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Enhancing Care Coordination in Oncology and Nononcology Thoracic Surgery Care Pathways Through a Digital Health Solution: Mixed Methods Study

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Nabelsi, Véronique, Plouffe, Véronique·2024·JMIR Formative Research
DOI 10.2196/60222PMC PMC11632290

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Abstract

Background: Health-system fragmentation in Quebec significantly impacts care coordination, leading to interruptions in patients’ care pathways and adverse effects on their health. Coordinating interfacility service corridors is complex and requires collaboration between multiple health care providers (HCPs) and care settings. Effective care coordination is essential to ensure optimal patient management at transition points. Objective: This study aims to improve oncology and nononcology thoracic surgery care pathways by enhancing care coordination during interfacility transfers through a digital health solution. Methods: A multicenter implementation study was conducted across 2 health regions and 2 health care facilities in Quebec. We conducted 27 semistructured interviews with HCPs and managers to better understand the care pathways. Participatory design workshops were held with future users and key stakeholders at an early stage of the technology’s design to validate the prototype’s functionalities and workflows. A web survey was sent to all end users (N=13) to assess their experience with the platform. Results: All participants (100%) either “agreed” or “strongly agreed” that the platform provided significant benefits. It enhanced interestablishment coordination (4/13, 31% agreed and 9/13, 69% strongly agreed) and continuity of care and services (8/13, 62% agreed and 5/13, 38% strongly agreed), and it contributed to better management and patient intake (10/13, 77% agreed and 3/13, 23% strongly agreed) and process fluidity (3/13, 77% agreed and 3/13, 23% strongly agreed). Surgeons from the McGill University Health Centre confirmed that the platform facilitated and secured information transmission (2/5, 40% agreed and 3/5, 60% strongly agreed) and kept track of oncology patient referrals, follow-up needs, and cases where surgery is unnecessary (2/5, 40% agreed and 3/5, 60% strongly agreed). Nursing staff from the Centre intégré de santé et de services sociaux de l’Outaouais and McGill University Health Centre reported high satisfaction with the platform’s support during preoperative visit, surgery, and discharge processes. All participants perceived the platform as intuitive and easy to use. Additionally, participants valued its efficiency in providing rapid access to patient data, which reduces task time and ensures document security, thereby improving care coordination across facilities. The project’s success has convinced the HCPs and senior management at both health care facilities to pursue long-term use of the Akinox digital health platform. Conclusions: This pilot project represents a significant advancement in thoracic surgery care pathways and the coordination of interfacility health care service corridors. The project provides care pathways that are adaptable to other surgical specialties. It also paves the way for improving care in cancer and other health care networks while highlighting the key role of nurse navigators in patient care management. The project underscores the value of strategic leadership and stakeholders’ collaboration to improve care coordination and operational efficiency by demonstrating technology’s essential role in patient care pathways.

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  • Nabelsi and Plouffe [28] engaged nurse navigators and interfacility teams to refine a web-based coordination platform designed to improve oncology and nononcologic thoracic surgery care pathways.

    “Nabelsi and Plouffe [28] engaged nurse navigators and interfacility teams to refine a web-based coordination platform designed to improve oncology and nononcologic thoracic surgery care pathways.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [28]

    The Methods (Study Design and Settings; page not provided) describe participatory workshops with nurses and other stakeholders whose input was incorporated into the platform prototype. The Results (Objective 2; page not provided) describe recruiting nurse navigators at both facilities and refining the interfacility care pathway and platform. Our copy does not establish that the workshop nurses were nurse navigators or explicitly describe the platform itself as web-based; it describes the workshops and a later survey as web-based. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Nabelsi, V., & Plouffe, V.
Affiliations
Université du Québec en Outaouais (CA)
Corresponding author
Nabelsi, Véronique
ORCID
Venue
JMIR Formative Research
Publisher
JMIR Publications Inc.
Published
2024-11-26
Volume
8
Pages
e60222
ISSN
2561-326X (ISSN-L)
DOI
10.2196/60222
PMC
PMC11632290
OpenAlex
W4403913829
Cited by
5
References
2
Citations by year
2026: 2 · 2025: 2 · 2024: 1
FWCI
2.50
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR Formative Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • McGill University
  • McGill University Health Centre
Topics
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
Keywords
care coordination, thoracic surgery, cancer surgery, digital health platforms, interfacility transfer, care pathways, continuity of care, care fragmentation, patient information exchange, stakeholder engagement, participatory design, Quebec health system, patient satisfaction, perioperative care, care transitions, information security, user experience, implementation evaluation
MeSH terms
Digital Health, Continuity of Patient Care, Female, Humans, Male, Medical Oncology, Quebec, Surveys and Questionnaires, Thoracic Surgery, Critical Pathways, Thoracic Surgical Procedures, Qualitative Research

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