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Pathways – Streamlining referrals, improving patient care

What is Pathways NL?

Pathways NL is a web-based resource designed by physicians, for physicians. It acts as an “Information Bridge” by facilitating efficient referrals and supporting optimal patient care by providing information such as: 

-consultants’ consultation requirements.  

-consultants’ areas of practice and limitations.  

-and referral wait times. 

Radially-organized list of Pathways features: 'which specialists or clinics provide the procedure or care your patient needs,' 'wait times,' 'investigations required by specialist or clinic,' 'information for patients,' 'languages spoken in office,' 'clinical tools & guidelines,' 'local allied health professionals,' 'local community services,' 'referral procedures and forms'

History of Pathways and Pathways NL

Pathways was originally developed in British Columbia and is widely used in all of divisions of family practice across British Columbia. Based on thorough research and meetings with multiple organizations and industry experts, all four Family Practice Networks (FPNs) in Newfoundland and Labrador agreed that adopting the Pathways British Columbia model in our province would greatly improve and enhance the referral process and ultimately expedite patient access to consultant care.

Who can use Pathways NL?

Pathways NL is available to all physicians, nurse practitioners, and relevant service providers providing patient referrals. Different levels of access are available based on an individual's role and whether they are directly involved in making patient referrals.

How do I request access?

You can request access by contacting the Pathways NL administrator at contact-us@pathwaysnl.ca or by selecting “Request Access” under “Clinician Login”.

How is Pathways NL funded?

Funding for Pathways NL is provided through the provincial government Innovation Fund and supplemented through earmarked surplus funds from Newfoundland & Labrador’s FPNs.

How do patients benefit from Pathways NL?

Pathways streamlines and simplifies the patient referral process, which results in more appropriate referrals, a reduction in re-referrals, and thereby more efficient patient care. The information in Pathways (e.g., wait times, details on specific areas of practice) enables referring physicians to identify the most appropriate care provider to address their patients’ needs in as timely a manner as possible. Pathways also contains an extensive peer-reviewed repository of patient resources (e.g. handouts, videos, websites) that can be emailed directly to patients.

How is Pathways NL organized?

Operations

Pathways BC is responsible for managing the technical infrastructure of Pathways, while the Pathways NL project team will provide administrative support to assist FPNs in implementing and maintaining Pathways NL. The Pathways NL project team will gather local data from family physicians, consultants, and relevant clinical services in each NL health zone, ensuring the accuracy and reliability of the Pathways resource.

Governance

Ultimate accountability for Pathways NL resides with the FPN Boards, however Pathways NL is currently in a demonstration project phase and the project is governed by a steering committee with two co-chairs (co-chairs are comprised of one family physician and one consultant).

Pathways BC operates as a not-for-profit society with a physician Board of Directors.

Benefits of Using Pathways

To FPs:

  • Helps identify the most appropriate consultant for a patient’s needs with the shortest wait time.
  • Provides physicians with information about specific areas of practice, areas of special interest, or specific cases consultants will not accept (e.g., orthopaedics, paediatrics) to inform referrals.
  • Provides a single access point to locate consultant/clinic contact details, patient instructions, and referral forms, reducing time consuming phone calls for office staff.
  • Provides access to patient resources that can be shared while in the exam room and even emailed to patients, some of which can be used to prevent inappropriate referrals.
  • Offers an opportunity for new family physicians to quickly build a patient panel or communicate changes like a new location.

To Consultants:

  • Decreases the incidence of inappropriate referrals by clearly outlining areas of practice and cases that will not be accepted, allowing for more efficient use of time.
  • Consultants have full use of Pathways and can use it to refer to another consultant, or Family Physicians in the community.
  • Saves office staff significant time answering calls about schedule, contact information, referral forms, etc.
  • Provides a host of resources searchable by specialty, including calculators, decision aids, and risk tables.
  • Offers an opportunity for new consultants to quickly build a patient panel, or communicate changes, such as a new location.

To the Health System:

  • Offers the potential to optimize wait times throughout the system, reducing the burden on consultants with extremely long wait lists, and help identify consultants with shorter wait times (e.g. recent grads or new to the community).
  • Reduces inappropriate referrals and the need for re-referrals, driving down costs to the health care system.
  • Improves recruitment and retention of physicians.
  • Pathways offers the potential to scale existing functionality to integrate with EMRs, even to be used as a platform for e-referrals.

Evaluation Results

Following the initial pilot, a comprehensive evaluation of Pathways' impact was conducted in BC. See the summary below.

Usefulness: %83 Specialist/Clinic info, %82 Wait time info, 41% Clinician tools, 20% Patient resources; Impacts: 97% report that Pathways has improved the referral process; Improved patient care, increased efficiency; (scale: 'Very poor,' 'Poor,' 'Fair,' 'Good,' 'Very good') Shorter wait times: Pre 2.9, Post 3.8; Faster appointment confirmations: Pre 2.9, Post 3.7; Better SP/patient matches: Pre 3.3, Post 4.2; More efficient referral process: Pre 3.5, Post 4.2; Improved FP/SP relationships: Pre 3.7, Post 4.0; Increased office efficiency: Pre 3.8, Post 4.3

Pathways does not provide medical advice. If you have an emergency please call 9-1-1. If you require assistance navigating services please call 8-1-1.

For general inquiries or for assistance, please email us:

contact-us@pathwaysnl.ca

If you are requesting clinical access to medical Pathways, please provide the following information via the email above:

  1. First Name
  2. Last Name
  3. Email
  4. In which city/town do you work?
  5. What is your role? E.g. Family Physician, Office Staff, Medical Resident
  6. Employer Name (for office staff)
  7. Office Phone

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