By: Anne-Marie Flanagan, Interim Chief Communications & External Relations Officer, North York General
North York General (NYG) is leading a digital project to help Ontario hospitals use the latest clinical evidence to provide timely, effective, consistent and culturally sensitive care to sickle cell disease (SCD) patients.
Evidence2Practice (E2P) is a provincial initiative, funded by Ontario Health, that uses technology to accelerate the adoption of the latest clinical evidence by embedding it directly into hospital systems. This work supports the province’s efforts to make the SCD quality standard a key part of Ontario’s Black Health Plan.
E2P reduces implementation delays and makes sure health care providers have easy access to the latest, standardized care protocols. It typically shortens implementation of the most up-to-date clinical evidence to four to six months — instead of years — while improving efficiency, clinical consistency and health outcomes.
Understanding Sickle Cell Disease (SCD)
SCD is a group of inherited red blood cell disorders that cause severe body pain and damage. More than 3,500 Ontarians are living with the incurable disease, which primarily affects Black and racialized people from Africa, the Caribbean Mediterranean, the Middle East, South America and South Asia. SCD patients can experience sudden, severe pain that requires timely, expert care. However, many people with SCD experience delayed care, misdiagnosis and undertreatment due to inconsistent approaches to treatment, lack of provider experience and systemic racism.
“There has been anti-Black racism and labelling of sickle cell disease patients as ‘drug-seekers’ who have opioid use disorders,” says Dr. Sagar Rohailla, NYG’s Chief of Medicine and Medical Program Director. “This false narrative perpetuates stigma and undermines the quality of care these patients receive.”
How E2P Supports Patients
E2P provides digital tools that support rapid, evidence-based decision-making to manage SCD pain. It improves triage and early identification of SCD patients in emergency departments and enhances provider education on best practices for managing the disease. It also supports better referral pathways to specialized SCD care centres and transitions to post-hospital care.
E2P also helps eliminate barriers to care for SCD patients by ensuring health care providers receive anti-racism and anti-oppression training. The project supports NYG’s health equity strategic direction, which is part of the hospital’s recently introduced 10-year Vision and Strategic Plan.
Dr. Rohailla, who provides care to many of the SCD patients treated at NYG, says E2P embeds SCD treatment best practices into hospital clinical order sets, which helps provide standardized guidance and consistent, culturally sensitive care to manage SCD pain and complications.
“E2P has really helped ensure that SCD patients get the medication they need quickly,” says Dr. Rohailla. “It also provides information on how to transition from high doses of medication to more stable ones.”
E2P also ensures that the NYG blood bank is notified immediately when an SCD patient arrives in the emergency department, so it can more quickly prepare and deliver a blood transfusion, if one is required.
Personalized and Holistic Care for Patients
“This program is truly a benefit to SCD patients in terms of giving them timely access to the medications and treatment they require,” says NYG Clinical Team Manager Rina-Marie Austrie-Fletcher, whose team cares for many of the hospital’s SCD patients. “Every patient now has a care plan specific to their individualized needs, so if they come back to the hospital we are not starting from scratch—we know what helped them before.”
North York General’s SCD approach also involves the use of individualized non-pharmaceutical therapies that can help patients manage their pain. Incorporating "non-pharmacological" therapies that are complimentary and synergistic with medication management ensures we help patients manage their pain in a more effective and holistic manner. The hospital also seeks input from SCD patients.
“We were able to gain insights from the first patient who was treated as part of the project,” says Austrie-Fletcher. “He said he received his pain medication right away and he told us that heat packs were very effective in helping him manage his pain.”
Implementation and Broader Applications
E2P was launched in 2021 and NYG is leading its acute care implementation. SCD was identified as a priority area for E2P in early 2024, most participating hospital sites joined the initiative by June 2024, and the pilot project began in late March 2025. Participating hospitals have introduced the SCD E2P in their emergency departments and NYG has also implemented it for inpatient care.
Ontario’s E2P program also includes projects addressing anxiety and depression, congestive heart failure and type 2 diabetes and prediabetes. Hospitals participating in E2P projects receive implementation support including project management, staff engagement and training and consultation to align digital tools with clinical workflows.
“I hope this program will go out to other hospitals,” says Austrie-Fletcher. “Highlighting inequities and knowledge gaps is important to helping us provide the best possible care and outcome for our patients.”