for effective public health care. 🍁
Systems thinker. Recovering UX, collaboration tech geek.
Innovator, analyst, small biz guy, writer, philosopher, unfocused… 🤦🏻♂️
Victoria BC https://markroseman.com
Systems thinker. Recovering UX, collaboration tech geek.
Innovator, analyst, small biz guy, writer, philosopher, unfocused… 🤦🏻♂️
Victoria BC https://markroseman.com
Govt publishes a database of open (still processing…) requests. Did some quick stats. Ministry of Health has most outstanding (general) requests… avg is >9mo, median elapsed time is >5mo
November 7, 2025 at 4:40 PM
Govt publishes a database of open (still processing…) requests. Did some quick stats. Ministry of Health has most outstanding (general) requests… avg is >9mo, median elapsed time is >5mo
Government data on Health Connect Registry (wait list to be attached to family doctor or nurse practitioner) across the province.
healthdatabc.ca/primarycare/
In some areas, virtually everyone who wants to be is attached. Others have tens of thousands waiting… often for years.
healthdatabc.ca/primarycare/
In some areas, virtually everyone who wants to be is attached. Others have tens of thousands waiting… often for years.
November 1, 2025 at 5:17 PM
Government data on Health Connect Registry (wait list to be attached to family doctor or nurse practitioner) across the province.
healthdatabc.ca/primarycare/
In some areas, virtually everyone who wants to be is attached. Others have tens of thousands waiting… often for years.
healthdatabc.ca/primarycare/
In some areas, virtually everyone who wants to be is attached. Others have tens of thousands waiting… often for years.
Latest CIHI data for same/next day access to a health provider.
While the numbers are not good anywhere, BC scores lowest in the country for both adults and children/youth.
While the numbers are not good anywhere, BC scores lowest in the country for both adults and children/youth.
November 1, 2025 at 5:16 PM
Latest CIHI data for same/next day access to a health provider.
While the numbers are not good anywhere, BC scores lowest in the country for both adults and children/youth.
While the numbers are not good anywhere, BC scores lowest in the country for both adults and children/youth.
Why are there no nurses available to staff ERs?
Well, many have ended up at UPCCs. Far more than we need. Far more nurses than primary care providers.
Nursing spending nearly doubled(!) from 2023-2024, outpacing all other areas.
Best use of a scarce resource?
Well, many have ended up at UPCCs. Far more than we need. Far more nurses than primary care providers.
Nursing spending nearly doubled(!) from 2023-2024, outpacing all other areas.
Best use of a scarce resource?
November 1, 2025 at 5:15 PM
Why are there no nurses available to staff ERs?
Well, many have ended up at UPCCs. Far more than we need. Far more nurses than primary care providers.
Nursing spending nearly doubled(!) from 2023-2024, outpacing all other areas.
Best use of a scarce resource?
Well, many have ended up at UPCCs. Far more than we need. Far more nurses than primary care providers.
Nursing spending nearly doubled(!) from 2023-2024, outpacing all other areas.
Best use of a scarce resource?
Say you're the BC government or Fraser Health. ER wait times at some of your hospitals are just becoming too embarrassing. What do you do about it?
Do you work to fix the problem, work with staff, and reduce wait times?
Or do you just stop reporting the wait times altogether?
Do you work to fix the problem, work with staff, and reduce wait times?
Or do you just stop reporting the wait times altogether?
November 1, 2025 at 5:12 PM
Say you're the BC government or Fraser Health. ER wait times at some of your hospitals are just becoming too embarrassing. What do you do about it?
Do you work to fix the problem, work with staff, and reduce wait times?
Or do you just stop reporting the wait times altogether?
Do you work to fix the problem, work with staff, and reduce wait times?
Or do you just stop reporting the wait times altogether?
According to this FOI data, >30% of Westshore residents are not attached to primary care.
68% are attached.
Of the rest, 17% are on the govt's HCR (Health Connect Registry, i.e., waiting list). 18% are not on that waiting list for whatever reason.
Source: docs.openinfo.gov.bc.ca/Response_Pac...
68% are attached.
Of the rest, 17% are on the govt's HCR (Health Connect Registry, i.e., waiting list). 18% are not on that waiting list for whatever reason.
Source: docs.openinfo.gov.bc.ca/Response_Pac...
October 22, 2025 at 2:37 PM
According to this FOI data, >30% of Westshore residents are not attached to primary care.
68% are attached.
Of the rest, 17% are on the govt's HCR (Health Connect Registry, i.e., waiting list). 18% are not on that waiting list for whatever reason.
Source: docs.openinfo.gov.bc.ca/Response_Pac...
68% are attached.
Of the rest, 17% are on the govt's HCR (Health Connect Registry, i.e., waiting list). 18% are not on that waiting list for whatever reason.
