Practice tip (for BC practitioners) utilizing PathwaysBC beyond specialist lookups — finding patient handouts, requisitions, point-of-care tools

Authors:

Drs. Tracy Monk (biography and disclosures), Nick Graham (biography and disclosures), Karin Kausky (biography and disclosures), Michele Thomasse (biography and disclosures), and Ryan Gallagher (biography and disclosures)

Disclosures:

All authors are members of the PathwaysBC Provincial Resource Committee. PathwaysBC is a collaborative non-profit GPSC initiated project, freely available to all BC physicians and their teams.

What we did before

We used to feel stressed at work while we struggled to quickly find trusted patient tools and information for things like anxiety, ADHD, mindfulness, migraines, arthritis pain, back strain, drug costs, etc. We were already using https://pathwaysbc.ca/ to help us find specialists, their wait times, and what to include in a referral, but we had not learned the stress-reducing powers of Pathways in finding what we needed quickly during a patient visit.

• What we did before for Patient Handouts and Websites: We used to google for handouts or keep folders of them in our EMRs or office drawers or expose our own email addresses sending handouts from UpToDate and other sources. Using the random googling method, one of us mistakenly sent a mum a handout about otitis media in horses!
• What we did before for Clinical Tools: While we all use UpToDate as a reference, sometimes we wanted more local and specific information from websites like the BCCDC or GPAC, BC Cancer or BC Centre on Substance Use, or dozens of others, but it took too long to navigate those sites and find what we needed to use during a visit.
• What we did before for Info about Health Authority and Community Services: We were always struggling to figure out what community and health authority services were available for our patients, especially for addictions and mental health.
• What we did before for Forms: Some had file folders of paper forms that were out of date. Some had lots of forms in their EMRs, but could not always find the forms they needed in their EMRs.

What changed our practice

We learned that Pathways is a quick-to-use curated repository of websites, handouts, forms, and clinical tools and we worked to improve the function of Pathways to act as a curated gateway to the internet (view PDF ) to make it quick and easy to find the handouts, websites, and services that our patients need.

Instead of feeling stressed, we realized we could quickly meet patient informational needs in real time: Need to send information on low FODMAP diet? Need to discuss non-drug approaches to treating chronic pain? Need some patient tips about insomnia or CBTi? Can’t remember everything in a GERD workup? Looking for info to support advance care planning conversations? These can all be searched in seconds while talking with the patient, and then sent via a no-reply Pathways email.

We began to open Pathways at the start of every day, in its own tab, alongside our EMR and UpToDate (or in a separate browser tab). With this approach we could use Pathways all day for:

• Emailing patient handouts/websites from a no-reply Pathways email.
  Here is a 3-minute video explaining how to email patient info from Pathways https://vimeo.com/531933603.
• Point of care clinical resources and tools.
  Here is a 3-minute overview of a range of clinical tools in Pathways relating to chronic pain https://vimeo.com/528999461.
• Finding appropriate Health Authority and community services.
  Here is a 3-minute video showing the Health Authority and Community Services tab in Pathways https://vimeo.com/528998738.
• Latest public health updates in the homepage banner.
  We check every day for the latest public health and COVID-19 information at the top of the home page. The blue banner includes the latest COVID-19 treatments and emailable patient info items like this one Positive Test Results or COVID-19 Symptoms – What to do Next? (BCCDC).
• Finding specialists including which ones do telehealth plus local protocols for referrals.
  Here is a video about how to find specialists who will do a telehealth virtual consultation. This is especially helpful for rural patients to reduce the need to travel https://vimeo.com/533386294.
• A complete, continuously updated repository of all forms in BC.
  Pathways works collaboratively with PHSA and all the Health Authorities to serve as the Provincial Forms Repository for over 1,900 forms.
• Useful clinical care pathways (created collaboratively by Shared Care projects) with embedded links to Pathways tools for easy use at point of care. Check out this overview of the Depression Care Pathway (view PDF ) and all the Gastroenterology Care Pathways.

Pathways was independently evaluated in 2015 and 97% of users said it improved the referral process (see the evaluation summary (view PDF )). Since the 2015 evaluation, Pathways usage has quadrupled with close to 5 million pageviews by logged in clinicians and their teams in 2021.

What we do now

We use PathwaysBC.ca every day and it has made our clinical days easier and improved the quality of information we are sending to our patients and streamlined our access to the tools and services we need.

We started to save our own “favourites” by clicking on the heart symbol so we can quickly find our own favorites. We also made sure everyone in our offices has their own Pathways account so that we can all save our own favourites.

Pathways is under continuous development. User feedback is what helps to make Pathways better. Use the feedback horn on any page:

Resources

1. Pathways Greatest Hits Webinar, Dec 8, 2021 (about Pathways and demos)
2. Gastroenterology Care Pathways (found at the top of the gastroenterology specialty page)
   • IBS – Irritable Bowel Syndrome – Enhanced Primary Care Pathway (Shared Care) (view PDF )
   • Constipation – Enhanced Primary Care Pathway (view PDF )
   • Dyspepsia – Enhanced Primary Care Pathway (Shared Care) (view PDF )
3. Depression Care Pathway (found at the top of the page for the specialty of Psychiatry: Adult)
   • Depression Care Pathway – Adult (view PDF ) The Depression care pathway includes links to listings of free and low-cost counselling services available in all areas of the province.

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Practice Tip for BC practitioners — utilizing PathwaysBC beyond specialist lookups — finding patient handouts, requisitions, point-of-care tools

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