How a Learning Health System Approach is Transforming Obstructive Sleep Apnea Care
A Pathway to Progress: How a Learning Health System approach is Transforming Obstructive Sleep Apnea Care in Alberta
Obstructive sleep apnea (OSA) is a prevalent and serious chronic disease linked to reduced quality of life, increased cardiovascular risk, and significant healthcare utilization. Beyond individual health impacts, untreated OSA contributes billions in societal costs through higher rates of motor vehicle collisions, workplace accidents, and lost productivity.
Limited specialist access, coupled with the high prevalence of OSA, leads many patients to experience unacceptable delays for OSA care exceeding Canadian guidelines. “An OSA care delivery model that relies on specialists is unsustainable and innovative strategies are needed to improve access,” says Dr. Sachin Pendharkar, a sleep and respiratory physician scientist, Professor of Medicine and Community Health Sciences, and member of the O’Brien Institute for Public Health at the University of Calgary. While recent evidence supports the safety and cost-effectiveness of managing OSA in primary care, barriers such as limited primary care provider knowledge and poor role clarity among clinicians persist.
From Concept to Care: A Living, Learning Pathway
Exploratory research conducted with partners across Alberta revealed key challenges to adopting a more community-oriented approach to OSA care. One of the most significant barriers identified was the complexity of navigating the healthcare system. To understand and address these challenges Dr. Pendharkar’s team conducted extensive engagement, including interviews, focus groups, and workshops with patients, primary care and specialist physicians and researchers. In response, a clinical pathway was launched in the Calgary Zone in 2018 as a targeted solution to support identification, diagnosis, and management of OSA in the primary care setting. This clinical pathway was refined through usability testing with primary care physicians and information gathered from a provider survey and referral data analysis from the FMC Sleep Centre.
In April 2025, the team scaled the initiative and officially launched the Provincial Adult Obstructive Sleep Apnea Primary Care Clinical Pathway which is available to primary care providers through the Alberta Pathways Hub. The pathway includes algorithms to diagnose and treat OSA using community-based facilities, indications for specialist referral, and additional considerations for comprehensive care.
Dr. Pendharkar’s team also designed and launched a patient-accessible care pathway to support individuals in understanding what to expect as they collaborate with their healthcare team to manage and treat OSA. This pathway is publicly accessible through MyHealth Alberta, providing patients with clear guidance throughout their care journey.
Evaluation and Adaptation in Action
Unlike traditional approaches that often separate scientific discovery from real-world application, this initiative is designed with clinical integration in mind from the outset. “There can be a tendency … to focus on the science in a vacuum and figure out the practical applications later. But this is counterproductive when the science and application are meant to integrate by design,” Dr. Pendharkar explains.
The team has embraced an iterative process, using each phase of the project to learn, adjust, and improve. They are now disseminating the clinical pathway and monitoring uptake, with the intent of further improving its implementation and developing a more comprehensive approach to supporting primary care OSA management.
The project’s iterative nature means that the pathway is never “finished.” Instead, it is continuously evolving based on new data, emerging needs, and ongoing end-user engagement. Over the next three months, the team will collect additional feedback from users and conduct further usability testing. These insights will inform the next round of revisions scheduled for release in the Fall.
This cycle of evaluate, adapt, and improve is the essence of a Learning Health System that ensures that innovations remain relevant, effective, and aligned with the realities of clinical practice.
Impact
This initiative endeavors to streamline processes, clarify roles and reduce unnecessary specialist referrals, making OSA care more efficient and patient-centered in a primary care setting. In a rural clinic where access to specialists is limited, this pathway can help a family doctor quickly and confidently start treatment and cut months off a patient’s wait for care.
By equipping primary care providers with the tools and guidance they need, the project helps bridge gaps in care and reduce health disparities. It also supports providers by offering a clear, evidence-informed framework for managing a complex condition.
Embedding evaluation, feedback, and adaptation into every stage of the process, is a reminder that meaningful change doesn’t come from research alone—it comes from research that listens, learns, and evolves.
To learn more visit:
Alberta Pathways Hub: Provincial Adult Obstructive Sleep Apnea Primary Care Clinical Pathway
MyHealth Alberta: Your journey with obstructive sleep apnea