Enhancing Care Coordination in Oncology and Nononcology Thoracic Surgery Care Pathways Through a Digital Health Solution: Mixed Methods Study
Bibliographic record
Abstract
BACKGROUND: Health-system fragmentation in Quebec significantly impacts care coordination, leading to interruptions in patients' care pathways and adverse effects on their health. Coordinating interfacility service corridors is complex and requires collaboration between multiple health care providers (HCPs) and care settings. Effective care coordination is essential to ensure optimal patient management at transition points. OBJECTIVE: This study aims to improve oncology and nononcology thoracic surgery care pathways by enhancing care coordination during interfacility transfers through a digital health solution. METHODS: A multicenter implementation study was conducted across 2 health regions and 2 health care facilities in Quebec. We conducted 27 semistructured interviews with HCPs and managers to better understand the care pathways. Participatory design workshops were held with future users and key stakeholders at an early stage of the technology's design to validate the prototype's functionalities and workflows. A web survey was sent to all end users (N=13) to assess their experience with the platform. RESULTS: All participants (100%) either "agreed" or "strongly agreed" that the platform provided significant benefits. It enhanced interestablishment coordination (4/13, 31% agreed and 9/13, 69% strongly agreed) and continuity of care and services (8/13, 62% agreed and 5/13, 38% strongly agreed), and it contributed to better management and patient intake (10/13, 77% agreed and 3/13, 23% strongly agreed) and process fluidity (3/13, 77% agreed and 3/13, 23% strongly agreed). Surgeons from the McGill University Health Centre confirmed that the platform facilitated and secured information transmission (2/5, 40% agreed and 3/5, 60% strongly agreed) and kept track of oncology patient referrals, follow-up needs, and cases where surgery is unnecessary (2/5, 40% agreed and 3/5, 60% strongly agreed). Nursing staff from the Centre intégré de santé et de services sociaux de l'Outaouais and McGill University Health Centre reported high satisfaction with the platform's support during preoperative visit, surgery, and discharge processes. All participants perceived the platform as intuitive and easy to use. Additionally, participants valued its efficiency in providing rapid access to patient data, which reduces task time and ensures document security, thereby improving care coordination across facilities. 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 advancement in thoracic surgery care pathways and the coordination of interfacility health care service corridors. The project provides care pathways that are adaptable to other surgical 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. The project underscores the value of strategic leadership and stakeholders' collaboration to improve care coordination and operational efficiency by demonstrating technology's essential role in patient care pathways.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".