SCOPE (Seamless Care Optimizing the Patient Experience) is a shared virtual interprofessional care team for primary care providers (PCPs) in Toronto who are unaffiliated with teams. SCOPE is a platform for primary care providers to come together and foster a community of practice.

The SCOPE program’s primary goal is to support primary care providers by improving access to high-quality care for their patients. SCOPE creates a virtual care team for family practices and provides a single point of access to a comprehensive range of interdisciplinary supports.

SCOPE is a platform which allows services to be added based on community and hospital needs (e.g. mental health, Registered Nurse (RN) health coaches, headache program, pharmacy and palliative care). It can also help identify and improve gaps in care. The program aims to help reduce avoidable Emergency Department visits and hospital re-admissions for patients in need.

Primary care providers in Toronto are provided direct and centralized access to a range of resources and providers:

  • Navigation Hub – access to a resource nurse navigator and homecare coordinator for assistance with linking to hospital and community resources
  • Internal Medicine – for phone-based consultations and rapid access to an assessment
  • Medical Imaging – for advice on appropriateness of imaging, interpretation of results and to expedite urgent imaging
  • Home and Community Care – access to a dedicated home and community care coordinator who provides curated care for your patients

Connecting with SCOPE

Primary care providers registered with SCOPE can connect to local specialists, imaging, and community services to serve their patients.

Internal Medicine Specialists

Immediate consultation or advice from a hospital internist and access to urgent assessments.

Nurse Navigator

General advice and assistance accessing specialist care, tests and healthcare resources. Additional SCOPE services can be accessed, including Registered Nurse (RN) Health Coaches, Substance Use Network, and transitional pain service.

Home and Community Care Coordinator

In-home assessment/case management and access to community-based resources and home care.

Medical Imaging

Same-day consultation from a radiologist for advice on appropriateness of imaging, interpretation of results, and to expedite urgent imaging.

What Primary Care Providers Are Saying About Scope

“I have been working with a SCOPE nurse navigator for a year now, and her help with navigating urgent referrals, or sometimes determining which type of specialists to refer a patient to, has been extremely impactful and an invaluable asset for my practice.”


Dr. Jane Chow Primary Care Physician – North Toronto

Our Reach


SCOPE Members

of solo primary care providers* in Toronto have access to SCOPE.

*Primary care providers who have no affiliation to team-based care (not to hospitals or hospital services)