Characterizing the impact of a novel electronic consultation platform on access to Hepatitis C treatment in a Manitoba context
| dc.contributor.author | MacKenzie, Lauren | |
| dc.contributor.examiningcommittee | Ireland, Laurie (Community Health Sciences) | |
| dc.contributor.examiningcommittee | Mignone, Javier (Community Health Sciences) | |
| dc.contributor.examiningcommittee | Breton, Mylaine (University of Sherbrooke) | |
| dc.contributor.guestmembers | Oppenheimer, Luis (Surgery) | |
| dc.contributor.supervisor | Becker, Marissa | |
| dc.date.accessioned | 2024-09-05T14:35:28Z | |
| dc.date.available | 2024-09-05T14:35:28Z | |
| dc.date.issued | 2024-08-26 | |
| dc.date.submitted | 2024-08-26T23:12:57Z | en_US |
| dc.date.submitted | 2024-09-04T22:59:24Z | en_US |
| dc.degree.discipline | Community Health Sciences | |
| dc.degree.level | Doctor of Philosophy (Ph.D.) | |
| dc.description.abstract | Introduction Current Canadian guidelines recommend that all individuals living with Hepatitis C virus (HCV) be considered as candidates for HCV treatment, though treatment uptake in Manitoba remains limited. Access to HCV treatment requires a specialist referral in Manitoba, and the availability and location of specialists may serve as a barrier to HCV treatment. A potential solution to improving access to HCV treatment is through the use of a novel electronic consultation platform (eConsult). Using eConsults, primary care providers (PCPs) can link to HCV specialists through electronic means and receive specialist advice directly, without the need for a face-to-face patient visit. We aimed to characterize the impact of using the eConsult platform as it relates to HCV treatment in Manitoba, situated within a rich description of the local provincial context and perspectives of relevant stakeholders. Methods This was a single case study design that took place at Nine Circles Community Health Centre, utilizing a sequential explanatory mixed methods design. Chart reviews were conducted for individuals referred for HCV treatment via a traditional referral between December 1, 2016 and December 1, 2017; and for individuals referred via eConsult between December 2017 and December 31, 2019. Stakeholder interviews were completed with two PCPs, as well as the sole HCV specialist who received HCV treatment referrals. Results Individuals referred for HCV treatment via eConsult were more likely to be linked to specialist care (100% vs. 69%, p = 0.026), and complete HCV treatment (79% vs. 36%, p = 0.049). The time from referral to achieving each step of the HCV cascade of care was shorter for individuals referred via eConsult. A modified access to care framework was able to capture elements of availability; accessibility; accommodation; affordability; acceptability; and awareness that facilitated or created barriers to the success of eConsult. Additional themes of agility; adaptability; and altruism were also described. Conclusion The use of eConsult can help to expand access to HCV treatment in Manitoba, but its success may depend on its perceived agility; adaptability to a variety of clinical contexts; and the extent to which it relies on the altruism of health care providers. | |
| dc.description.note | October 2024 | |
| dc.description.sponsorship | University of Manitoba Institute for Global Public Health | |
| dc.identifier.uri | http://hdl.handle.net/1993/38515 | |
| dc.language.iso | eng | |
| dc.rights | open access | en_US |
| dc.subject | Hepatitis C | |
| dc.subject | eConsult | |
| dc.subject | Winnipeg | |
| dc.subject | Cascade of care | |
| dc.subject | Access to care | |
| dc.title | Characterizing the impact of a novel electronic consultation platform on access to Hepatitis C treatment in a Manitoba context | |
| dc.type | doctoral thesis | en_US |
| local.subject.manitoba | yes | |
| oaire.awardTitle | Faculty Development Committee PhD Funding Award | |
| project.funder.identifier | http://dx.doi.org/10.13039/100017552 | |
| project.funder.name | University of Manitoba Faculty Development Committee |