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One:carepath is looking to partner with primary care physicians and clinic teams who use MedAccess, PS Suite, Healthquest or Accuro EMRs to care plan with up to 10 complex patients over an 18-month period. There are funds to support this work and participation in this project can be used as part of the PPIP-CPSA QI requirements. One:carepath is a provincial research study that takes a proactive and co-managed approach to care planning with patients who have advanced/decompensated/non-curative COPD, heart failure, cirrhosis, kidney disease, and stage 3 or 4 solid organ cancers. The focus is on integrating supportive care in the Patient’s Medical Home, through symptom and crisis management, helping patients maintain quality of life and functional status, avoid aggressive treatments where appropriate, and align care with patient preferences and values. The goal is to enable informational, relational, and management continuity among all those involved, and reduce hospital admissions and emergency department visits.
Study Title: One:carepath Implementation: Implementation and Evaluation of an Innovative Integrated Conservative (Non-Dialysis) Kidney Management Pathway by Community Care Providers across Alberta, and the Development, Implementation and Evaluation of an Innovative Integrated Supportive Care Pathway by Primary Care across Alberta (Pro00122633).
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