Source: docs.openinfo.gov.bc.ca/Response_Pac...
Some FOI data on how many people are waiting on the Health Connect Registry to be attached to primary care.
(Attachment doesn't mean can reliably access, but it's a metric nonetheless).
FOI data: docs.openinfo.gov.bc.ca/Response_Pac...
(Attachment doesn't mean can reliably access, but it's a metric nonetheless).
FOI data: docs.openinfo.gov.bc.ca/Response_Pac...
October 22, 2025 at 2:36 PM
Some FOI data on how many people are waiting on the Health Connect Registry to be attached to primary care.
(Attachment doesn't mean can reliably access, but it's a metric nonetheless).
FOI data: docs.openinfo.gov.bc.ca/Response_Pac...
(Attachment doesn't mean can reliably access, but it's a metric nonetheless).
FOI data: docs.openinfo.gov.bc.ca/Response_Pac...
Government releases (via FOI) list of 1800+ unscheduled ER closures in BC.
Seven ER's w/ > 100 closures each.
Have we actually seen stats like this before?
Will we see these in the media anywhere?
Details: healthdatabc.ca/emrg/
Seven ER's w/ > 100 closures each.
Have we actually seen stats like this before?
Will we see these in the media anywhere?
Details: healthdatabc.ca/emrg/
October 22, 2025 at 2:35 PM
Government releases (via FOI) list of 1800+ unscheduled ER closures in BC.
Seven ER's w/ > 100 closures each.
Have we actually seen stats like this before?
Will we see these in the media anywhere?
Details: healthdatabc.ca/emrg/
Seven ER's w/ > 100 closures each.
Have we actually seen stats like this before?
Will we see these in the media anywhere?
Details: healthdatabc.ca/emrg/
But last week, they suddenly removed this data from the underlying data feed.
What changed? And why?
My best is that they finally got wise to the fact that the horrible wait times were actually still available, and closed the loophole.
In what world is this acceptable?
What changed? And why?
My best is that they finally got wise to the fact that the horrible wait times were actually still available, and closed the loophole.
In what world is this acceptable?
August 27, 2025 at 2:30 PM
But last week, they suddenly removed this data from the underlying data feed.
What changed? And why?
My best is that they finally got wise to the fact that the horrible wait times were actually still available, and closed the loophole.
In what world is this acceptable?
What changed? And why?
My best is that they finally got wise to the fact that the horrible wait times were actually still available, and closed the loophole.
In what world is this acceptable?
But on March 31, they stopped reporting waits at Royal Columbian Hospital and Eagle Ridge Hospital.
The website shows "unable to display wait times"
Wait time data was still available. But they deliberately chose not to display it.
The website shows "unable to display wait times"
Wait time data was still available. But they deliberately chose not to display it.
August 27, 2025 at 2:30 PM
But on March 31, they stopped reporting waits at Royal Columbian Hospital and Eagle Ridge Hospital.
The website shows "unable to display wait times"
Wait time data was still available. But they deliberately chose not to display it.
The website shows "unable to display wait times"
Wait time data was still available. But they deliberately chose not to display it.
Fraser Health and the BC government has been deliberately withholding data on ER wait times.
The edwaittimes.ca shows real-time waits for virtually all lower mainland ER's.
The edwaittimes.ca shows real-time waits for virtually all lower mainland ER's.
August 27, 2025 at 2:30 PM
Fraser Health and the BC government has been deliberately withholding data on ER wait times.
The edwaittimes.ca shows real-time waits for virtually all lower mainland ER's.
The edwaittimes.ca shows real-time waits for virtually all lower mainland ER's.
BC citizens need an independent health data czar for BC. The current system, where the government (who provides the services) is responsible for reporting on the effectiveness of the services is simply not credible. No matter who is in government. The incentives to spin the data are far too strong.
August 1, 2025 at 4:16 PM
BC citizens need an independent health data czar for BC. The current system, where the government (who provides the services) is responsible for reporting on the effectiveness of the services is simply not credible. No matter who is in government. The incentives to spin the data are far too strong.
This is the how the BC health system thinks about management and accountability… keep that in mind as we see more of the bogus health authority and primary care "reviews."
All meant to deflect from the widespread failures, cover ups, harassment, corruption, and grift.
All meant to deflect from the widespread failures, cover ups, harassment, corruption, and grift.
June 12, 2025 at 2:43 PM
This is the how the BC health system thinks about management and accountability… keep that in mind as we see more of the bogus health authority and primary care "reviews."
All meant to deflect from the widespread failures, cover ups, harassment, corruption, and grift.
All meant to deflect from the widespread failures, cover ups, harassment, corruption, and grift.
