SCOPE (logo)

Seamless Care Optimizing the Patient Experience

SCOPE is a platform that promotes collaborative work between primary care, hospital services, and community health partners to serve patients with complex needs in real-time.

SCOPE in Mississauga is a partnership between the Mississauga Ontario Health Team (Mississauga Health), Trillium Health Partners (THP), and the Mississauga Health Primary Care Network (PCN).

Mississauga Ontario Health Team
Primary Care Network Mississauga Health
THP Solutions

Need help navigating health care for your patients?
Contact Mississauga Health SCOPE at SCOPE@moht.ca

Overview

SCOPE is a virtual interprofessional program that connects primary care providers through a single point of access. Family physicians and nurse practitioners registered with SCOPE can quickly connect to internists, outpatient services & diagnostic imaging.

For more information visit www.scopehub.ca

Description of Current Services

SCOPE Navigator

The SCOPE Navigator provides general advice and assistance navigating hospital and community resources and access to specialist care and other OHT services, for Primary Care Providers. The Navigator also acts as the access point for services offered through SCOPE.

Primary Care Provider’s Consultation with General Internal Medicine/Internist on-Call

The Internist on-call provides the primary care provider with an urgent consultation, assessment and management of their patients’ medical conditions.

Patient’s Virtual Visit with General Internal Medicine/Internist on-Call

Though SCOPE, primary care providers can refer their patients for a virtual video-based visit with the General Internal Medicine specialist to provide an urgent consultation, assessment and management of the patients’ medical conditions.

Diagnostic Imaging

Primary care providers registered with SCOPE can access diagnostic imaging (i.e. X-Ray, Ultrasound, CT, and MRI) for select indications, as appropriate and can receive advice from the radiologist on-call.

Orthopedic Clinic

Primary care practitioners can call SCOPE or directly refer adult patients for an orthopedic consult for select musculoskeletal conditions such as joint arthritis, low back pain, neck pain, tendinitis, cuff tears etc. Please note that patients with fractures, motor vehicle accidents, WSIB related concerns, or with established chronic pain disorders are not eligible for this pathway.

Home and Community Care Support Services

The SCOPE Navigator will assist with facilitating access to Home and Community Care Support Services resources for patients with complex or chronic care needs and/or existing Home and Community Care clients.

Register Now

Mississauga Health SCOPE launched in March 2023 and registrations are now open to all Mississauga-based primary care providers.
Click here to sign-up





 

About SCOPE

SCOPE launched as a quality improvement collaboration between Women’s College Hospital, University Health Network, and the Toronto Central LHIN Home and Community Care in 2012. It was designed in response to the following concerns identified by primary care providers:

  • Timely access to specialist care
  • Single point of access to services
  • Assistance with homebound patients
  • Access to hospital reports

The objective of SCOPE is to strengthen relationships between hospitals, community services, and primary care, in order to improve care delivery for complex patients who may not have access to an interdisciplinary care team.

Over the years, the program has expanded to over 16 sites across Ontario.

Other SCOPE Programs in the region:

Mississauga Health SCOPE

SCOPE in Mississauga launched in March 2023 and is open for all Mississauga-based primary care providers for registration. The SCOPE model promotes patient-centred interdisciplinary care, which is the foundation of Ontario Health Teams (OHT). The goal of SCOPE is to:

  • Reduce emergency department visits.
  • Provide patients with more equitable and pragmatic access to team-based care and specialists.
  • Establish an effective channel to deliver best practices and emerging standards of care.
  • Provide an opportunity for ongoing physician engagement.

Click to open PDF file

Resources for Primary Care Providers

Access to General Services and Resources

The Health Line
Directory and search tool for health care and community resources in Mississauga, and across Ontario. The Directory for Mississauga can be found here.

211 Central
Directory and search tool for community and social services in Toronto, Durham, Peel, and York Region

Health811
Heatlh811 is free, secure and confidential service anyone can call or access online 24/7 to get health advise from a RN or find health service information. How to Contact: Call 811 (Toll free TTY line: 1-866-797-0007) or Chat online here

Hip and Knee Rapid Access Clinic
Trillium Health Partners HIP and Knee Rapid Access Clinic has openings for arthroplasty for patients with moderate to severe arthritis with functional limitations. Utilize the following link to access this program.


