Multiple Sclerosis Pathway - Coordination of Care

A person with Multiple Sclerosis (MS) should try to maintain their own current contact list of care providers to call with an emergency, a relapse, or a problem or question about medications. You can register at MySaskHealthRecord to access information about your lab results, medical imaging reports, and clinic visits. You can also enter additional information in MySaskHealthRecord about your contacts, medications and appointment reminders.

Due to the diverse effects of MS, people may see a variety of different care providers. The goal of the MS Care Pathway is coordinated MS Care. Your family doctor, an MS nurse educator and a neurologist should play a role in navigating you to the care you need. Ideally, most information about you and your health status should be collected and shared by this care team.

Neurologist

A neurologist is a doctor who specializes in conditions affecting the brain and nervous system. General neurologists support people with a range of conditions like MS, Parkinson’s disease, stroke, epilepsy, dementia and brain injury.

A person with MS should have a regular neurologist, and should be seen for a comprehensive visit annually. The neurologist is also the person to call for suspected relapses or troubling neurological symptoms. The neurologist orders brain imaging and tracks the progress of the disease by reviewing MRI scans and keeping track of clinical symptoms. If appropriate, the neurologist will discuss MS treatments and help select a treatment. In Saskatchewan, neurologists are only located in tertiary centres (Regina and Saskatoon). MS specialist neurologists are only located at the Saskatoon MS Clinic.

MS can only be diagnosed by a neurologist, so anyone with an MS diagnosis has seen a neurologist at least once. If for any reason you would like to see a different neurologist than the one who diagnosed you, speak to your family doctor to get a referral.

MS nurses

MS nurses are located at the MS Clinic in Saskatoon (see next section) and at the SK MS Drugs Program office. MS nurses are trained in the comprehensive care of people living with MS, including management of MS symptoms and the use of MS drugs.

A person with MS can self-refer to the nurse educator with the SK MS Drugs Program – the nurse is available by phone to all residents of Saskatchewan and no physician referral is required.

Physicians may also refer a patient to the SK MS Drugs Program Nurse Educator for further education concerning management of their MS and information about MS drugs. The SK MS Drugs Program coordinator is also available to address questions on the process for accessing MS drugs, including eligibility criteria for coverage of various therapies.

To contact the SK MS Drugs Program Coordinator phone toll free at 1-866-655-7966.

To contact the SK MS Drugs Program Nurse Educator phone 306-655-8673/ Fax 306-655-8404, or call the MS Drugs Program.

MS society knowledge network

Multiple Sclerosis Society of Canada’s MS Knowledge Network is a service of knowledgeable navigators, available to talk to MS patients and families and provide consistent, quality MS information and support for anyone in Canada.

MS Navigators are not medical professionals, but they have access to vast stores of information collected by the MS Society about every aspect of MS. They can provide trusted information on MS to help you manage your own care, and help you find information and support that is tailored to your unique needs. Navigators can also connect people to the local MS Society staff for assistance with local programs and services.

Contact an MS Navigator to learn more about:

Reliable information about multiple sclerosis
Resources for managing your symptoms
News about programs and services in your area
Making sense of advances in MS research
Guides and online resources for everyday use (e.g. how to apply for CPP, how to talk to children about MS)
Help navigating health and community services
Practical assistance finding income and employment support, financial planning and more.

To contact the knowledge network phone 1-844-859-6789, e-mail msnavigators@mssociety.ca or web chat with navigators from 8am-8pm ET at mssociety.ca.

Saskatoon MS Clinic

The Saskatoon MS Clinic houses the province’s clinical leadership in MS care and research, including the Saskatchewan MS Research Chair and the MS Drugs program. The clinic sees patients with suspected MS or confirmed MS, as well as patients with rare diseases of the central nervous system.

To attend the MS Clinic for the first time, patients require a physician’s referral. After the first visit, patients can contact the MS Clinic directly. The MS Clinic is a full service clinic that provides clinical assessment by a specialized neurologist and access to diagnostic imaging. In-house neurologists prescribe MS treatment and other medications, and monitor health status and disease progress. Patients may see other in-house providers for symptom management during their clinic visit, or the clinic will set up referrals to other providers.

Any MS patient can attend the Saskatoon MS Clinic for ongoing care, but many people with MS continue to see their local neurologist and MS nurse educator for day to day management and referrals, with access to the Saskatoon MS Clinic for specialized assessment and services.