Clinician Scientist, Neurology The Hospital for Sick Children, Toronto
Rationale: The surgical treatment of epilepsy in patients with drug resistant epilepsy (DRE) is well known to be efficacious in both children and adults in a significant number of properly selected surgical candidates both in terms of curing the epilepsy or decreasing seizure severity and frequency, as well as improving the quality of life in these patients and their families. However, despite ever mounting evidence supporting the effectiveness of epilepsy surgery, relatively few patients with DRE receive this therapeutic modality due to a number of barriers to access. Here we describe a unique partnership between epilepsy caregivers of all disciplines, patients and their families, and the Ontario Ministry of Health that has been focused primarily on the way to provide epilepsy surgery in the most efficient manner to properly selective children, youth, and adults with DRE, all in the context of providing comprehensive epilepsy care for all those in the Province of Ontario Canada who suffer from epilepsy. The object of this presentation is to describe this process and its outcome which has resulted in an extraordinary transformation of epilepsy care in Ontario, Canada. Methods:
In 2011 an epilepsy care model was presented to the Ontario Ministry of Health and Long Term Care by an expert panel on a Provincial Strategy for Epilepsy Care in Ontario. Complex epilepsy care would occur at district epilepsy centers (DEC) located throughout the province and epilepsy surgery would be performed at regional epilepsy surgery centers of excellence (RESC). Subsequently, an Epilepsy Implementation Task Force (EITF) was struck to operationalize the Provincial strategy, establish standards of epilepsy care, and develop knowledge translation [KT] strategies for epilepsy. Results: Ontario now has three adult and two pediatric DECs and two adult and two pediatric RESCs across the Province, each with a comprehensive epilepsy program. Six different epilepsy guidelines have been created and a KT program developed which utilizes the Project ECHO model in which each of the DECs and RESCs constitute a hub. EMU volumes in Ontario have increased from 450 in 2012/13 to over 2000 in 2018/19 and epilepsy surgery volumes have increased from 208 in 2012/13 to 400 in 2018/19. Conclusions: A novel partnership between government, epilepsy caregivers, patients, and families has resulted in the provision of end-to-end epilepsy care in Ontario with a resultant increase in patients evaluated for, and receiving epilepsy surgery. Funding: Please list any funding that was received in support of this abstract.: The Ontario Ministry of Health