STOP on the NET is an online program to help individuals quite smoking cigarettes. It is accessible from home and provides free nicotine replacement therapy (NRT) patches and gums/lozenges mailed directly to registrants. Patients interested in quitting smoking can be directed to this link to check for eligibility.

Ontario Structured Psychotherapy (OSP)
OSP is a free, publicly funded program for adults 18+ experiencing mild-to-moderate anxiety, depression or other anxiety concerns. Through OSP, patients can access short-term, evidence based cognitive behavioral therapy (CBT).
OSP is a stepped-Care Model: services include self-led resources, guided by a coach or clinician, and a one-on one or group therapy session.
How to refer: CAMH referral click here; Via Ocean (search CAMH referral form) or Self-refer by calling 416-535-8501 ext 36777. Click here to learn more about OSP.

Access to Specialists Directory

Ontario Telemedicine Network (OTN) – Health Services Directory
Use the directory to access specialists and community health services anywhere in Ontario

Seniors Care

Peel Senior Link: A variety of programs and services to help seniors live independently.

Getting the right care: Specialized Navigation Services

Mississauga Health is developing a centralized health system Navigation service to support patients and providers to easily identify the right services to meet their needs.

Case Studies/Testimonials

Case Studies

General Internal Medicine (GIM)

1. A PCP called in regarding a patient with a 3-week history of shakiness and a recent diagnosis of hyperthyroidism (blood work revealed a TSH 0.01 mIU/L and T4 of 26 pmol/L). The patient was tachycardic but normotensive. The PCP wanted to discuss this patient with the GIM on-call to see if there are any red flags to monitor for and appropriate next steps.

SCOPE Intervention:
The GIM on-call recommended initiation of beta-blocker therapy and urgent referral to endocrinology. The GIM-on call provided name and information of endocrinologist accepting new patients within the organization to ensure a timely referral for this patient.

2. A family physician called SCOPE regarding a 69-year old patient with a newly diagnosed atrial fibrillation on blood thinners, and had impending travel.

SCOPE Intervention:
SCOPE navigator set up a General Internal Medicine (GIM) phone consultation within 16 minutes of the initial call. GIM provided advice with respect to medication changes and follow-up with cardiology.

SCOPE Navigator

1. SCOPE call regarding a 54-year old female with recent debulking of a brain mass by a Trillium Health Partners’ neurosurgeon. Pathology results recently identified a glioblastoma, but the follow-up appointment was not for another 4–6-week time. Family physician was hoping if the follow-up appointment could be expedited.

SCOPE Intervention:
SCOPE navigator connected with the relevant neurosurgeon and the follow up appointment and radiation treatment was expedited.

2. Navigator received a call from a primary care provider regarding a 68-year old patient with previous back surgery and difficulty getting off opioid analgesics, the Primary Care Provider sought advice as to what addiction clinic options were available.

SCOPE Intervention:
SCOPE Navigator shared appropriate community resources.

Diagnostic Imaging

1. Primary Care Provider called regarding a 27-year old female with history of right iliac fossa pain. PCP requested an expedited pelvic ultrasound to rule out appendicitis.

SCOPE Intervention:
SCOPE team facilitated an ultrasound appointment within hours. Diagnostics were negative for appendicitis, however, a growth on the ovary was discovered. Emergency Department visit was averted, and care plan modified accordingly with follow up diagnostics.

2. A PCP was concerned regarding a patient’s redness, swelling and pain in the right lower calf. The patient was on anticoagulation therapy at home, however, the PCP was hoping to get an ultrasound done as soon as possible to determine if the patient had a DVT. As the patient was resistant to going to the hospital, the PCP asked that for the results of the ultrasound to be shared with him when available, so if there was a DVT it could be treated at home versus the patient going to the emergency department.