The ideas are right (focus on metrics) but getting MOH to actually disclose the real information that's needed (vs. talk about strategies or hand-wave) is risky.
The details and deadlines need to firm up.
There's a reason there's no truly independent component to this review.
The details and deadlines need to firm up.
There's a reason there's no truly independent component to this review.
June 6, 2025 at 11:33 PM
The ideas are right (focus on metrics) but getting MOH to actually disclose the real information that's needed (vs. talk about strategies or hand-wave) is risky.
The details and deadlines need to firm up.
There's a reason there's no truly independent component to this review.
The details and deadlines need to firm up.
There's a reason there's no truly independent component to this review.
This is data for fiscal year ending Mar/24. Over a year ago.
Govt obstructed release for 213 business days, after complaints, the end of the legislative session, and announcing a sham review of primary care. healthdatabc.ca/meta/foi-pen...
Will we ever see data for FY ending Mar/25?
Govt obstructed release for 213 business days, after complaints, the end of the legislative session, and announcing a sham review of primary care. healthdatabc.ca/meta/foi-pen...
Will we ever see data for FY ending Mar/25?
June 6, 2025 at 6:37 PM
This is data for fiscal year ending Mar/24. Over a year ago.
Govt obstructed release for 213 business days, after complaints, the end of the legislative session, and announcing a sham review of primary care. healthdatabc.ca/meta/foi-pen...
Will we ever see data for FY ending Mar/25?
Govt obstructed release for 213 business days, after complaints, the end of the legislative session, and announcing a sham review of primary care. healthdatabc.ca/meta/foi-pen...
Will we ever see data for FY ending Mar/25?
They also answered questions about attaching patients to FPs/NPs. Half the UPCCs don't. At all.
For those that do, it's not many (<20k total, or 0.35% of BC's population).
And those in VCH are getting out of it entirely.
At least they're giving up the charade.
For those that do, it's not many (<20k total, or 0.35% of BC's population).
And those in VCH are getting out of it entirely.
At least they're giving up the charade.
June 6, 2025 at 6:37 PM
They also answered questions about attaching patients to FPs/NPs. Half the UPCCs don't. At all.
For those that do, it's not many (<20k total, or 0.35% of BC's population).
And those in VCH are getting out of it entirely.
At least they're giving up the charade.
For those that do, it's not many (<20k total, or 0.35% of BC's population).
And those in VCH are getting out of it entirely.
At least they're giving up the charade.
What's most shocking (and that says a lot) is what's changed from the previous year.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
June 6, 2025 at 6:37 PM
What's most shocking (and that says a lot) is what's changed from the previous year.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
If you want to go into details for each individual UPCC, both in terms of how much they spent, and how that compared with their budget, you can do that.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
June 6, 2025 at 6:37 PM
If you want to go into details for each individual UPCC, both in terms of how much they spent, and how that compared with their budget, you can do that.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
BREAKING: Updated performance data on UPCCs. 🧵
Full sources and details now updated at healthdatabc.ca/primarycare/...
First, effective cost per visit jumped > 40% to an insane $182.50. Many sites much higher.
Full sources and details now updated at healthdatabc.ca/primarycare/...
First, effective cost per visit jumped > 40% to an insane $182.50. Many sites much higher.
June 6, 2025 at 6:37 PM
BREAKING: Updated performance data on UPCCs. 🧵
Full sources and details now updated at healthdatabc.ca/primarycare/...
First, effective cost per visit jumped > 40% to an insane $182.50. Many sites much higher.
Full sources and details now updated at healthdatabc.ca/primarycare/...
First, effective cost per visit jumped > 40% to an insane $182.50. Many sites much higher.
What's most shocking (and that says a lot) is what's changed from the previous year.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
June 6, 2025 at 5:57 PM
What's most shocking (and that says a lot) is what's changed from the previous year.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
Visits up 3% but costs up 46%!!!
There's now a huge excess of nurses (could they be better used elsewhere) who can't deliver many primary care services. More FPs/NPs but still not enough.
If you want to go into details for each individual UPCC, both in terms of how much they spent, and how that compared with their budget, you can do that.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
June 6, 2025 at 5:57 PM
If you want to go into details for each individual UPCC, both in terms of how much they spent, and how that compared with their budget, you can do that.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
Note how many have failed to recruit adequate number of physicians or nurse practitioners, and how many exceeded overhead.
And if Jeremy Valeriote wants to start by getting a simple answer about UPCC patient visits as I've been requesting for nearly a year, that would be a good litmus test of cooperation.
June 3, 2025 at 12:50 AM
And if Jeremy Valeriote wants to start by getting a simple answer about UPCC patient visits as I've been requesting for nearly a year, that would be a good litmus test of cooperation.