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

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.  

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.

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.

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.