SCOPE Intervention:
SCOPE team able to work with bookings to get patient into ultrasound within the next 2 hours. The technologists were aware of plan of action to call PCP at an after-hour’s number in the event that the ultrasound was positive for a DVT.

Home and Community Care Support Services (HCCSS)

An elderly patient with a recent fall and confined to bed was experiencing pain and had no support services arranged. The PCP called to see what in-home options could be set up to prevent an emergency department visit and keep the patient in her home.

SCOPE Intervention:
The SCOPE Navigator was able to connect them with the HCCSS Coordinator to arrange in-home physiotherapy to help with the patient’s mobility and rehabilitation, as well as PSW support to help with bathing and other ADLs. The patient was very happy she was able to stay at home and get the support she needed.

Testimonials

  • Customer Testimonails

    I want to thank you so very much. My patient now has her radiation [appointment] all set up for next week.

    PRIMARY CARE PROVIDER
  • Customer Testimonails

    The SCOPE program has allowed me to have access to same day diagnostic imaging, something that was only available with the patient being sent to ER. My patients are very appreciative of this service, specifically being able to avoid the ER department. As community physicians, we do not have the ability to refer patients to the AIM clinic. The SCOPE program has created a very efficient pathway to have a similar service available to community physicians.

    DR. SALESH BUDHOO
  • Customer Testimonails

    I really appreciate your getting the Ultrasound done, it saved her an ER visit.

    DR. ALI DAMJI
  • Customer Testimonails

    The SCOPE navigator service has allowed me to ensure timely care for my patients when they’ve needed a time-sensitive consultation with a specialist or an urgent imaging study. This serves as a model to how effective outpatient primary care should be. No patient should be waiting in an emergency room for hours waiting for an urgent imaging study or consultation, when it can be arranged in a timely fashion through a more organized and efficient system. The SCOPE navigator serves as a model for that system in our region. We truly appreciate your services.

    DR. FADY AKLADIOS
  • Customer Testimonails

    The PCPs I speak to have been grateful for the support and someone to have in real time on the other end of the call, to have specialists to consult with regarding patient care, and to receive expedited diagnostics as required especially when dealing with complex patients.

    LIZ GABISON SCOPE Navigator

Mississauga Health SCOPE Team

Dr. James Pencharz
Primary Care Co-Lead at Mississauga Health

Dr. James Pencharz is the Primary Care Co-Lead at Mississauga Health. He is a family physician with the Credit Valley Family Health Team and has been in practice since 2009, providing comprehensive family medicine.

He is an active educator with the University of Toronto, Faculty of Medicine department, teaching medical students and residents for the past nine years. He is the former Site Program Director for the Trillium Health Partners – Credit Valley Hospital Family Medicine Residency program. From 2009 – 2014, he also worked as a hospitalist physician at THP- Credit Valley Hospital.

 

Dr. Sohal Goyal
Chair, Mississauga Health Primary Care Network

Dr. Goyal is the Co-Chair of the Mississauga Ontario Health team and one of the Regional Primary Co-Leads for Ontario Health. He is also the Chair of District 5 at the Ontario Medical Association (OMA) and was on the board of the Section of General and Family Practice at the OMA.

In his 20-year career, Dr. Sohal Goyal has established a vast network of healthcare relationships. Dr. Goyal is an assistant clinical professor with McMaster University Department of Family Medicine. His passion is to support and engage community physicians.

 

Dr. Sheikh Noor Ul Amin
THP Physician Lead for SCOPE

Dr. Amin joined THP in 2018. He completed his Family Medicine Residency at The University of Manitoba and a fellowship in Sport and Exercise Medicine at the University of Toronto. Through the course of the COVID 19 pandemic, Dr. Amin was instrumental in supporting as the Physician Lead for both the THP Vaccination program and the THP COVID 19 Assessment Centres.

He is the current Co-Chair for the MOHT Data Strategy Table and serves on the Board of Directors for the Mississauga Primary Care Network.

