Creating a provincial post COVID-19 interdisciplinary clinical care network as a learning health system during the pandemic: Integrating clinical care and research

Adeera Levin; Michelle Malbeuf; Alison M Hoens; Christopher Carlsten; Christopher J Ryerson; Alessandro Cau; Stirling Bryan; Jaclyn Robinson; Tamsin Tarling; Joanne Shum; Danielle C Lavallee

doi:10.1002/lrh2.10316

Creating a provincial post COVID-19 interdisciplinary clinical care network as a learning health system during the pandemic: Integrating clinical care and research

Learn Health Syst. 2022 May 15;7(1):e10316. doi: 10.1002/lrh2.10316. Online ahead of print.

Authors

Adeera Levin^{1

2

3}, Michelle Malbeuf^{2

4}, Alison M Hoens^{5

6

7

8

9}, Christopher Carlsten^{3

10

11}, Christopher J Ryerson^{3

10}, Alessandro Cau³, Stirling Bryan^{5

8

12}, Jaclyn Robinson^{2

13}, Tamsin Tarling³, Joanne Shum², Danielle C Lavallee^{5

12}

Affiliations

¹ Division of Nephrology University of British Columbia Vancouver British Columbia Canada.
² Provincial Health Services Authority Vancouver British Columbia Canada.
³ Department of Medicine University of British Columbia Vancouver British Columbia Canada.
⁴ Providence Health Care Vancouver British Columbia Canada.
⁵ Michael Smith Health Research BC Vancouver British Columbia Canada.
⁶ Department of Physical Therapy University of British Columbia Vancouver British Columbia Canada.
⁷ Arthritis Research Canada Vancouver British Columbia Canada.
⁸ Centre for Clinical Epidemiology and Evaluation Vancouver Coastal Health Research Institute Vancouver British Columbia Canada.
⁹ Centre for Health Evaluation and Outcome Sciences St. Paul's Hospital Vancouver British Columbia Canada.
¹⁰ Centre for Heart Lung Innovation St. Paul's Hospital Vancouver British Columbia Canada.
¹¹ Legacy for Airway Health Vancouver Coastal Health Research Institute Vancouver British Columbia Canada.
¹² School of Population and Public Health University of British Columbia Vancouver British Columbia Canada.
¹³ Vancouver Coastal Health Authority Vancouver British Columbia Canada.

Abstract

Introduction: Coronavirus Disease-2019 (COVID-19) affects multiple organ systems in the acute phase and also has long-term sequelae. Research on the long-term impacts of COVID-19 is limited. The Post COVID-19 Interdisciplinary Clinical Care Network (PC-ICCN), conceived in July 2020, is a provincially funded resource that is modelled as a Learning Health System (LHS), focused on those people with persistent symptoms post COVID-19 infection.

Methods: The PC-ICCN emerged through collaboration among over 60 clinical specialists, researchers, patients, and health administrators. At the core of the network are the post COVID-19 Recovery Clinics (PCRCs), which provide direct patient care that includes standardized testing and education at regular follow-up intervals for a minimum of 12 months post enrolment. The PC-ICCN patient registry captures data on all COVID-19 patients with confirmed infection, by laboratory testing or epi-linkage, who have been referred to one of five post COVID-19 Recovery Clinics at the time of referral, with data stored in a fully encrypted Oracle-based provincial database. The PC-ICCN has centralized administrative and operational oversight, multi-stakeholder governance, purpose built data collection supported through clinical operations geographically dispersed across the province, and research operations including data analytics.

Results: To date, 5364 patients have been referred, with an increasing number and capacity of these clinics, and 2354 people have had at least one clinic visit. Since inception, the PC-ICCN has received over 30 research proposal requests. This is aligned with the goal of creating infrastructure to support a wide variety of research to improve care and outcomes for patients experiencing long-term symptoms following COVID-19 infection.

Conclusions: The PC-ICCN is a first-in-kind initiative in British Columbia to enhance knowledge and understanding of the sequelae of COVID-19 infection over time. This provincial initiative serves as a model for other national and international endeavors to enable care as research and research as care.

Keywords: interdisciplinary care; knowledge translation; learning health system; post‐COVID‐19 care; provincial network.