Adoption and sustainability of a virtual interprofessional team for primary care in Ontario: a qualitative study

Primary care providers across Canada face challenges caring for patients with increasingly complex care needs. Team-based care has been identified as an approach to improve care for patients with complex needs. The Mississauga Ontario Health Team recently adopted SCOPE, a telephone-based support line to improve care coordination between primary care, hospital and community services. To understand how Mississauga Health SCOPE supports primary care providers and how it can be improved, this study addresses the following research question: why do primary care providers adopt or not adopt Mississauga Health SCOPE, and what motivates sustained use or abandonment?

Semi-structured interviews were conducted over Zoom with three stakeholder groups: primary care providers (n = 20), general internal medicine physicians (n = 3), and members of the project team (n = 6). Interviews focused on the adoption and continued use of Mississauga Health SCOPE. Data were analyzed inductively, using Proctor et al.'s Adoption and Sustainability concepts.

Within the broad concepts of Adoption and Sustainability, we identified seven themes that shaped whether PCPs would use and continue to use MHSCOPE: Broken healthcare system, Awareness of Mississauga Health SCOPE, Service misalignment, Useful and usable, Trying it out, Breaking the habit, and Making PCPs feel heard.

Telemedicine support services like Mississauga Health SCOPE can help primary care providers deliver appropriate and timely care to patient in the community. Succcesful implementation requires that clinicians feel supported in using the intervention, have a clear understanding of procedures and benefits, and are prepared to take time to learn to work with new tools to overcome hurdle of initial adoption.