 

Dr. Eshan Fernando
Clinician Innovator at THP Solutions & Virtual Care GIM Lead

Dr. Fernando is a Clinician Innovator at THP Solutions and supports General Internal Medicine physicians involved in our Virtual Solutions Clinic,
Dr Fernando has been practicing as a General Internal Medicine specialist for the past 6 years at Trillium Health Partners.  He is also the Division Head of General Internal Medicine at Trillium Health Partners.

Dr. Fernando is passionate in building sustainable and supportive care for patients served by Trillium Health Partners.

 

Liz Gabison
SCOPE Navigator
SCOPENavigator@moht.ca

Liz Gabison is the SCOPE Patient Navigator at Trillium Health Partners (Mississauga and Etobicoke).

Liz graduated from the University of Toronto with her Bachelor of Science, York University with a Bachelor of Education, the Canadian Memorial Chiropractic with her Doctor of Chiropractic and from the University of Fredericton with her Masters in Business Administration.

Liz has experience working in both hospital and community settings and has most recently worked as an assessor in the MSK WSIB specialty programs and in the OHAP program side by side with the Orthopaedic Surgeons and Primary care providers. Prior to her role as an assessor, Liz worked as a Director of Clinical Operations at Cira Medical, and as a Case Manager in the insurance sector. She also has extensive experience in the Vocational Rehabilitation industry.

In her role as SCOPE Patient Navigator, Liz will provide primary care providers with assistance navigating hospital and community resources to support primary care and improve patient care needs.

 

Andrew Bidos
Virtual Care Operations Lead
Andrew.Bidos@thp.ca

Mr. Andrew Bidos is the operational manager of Virtual Hub. In addition, he supports Insight Health’s Musculoskeletal Teams.

Mr. Bidos is passionate about healthcare improvement and has over 16 years of both clinical and managerial experience in various public and private healthcare organizations.

With a passion to improve healthcare quality, Andrew looks forward to work with primary care providers for coordinated SCOPE operations.

 

Lindsay Wingham-Smith
Executive Director, Mississauga Health &
Co-Lead, Mississauga Health SCOPE

Lindsay Wingham-Smith is a transformational health system leader with a proven track record of integrating and advancing complex regional and provincial initiatives by leveraging strong cross-sector relationships with key stakeholders. Prior to joining Mississauga Health, she was the Vice President, Home and Community Care at the Home and Community Care Support Services Toronto Central (HCCSS) and was Vice President, Health System Capacity Access and Flow at Ontario Health (OH) Toronto Central Region.

Throughout her career, Lindsay has been responsible for driving continuous growth and the optimization of programs, policies, and strategies by leveraging innovative and sophisticated approaches and partnerships across the continuum. Her track record of engagement of staff, stakeholders, and the community will be of great benefit to Mississauga Health.

Lindsay holds a Master of Social Work from the University of Windsor and a Bachelor of Social Work from Carleton University.

 

Hayley Baranek
Project Director, Health System Innovation

Hayley joined the team as the Project Director of Health System Innovations supporting SCOPE operations. She has held progressive leadership positions, most recently as the Manager of Virtual Clinics and Interim Program Director of SCOPE at Women’s College Hospital.

In her position, Hayley was responsible for overseeing the clinical care delivery of Women’s Virtual (WV) across the COVIDCare@Home, LTC+, eConsult, and SCOPE programs. Previously, Hayley was the Manager of Strategic Projects at Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (WIHV).

Hayley has her PMP and Master’s in Public Health from Queen’s University.

 

Frequently Asked Questions

I am not sure if my request is appropriate for SCOPE. How can I find out?
When in doubt, you can always call SCOPE. We will try to help you with your patient request, no matter how big or small.

My patient needs mental health support and/or mental health case management, what should I do?
One-Link provides coordinated access to a number of addictions and mental health services within Mississauga and Halton through one referral and intake assessment process.

My patient has an abnormal lab result and limited ability to use certain medications base on their medical profile. Can you please provide advice on the plan of management?
Please feel free to reach out to SCOPE on 905-848-7592 and we will be happy to schedule a phone consult with our General Internal Medicine specialist.

 

Media

Mississauga Health SCOPE Kick off Meeting

March 8, 2023