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

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.

FIGURE 1

The structure of the Network and Registry within the province of BC. SRAC, Strategic Research Advisory Council; GPAC, Guidelines and Protocols Advisory Committee; COR‐TF, Clinical Operations and Research Task Force; PHSA, Provincial Health Services Authority; FH, Fraser Health; VIHA, Vancouver Island Health Authority; VCH, Vancouver Coastal Health; PHC, Providence Healthcare; NH, Northern Health; IH, Island Health

FIGURE 2

Patient access to Allied Health facilitated education and therapy

FIGURE 3

The logistics of data capture for the Registry. PC‐ICCN, Post COVID‐19 Interdisciplinary Clinical Care Network; PROMIS, Patient Registration and Outcomes Management Information Systems; CIHI DAD, Canadian Institute of Health Information Discharge Abstract Database; MSP, Medical Services Plan