Abstract Details

Title A Unique Population Based Epilepsy Network in Ontario Enhances Epilepsy Care and the Availability of Epilepsy Surgery

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S10 - Epilepsy and Clinical Neurophysiology (EEG) 2 (4:24 PM-4:32 PM)

Poster/Presentation
Number 004

Background

In 2013 the Ontario Ministry of Health [MOH], in partnership with epilepsy care providers, undertook the following: development of District Epilepsy Centers [DEC] and Regional Epilepsy Surgery Centers of Excellence [RESC] throughout Ontario; issuance of Provincial Guidelines on Epilepsy Care, and creation of a Provincial knowledge translation [KT] strategy for epilepsy.

Objective

To describe the extraordinary transformation of epilepsy care in Ontario, Canada.

Design/Methods

By 2016 the DECs and RESCs, each with a comprehensive epilepsy program, were operationalized with 3 adult and 2 paediatric DECs and 2 adult and 2 paediatric RESCs established across Ontario. Six Provincial Guidelines were created. In 2018 Project ECHO: Epilepsy Across the Lifespan was launched to provide epilepsy KT in Ontario. Project ECHO® (Extension for Community Healthcare Outcomes) is an innovative model for medical education that uses ZOOM conferencing to connect specialist multidisciplinary teams at academic health centres to community healthcare providers (CHCPs). Using didactic and case-based learning. Epilepsy monitoring unit [EMU] and epilepsy surgery volumes were collected from all DECs and RESCs. From April 2018 to April 2019 Pre and post ECHO surveys were performed to evaluate change in knowledge and skills following completion of the pediatric curriculum of our Project ECHO.

Results

EMU volumes in Ontario increased from 450 in 2012/13 to over 2000 in 2018/19 and epilepsy surgery volumes increased from 208 in 2012/13 to 400 in 2018/19. Following the ECHO sessions, participants were statistically significantly more likely to agree they had sufficient knowledge and confidence to diagnose, treat and counsel regarding epilepsy and more likely to acknowledge changes in their practice with regards to these areas.

Conclusions

A novel partnership between government, epilepsy caregivers, patients, and families has resulted in the provision of unique end-to-end epilepsy care in Ontario with a resultant increase in patients evaluated for and receiving epilepsy surgery.

Authors/Disclosures
O. C. Snead III, MD, FAAN (Hospital for Sick Children) PRESENTER	Dr. Snead has nothing to disclose.
Elizabeth Donner, MD, FRCPC (The Hospital for Sick Children)	Dr. Donner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Donner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Donner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pendopharm. Dr. Donner has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seizure. The institution of Dr. Donner has received research support from SickKids Centre for Brain and Mental Health. The institution of Dr. Donner has received research support from Ontario Brain Institute. The institution of Dr. Donner has received research support from CIHR.
Sharon E. Whiting, MBBS, FR	Dr. Whiting has nothing to disclose.
Tadeu Fantaneanu, MD	Dr. Fantaneanu has nothing to disclose.
Lysa Boissé Lomax, MD (Queen'S University)	Dr. Boissé Lomax has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Boissé Lomax has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB, Eisai, Sunovion. Dr. Boissé Lomax has received personal compensation in the range of $0-$499 for serving as an Expert Witness for Correctional Service Canada. The institution of Dr. Boissé Lomax has received research support from UCB.
Esther Bui, MD (Toronto Western Hospital)	Dr. Bui has nothing to disclose.
Danielle M. Andrade, MD (University of Toronto)	Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biocodex. Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zodiac. Dr. Andrade has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stoke therapeutics. Dr. Andrade has received publishing royalties from a publication relating to health care. Dr. Andrade has a non-compensated relationship as a Chair of task force on Transition with International League Against Epilepsy that is relevant to AAN interests or activities.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Rajesh RamachandranNair, MD (McMaster Children's Hosp, Div of Ped NEU)	Dr. RamachandranNair has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Canada.
Michelle Shapiro, MD	Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pendopharm. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Shapiro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB.
	No disclosure on file
Andrea Andrade (Schulich School of Medicine and Dentistry Western University)	No disclosure on file
Ayman E. Hassan, MD, FAAN (Thunder Bay Regional Health Science Centre)	Dr. Hassan has nothing to disclose.
Jorge G. Burneo, MD, MSPH, FAAN (University of Western Ontario)	Dr. Burneo has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier, Clinical Neurology and Neurosurgery Journal. Dr. Burneo has received research support from The Jack Cowin Endowed Chair in Epilepsy Research. Dr. Burneo has received publishing royalties from a publication relating to health care.