JMIR Publications

ABSTRACT

Background:

Health system fragmentation is a significant issue in Quebec, Canada, and has a significant impact on the coordination of care. This fragmentation can lead to interruptions in patients’ care pathways, with adverse consequences for their health and well-being. Coordinating inter-facility service corridors is complex, and requires cross-functional, integrated organization involving several health care providers (HCPs) and care settings. This issue is all the more critical in specialized fields such as thoracic surgery, especially oncology surgery for the treatment of lung and esophageal cancer. Effective care coordination between HCPs and health care facilities is essential to ensuring optimal patient care management at transition points.

Objective:

The aim of the pilot project is to optimize the inter-facility thoracic surgery care pathway, making it safer and facilitating care coordination, by implementing an integrated digital health solution.

Methods:

We conducted a multicenter implementation study in two different health regions (Montreal and Gatineau) and two health care facilities in the province of Quebec, Canada. Investigators conducted 27 semi-structured interviews with HCPs and managers to better understand the care pathway. Participatory design workshops were held with future users and other key stakeholders at an early stage of the technology’s design, to validate the prototype’s intended functionalities and workflows. An online survey was sent to all end users (N=13) to assess their experience of using the platform.

Results:

The platform was able to resolve dysfunctions in the coordination of inter-facility thoracic surgery service corridors. The results show that the platform provides integrated, coordinated, and equitable care for patients throughout the care pathway. The project’s success has convinced the HCPs and senior management at both health care facilities to pursue long-term use of the Akinox digital health platform.

Conclusions:

This pilot project represents a significant advance in the field of thoracic surgery care pathways and the coordination of inter-facility health care service corridors. The project provides a specialty-specific care pathway, while being adaptable to other medical specialties. It also paves the way for improving care in cancer and other health care networks, while highlighting the key role of nurse navigators in patient care management.