Abstracts

Rationale:
Prolonged wait times to visit an epilepsy specialist can increase risk of number of seizures, seizure-related injuries, or death. Wait times for a neurologist in Ontario, Canada can range from 2 – 6 months. The COVID-19 pandemic has exacerbated wait-times, making it more difficult for patients living with epilepsy to access timely care. The Virtual Rapid Access Epilepsy Clinic (VEC) was developed in response to these concerns. The clinic combines novel infrastructural approaches to virtual care: a multidisciplinary consultative model and an online referral pathway that permits patients to be evaluated by an epilepsy specialist within 1 week from referral. This model has particular implications for patients living in remote areas as they often face protracted wait-times or an absence of local specialty care.
Method:
The VEC is an online, “walk-in” style clinic where appointments are conducted by video conference. Patients across Ontario obtain a referral from their healthcare practitioner and register online the day of the clinic to receive a same-day appointment. The team consists of an epilepsy specialist, a preliminary assessor (physician assistant, nurse practitioner, or nurse with training in epilepsy) and a social worker from Epilepsy Toronto - a local patient advocacy and services organization. The social worker addresses psychosocial patient concerns and offers connection to networks of support in the community. Following every appointment, patients are asked to complete a survey based on their experience.
Results:
Responder rate was 51% (44/86). Majority of patients reported that the team listened to their needs and explained treatment options “extremely well” (28/44, 64%) or “very well” (15/44, 34%). Patients’ concerns decreased after being seen (from a concern level of 74/100 to 50/100). Fifty percent of patients (22/44) had an appointment booked with another specialist with an average wait time of two months. Majority of patients were “very likely” or “likely” (34/44, 77%) to use the virtual clinic over a traditional in-person appointment assuming absence of COVID-19 limitations. Qualitative responses indicated that the multi-disciplinary team approach provided patients with helpful insight and advice.
Conclusion:
High satisfaction from the surveyed patients supports the patient-centered care model of the VEC, particularly during the recent COVID-19 pandemic. Results indicate interest in adopting this model of virtual care for specialized areas within medicine, such as epilepsy. It is our goal that this virtual clinic format catalyzes improvement of access to specialist care, reduces wait times, and promotes health equity for patients in Ontario and other similar healthcare systems. There is potential to scale to other areas of specialist care to serve during future pandemics or times of crisis when resources are limited and access to specialists is reduced. Future assessment will explore clinical patient outcomes and compare to more traditional models of care.
Funding:
:No funding