A Flexible Care Delivery Model for Arthritis (FlexCAre)
Scientific study title:
FlexCAre: Co-developing a Flexible Care Delivery Model for Inflammatory Arthritis
Principal Investigator:
Diane Lacaille, MD, MHSC, FRCPC, Scientific Director, Arthritis Research Canada, Professor, Division of Rheumatology, UBC
Co-Investigators:
Susan Bartlett, Professor, Department of the Medicine, McGill University
Nick Bansback, Associate Professor, School of Population and Public Health, University of British Columbia
Claire Barber, Associate Professor, Division of Rheumatology, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary
Cheryl Barnabe, Professor, Division of Rheumatology, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary
Ines Colmegna, Associate Professor, Division of Rheumatology, Department of Medicine, McGill University
Deborah Da Costa, Associate Professor, Department of Medicine, Faculty of Medicine, McGill University
Paul Fortin, Professor, Division of Rheumatology, Université Laval
Glen Hazlewood, Associate Professor, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary
Alison Hoens, Clinical Professor and Knowledge Broker, Department of Physical Therapy, University of British Columbia
Cheryl Koehn, Founder and President, Arthritis Consumer Experts
Linda Li, Professor, Department of Physical Therapy, University of British Columbia
Laetitia Michou, Associate Professor, Division de rheumatologie, Départment de Médicine, Faculty of Medicine, Université Laval
Nelly Oelke, Medicine and Community Health Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan
Patient Partners:
Marie-Claude Beaulieu, Patients Intéressés par la Recherche sur l’Arthrite
Hélène Garceau, Patients Intéressés par la Recherche sur l’Arthrite
France Gervais, Patients Intéressés par la Recherche sur l’Arthrite
Mame Awa Lajante, Patients Intéressés par la Recherche sur l’Arthrite
Shanon McQuitty, Arthritis Patient Advisory Board
Philippa Mennell, Arthritis Patient Advisory Board
Collaborators:
Mo Bardi, Clinical Instructor, University of British Columbia; Mary Pack Arthritis Program; Director, Vancouver Downtown Eastside Rheumatology Clinic.
Marie-Claude Bray, Ministère de la Santé et des Services sociaux (Québec); Direction générale des affaires universitaires, médicales, infirmières et pharmaceutiques.
Louis Bessette, Assistant Professor, Division of rheumatology, Université Laval; Centre de l’ostéoprose et de rhumatologie de Québec, Groupe de recherche en rhematologie et maladies osseuses; Member, Board of Directors, Association des Medecins Rhumatologues du Quebec (AMRQ).
Sherman Chan, Director, Family & Settlement Services, Multilingual Orientation Services Association for Immigrant Communities (MOSAIC).
Catherine Eastwood, Operations Manager, Centre for Health Informatics, Cumming School of Medicine, University of Calgary.
Jason Kur, Clinical Associate Professor, Division of Rheumatology, University of British Columbia; President, British Columbia Society of Rheumatology; Medical Director, ARTUS Health Centre.
Waqar Mughal, BC SUPPORT Unit.
Brent Ohata, Clinical Instructor, University of British Columbia.
Patricia Patrick, Registered Nurse, Vancouver Coastal Health; Former President, BC Nursing Association.
Jill Robert, Senior Provincial Director, Bone & Joint Health and Strategic Clinical Network, Alberta Health Services.
Kamran Shojania, Clinical Professor, Division of Rheumatology, University of British Columbia; Medical Director, Mary Pack Arthritis Program; Chief of Rheumatology, Vancouver General Hospital.
Study Start Date:
January 2023
Study End Date:
December 2027
Why do this research?
The way that patients receive healthcare for their inflammatory arthritis (IA) is outdated and doesn’t meet their needs. We urgently need to design a new way of delivering care. We aim to design an innovative FlexCAre model that can take advantage of new technology to deliver care that is more focused on individual patient needs. This will better meet the diversity of needs and will result in better health and more equality for people living with IA.
Importantly, this work aims to understand how to improve care delivery among patients traditionally underserved by existing ways of delivering health care by working with people at risk for health inequities such as recent immigrants, those with low income, those who are housing insecure, and those living in remote/rural areas.
What will be done?
Our team of researchers will work with patients, families, and healthcare professionals to design a system of delivering care (a ‘model’). This will be based on patients determining when they need care, whether they receive it in-person or virtually, and how their health will be monitored between visits.
Information such as symptoms and laboratory tests will be gathered into a web-based remote monitoring system, which will trigger ‘alerts’ to the clinical team when results indicate a need for care (e.g., when there are more severe symptoms). These alerts will guide individualized care to determine when an appointment is set, what kind of appointment is set (virtual vs. in-person), and which kind of health care professional is to be seen (e.g. doctor vs. nurse).
This study will involve multiple steps:
1) Engaging with key engagement partners, including:
a) persons living with IA;
b) organizations that serve communities at greater risk of health inequities;
c) health care professionals providing IA care;
d) clinic administrative staff;
e) health care decision makers and policy makers;
f) technical experts.
2) Conducting focus groups and interviews with key stakeholders to identify main features needed to make the model both workable and acceptable.
3) Surveying patients and clinicians to identify what kind of data needs to be collected from healthcare experiences.
4) Developing and testing the web-based alert system that will be created to monitor patient’s health remotely and guide care.
Who is involved?
Persons living with IA, health care professionals providing IA care, clinic administrative staff, health decision makers, scientists, and researchers.
How are Equity, Diversity and Inclusion addressed or taken into consideration?
We will use The Equity, Diversity and Inclusion Action Toolkit for Organizations (Equity, Diversity, Inclusion: Action Toolkit for Organizations (apha.org)) to develop a structure that will ensure EDI in the research.
We will use a gender and EDI lens to guide recruitment and data analysis. Sex and gender identity will be measured using multiple identity options. Because men are under-represented in healthcare-opinion research, we will conduct separate focus groups by gender so that we can have an in-depth understanding of gender-specific needs and other sociodemographic factors that may be related to gender (e.g. age, race, economic status, etc.).
To make sure that individuals involved in the research have different levels of healthcare experience and health knowledge, we will ensure representation during stakeholder engagement and recruitment by inviting a variety of social identities (e.g., race and/or ethnicity, gender, socioeconomic status, location of residence).
Funding Agency
The Arthritis Society and Canadian Institutes of Health Research
How can people get involved?
We are now recruiting for the focus groups phase of the study. If you are interested in participating click here or email us at flexcare@arthritisresearch.ca.
