Using Portable Nasal Endoscopy for Early Diagnosis of Chronic Rhinosinusitis in Primary Care, co-developing a collaborative care pathway and implementation partnership in British Columbia, Canada

This project aims to address challenges related to delayed diagnosis and limited access to ENT specialist clinical assessment for patients with chronic rhinosinusitis (CRS) in British Columbia (BC). Current diagnosis and management of CRS often relies on in-person nasal endoscopy performed by ENT specialists. However, prolonged wait times for these consultations can delay start of treatment and contribute to ongoing symptom burden, repeated healthcare visits, increased use of antibiotics and/or oral corticosteroids, and impaired quality of life. These challenges are especially significant in rural and underserved areas with limited access to rhinology services. Our project is an opportunity to explore whether portable nasal endoscopy (PNE) performed by non-ENT trained healthcare staff in primary care settings could support earlier assessment and remote triaging by ENT specialists, potentially improving access to care and optimizing specialist resource utilization.
The proposed activities will consist of a series of collaborative engagement and consultation sessions conducted over approximately 3-4 months. Activities will include virtual meetings, small group consultations, and one hybrid workshop involving GP and ENT clinicians, and researchers. The sessions will focus on identifying application barriers and solutions, workflow considerations, training needs, patient perspectives, and opportunities for integrating PNE into existing referral and triaging pathways. Participants will include ENT specialists, family physicians, GPs, primary care providers, medical trainees, researchers, health system stakeholders, and people with lived experience of CRS, particularly individuals who have experienced prolonged wait times or barriers accessing specialist care. The project will support discussions around implementation feasibility and accessibility.
The anticipated outcomes of these activities include a) better understanding of the issue; b) strengthening collaboration between researchers, clinicians, patients, and health system staff; c) identifying key barriers and opportunities related to PNE implementation in primary care settings; and d) co-developing future research and application priorities. These engagement activities can lead the development of patient-centered and feasible care pathways aimed at improving earlier diagnosis of CRS, enhancing coordination between primary and specialist care, and supporting more equitable access to ENT services across BC.