Non-adoption and sustainability of a virtual interprofessional team for primary care in Ontario: A Qualitative Study

Background: Primary care providers across Canada face increasing challenges navigating patients to appropriate care pathways. 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, telephone-based support line to improve care coordination between primary care and hospital 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 who have access to Mississauga Health SCOPE decide to not use it? Methods: 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 and deductively, using Adoption and Sustainability as sensitizing concepts Results: Three broad themes were identified: broken healthcare system, making PCPs feel heard, and (Non-)Adoption of SCOPE. Five subthemes were identified within the third theme: Awareness of Mississauga Health SCOPE, Service misalignment, Useful and usable, Trying it out, and Breaking the habit. Conclusions: Telemedicine support services like Mississauga Health SCOPE can help primary care providers deliver appropriate and timely care to patient in the community by improving system navigation, and mitigate the growing workload. Continuous co-design with primary care providers is necessary to make sure that services meet the needs of primary care providers in a changing health system.