Theme: Models of Care Year: 2019
Background: The TrueNorthMedical.com telemedicine addiction program services thousands of
patients in Ontario across 50 communities. Our group does over 3000 OTN (Ontario Telemedicine
Network) visits per month. Approximately 40% of our patients are Hep C Ab +ve. Our traditional
approach to Hep C was to refer our patients to Hepatology clinics. Unfortunately, many of the towns
we work in have no Hep C clinics. Moreover, even when we could find Hep C clinics for our patients,
these clinics generally required referrals, scheduled appointments, off site lab testing etc. Because
of these barriers- Less than 1% of our Hep C patients ended up getting treatment in this “traditional”
model.
Description of model of care/intervention: TrueNorth now provides Hep C care using an innovative
cloud-based model. Instead of sending patients off site for testing and appointments, we instead
offer on-site Hep C Ab “POC” (Point of Care) testing and Hep C genotype “DBS” (Dried Blood Spot)
testing. Hep C patients are then assessed and offered “hassle-free” Hep C treatment on-site.
Assessment and treatment are available on a walk-in basis with no appointment, no referral. We
accomplish this by using a wide of cloud-based tools including OTN videoconfercing and the use of a
cloud-based EMR that is shared between the addiction program and the Hep C program.
Effectiveness: In our 2018 initial pilot (in Toronto and Windsor) we treated over 40 patients with
comorbid Hep C and substance use disorder using this model. SVR12 among these patients was over
95%. In 2019, we plan to roll this program out to an additional 10 sites.
Conclusion and next steps: Using cloud-based technology allows programs and sites to pool
resources in ways that face-to-face simply cannot. In our experience, providing Hep C care using
cloud based technology is not only feasible, it has many advantages.
Disclosure of Interest Statement: No disclosure of interest.