Pilot randomized control trial of an online communication tool for collaborative care in complex patients
MSU-13-016 Loop challenges the way that healthcare is currently organized in silos of specialties, settings, data and privacy. Our team is poised to inform this transformation in healthcare communication. We were successful in securing funding for the next phase of work from the Canadian Cancer Society Research Institute’s (CCSRI) Innovation to Impact Grant, building on our earlier CCSRI Innovation Grant and this AMO grant. The work to date has exposed some of the barriers and enablers to implementation of Loop. Our current CCSRI funded work investigates how to improve the uptake and use of Loop to the level seen in some of the highest functioning teams in the pilot RCT. We are employing implementation science methods to test Loop implementation and effectiveness concurrently.
MSU-13-006 Patients with complex care needs are increasing in number and account for disproportionate healthcare costs. Their care requires the expertise of many healthcare professionals, across organizations and settings. However, communication, coordination and collaboration is often poor and care is fragmented. This poses a burden on patients, families and healthcare professionals. Currently there is no whole system approach to this communication that follows the patient’s trajectory. The aim of this project was to pilot and test a novel web-based clinical collaboration tool, Loop, developed with the input of users. The trial focused on advanced cancer as an example of complex care. The project’s primary objective was feasibility of implementation of Loop and recruitment of teams with the patient as the hub. Secondary objectives were to determine effect on patient-reported continuity of care, quality of care, symptom distress, and health services utilization. This was a feasibility randomized controlled trial (RCT) recruiting advanced cancer patients from ambulatory care clinics at a regional cancer centre and from a home-based palliative care program, their caregivers and healthcare team. With a target sample of 50, we recruited 48 patients and their teams of care: 24 intervention (Loop) teams and 24 in control (usual care) teams. Data was collected monthly for 3 months of follow up. Findings show that it was feasible to recruit and enroll patients on Loop; Loop performed reliably and was used as intended. A consistent improvement in continuity of care over time in the Loop teams was observed. Two papers on the findings have been published so far.