What is Pathways?

Pathways is an online resource that provides physicians and their office staff/teams quick access to current and accurate referral information, including wait times and areas of expertise of specialists and specialty clinics. Pathways can also provide access to hundreds of patient and clinician resources, as well community service and allied health information that is categorized and searchable.

History of Pathways

In 2014, the Fraser Northwest Division of Family Practice developed Pathways as a tool to help improve the process of family doctors referring patients to specialists and specialty clinics. In 2017, Pathways became an independent federally incorporated not for profit society. It is now accessible to Divisions across BC.

Who can use Pathways?

Pathways is available for use by all physicians in BC and their teams, nurse practitioners, Primary Care Network (PCN) team members, health authority clinic managers and staff, and Joint Collaborative Committee (JCC) staff such as Divisions of Family Practice, Facility Engagement, and Shared Care. Different levels of access are available based on an individual's role and whether they are directly involved in making patient referrals.

How do I request access?

• Family physicians or their MOAs should request access through their local Division of Family Practice.
• Specialists and their MOAs can request access here by selecting "Request access" under "Clinician Login".
• Nurse practitioners can request access through NNPBC.
• All other requests can be made here by selecting "Request access" under "Clinician Login".

How is Pathways funded?

Funding for Pathways is provided through the Family Practice Services Committee (FPSC), a joint collaboration between Doctors of BC and the BC government. Individual Divisions of Family Practice also contribute operational funding at a local level.

How do patients benefit from Pathways?

Pathways streamlines and simplifies the patient referral process, which results in more appropriate referrals, a reduction in re-referrals, and thereby more efficient patient care. The information in Pathways (e.g., wait times, details on specific areas of practice) enables family doctors to identify the most appropriate care provider to address their patients’ needs in as timely a manner as possible. Pathways also contains an extensive peer-reviewed repository of patient resources (ie. handouts, videos, websites) that can be emailed directly to patients.

How is Pathways organized?

Operations

The provincial Pathways support team provides the technical infrastructure to operate Pathways and also provides administrative support to help guide Divisions of Family Practice in their implementation and maintenance of Pathways. Individual Divisions also provide their own Pathways Administrators to curate specialist and clinic data within their local region.

Governance

Pathways operates as a not for profit society with a Board of Directors composed of physicians from across BC.

To FPs:

• Help identify the most appropriate specialist for a patient’s needs with the shortest wait time.
• Make better informed referrals by providing information about specific areas of practice, areas of special interest, or specific cases specialists will not accept (ie. WCB, paediatric patients).
• Provides a single access point to locate specialist/clinic contact details, patient instructions, and referral forms, reducing time consuming phone calls for office staff.
• Provides a host of evidence based clinician tools searchable by specialty, including calculators, algorithms, decision aids, and risk tables.
• Provides access to patient resources that can be shared while in the exam room and even emailed to patients, some of which can be used to prevent inappropriate referrals.

To Specialists:

• Decreases the incidence of inappropriate referrals by clearly outlining areas of practice and cases that will not be accepted, allowing for more efficient use of time.
• Specialists have full use of Pathways and can use it to refer to another specialist, health authority program, or FPs in the community.
• Saves office staff significant time answering calls about schedule, contact information, referral forms, etc.
• Provides a host of evidence based clinician tools searchable by specialty, including calculators, algorithms, decision aids, and risk tables.
• Offers an opportunity for new specialists to quickly build a patient panel, or communicate changes, such as a new location or languages spoken on site.

To the health system:

• Offers the potential to optimize wait times throughout the system, reducing the burden on specialists with extremely long wait lists, and helping identify specialists with shorter wait times (ie. recently certified or new to the community).
• Reduces inappropriate referrals and the need for re-referrals, driving down costs to the health care system.
• Can be used as an attachment mechanism for patients without an existing family physician (by specialists looking to refer to community FPs).

Following the initial pilot, a comprehensive evaluation of Pathways' impact was conducted. See the summary below.