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Pathways – Streamlining referrals, improving patient care


What is Pathways?

Pathways is an online resource that provides family doctors and their office staff quick access to current and accurate referral information, including wait times and areas of expertise of specialists and specialty clinics. Pathways can also provide access to hundreds of patient and physician resources, as well community service and allied health information that is categorized and searchable.

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

In 2014, the Fraser Northwest Division of Family Practice developed Pathways as a tool to help improve the process of family doctors referring patients to specialists and specialty clinics. In 2017, Pathways become an independent federally incorporated not for profit society. It is now accessible to Divisions across BC.


Who can use Pathways?

Access to Pathways is limited to family physicians who are members of a Division of Family Practice, their practice team members, and/or nurse practitioners, and to specialists and their staff.


How is Pathways funded?

Funding for Pathways is provided through the General Practitioner Services Committee (GPSC), a joint collaboration between Doctors of BC and the BC government. Individual Divisions of Family Practice also contribute operational funding at a local level.


How do patients benefit from Pathways?

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 family doctors 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 (ie. handouts, videos, websites) that can be emailed directly to patients.


How is Pathways organized?

Operations

The provincial Pathways support team provides the technical infrastructure to operate Pathways and also provides administrative support to help guide Divisions of Family Practice in their implementation and maintenance of Pathways. Individual Divisions also provide their own Pathways Administrators to curate specialist and clinic data within their local region. Decisions about Pathways development and priority setting are made by the Pathways User Group. Each Division participating in Pathways is encouraged to send a representative to the User Group.

Governance

Pathways operates as a not for profit society with a Board of Directors composed of physicians from various Divisions of Family Practice across BC.

Benefits of Using Pathways


To GPs:

  • Help identify the most appropriate specialist for a patient’s needs with the shortest wait time.
  • Make better informed referrals by providing information about specific areas of practice, areas of special interest, or specific cases specialists will not accept (ie. WCB, paediatric patients).
  • Provides a single access point to locate specialist/clinic contact details, patient instructions, and referral forms, reducing time consuming phone calls for office staff.
  • Provides a host of evidence based physician resources searchable by specialty, including calculators, algorithms, decision aids, and risk tables.
  • 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.


To Specialists:

  • 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.
  • Specialists have full use of Pathways and can use it to refer to another specialist, health authority program, or GPs in the community.
  • Saves office staff significant time answering calls about schedule, contact information, referral forms, etc.
  • Provides a host of evidence based physician resources searchable by specialty, including calculators, algorithms, decision aids, and risk tables.
  • Offers an opportunity for new specialists to quickly build a patient panel, or communicate changes, such as a new location or languages spoken on site.


To the health system:

  • Offers the potential to optimize wait times throughout the system, reducing the burden on specialists with extremely long wait lists, and helping identify specialists with shorter wait times (ie. recently certified or new to the community).
  • Reduces inappropriate referrals and the need for re-referrals, driving down costs to the health care system.
  • Can be used as an attachment mechanism for patients without an existing family physician (by specialists looking to refer to community GPs).

Evaluation Results

In 2015, a comprehensive evaluation of Pathways' impact was conducted. See the summary below.

Usefulness: %83 Specialist/Clinic info, %82 Wait time info, 41% Physician resources, 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 GP/SP relationships: Pre 3.7, Post 4.0; Increased office efficiency: Pre 3.8, Post 4.3

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