UNDERSTANDING THE GAPS:
OUR NATIONAL NEEDS ASSESSMENT
Before building a national virtual care program, we needed to answer two questions: where in Canada is specialist IBD care hardest to reach, and what do patients and care teams actually need from a virtual program? To find out, CaNVAS-IBD carried out a national needs assessment with two parts: a quantitative mapping study of specialist access across the country, and a qualitative study that brought together the voices of patients, clinicians and health system leader
Part One: Mapping access to gastroenterologists
Working with research teams in seven provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario, Quebec and Saskatchewan), we counted every practising adult gastroenterologist and every adult living with IBD, then compared the two within each of Canada's 96 health regions. This gave us a clear picture of how specialist supply lines up with where people with IBD actually live.
7 provinces studied
96 health regions mapped
926 specialists
237,269 adults living with IBD
What we found
-
Nearly one in three health regions (29 of 96) had no gastroenterologist practising locally at all.
-
Specialist availability was more than four times higher in urban regions than in rural and remote ones.
-
Every one of the northern and remote health regions, including areas with a high proportion of Indigenous residents), had no local gastroenterologist.
-
Regions with an academic teaching hospital had roughly five times the specialist density of regions without one.
-
Some regions with no local specialist were not remote at all, but sat next door to well-served cities. One region, Gaspésie–Îles-de-la-Madeleine in Quebec, had no local gastroenterologist for its roughly 960 adults with IBD and no well-supplied neighbour.
Figure 1. Where IBD specialists practise across Canada. This map shows how many gastroenterologists work in each health region compared with the number of people living with IBD there. Darker areas have more specialists. Areas shown in white have no gastroenterologist practising locally. Grey areas are regions we did not have data for.
Part Two: Listening to patients and care teams
Numbers tell us where the gaps are, but not what it feels like to live with them or how to close them. Working with an independent research firm, we held 11 online focus groups with 47 Canadians living with IBD from every province. We also conducted 43 in-depth interviews with more than 50 stakeholders, including gastroenterologists, IBD nurses, surgeons, telemedicine implementers, and provincial and territorial health officials, among them participants from Yukon, the Northwest Territories and Nunavut.
What patients told us
-
Distance is a daily cost. Participants in rural areas described driving an hour or more each way, often spending longer travelling than in the appointment itself.
-
Waiting is the norm. Long waits to reach a doctor or nurse, to get testing, and even to get a diagnosis came up across every region.
-
Continuity keeps breaking. High turnover among specialists meant repeating medical histories again and again, and starting over with someone new.
-
The ideal clinic is a team. Patients described wanting IBD-trained nurses, dietitians, psychologists and other specialists working together, rather than care assembled piece by piece.
-
Virtual care is welcome, as a complement. Participants valued the convenience and the ability to be seen from home, and many suggested keeping in-person visits for procedures while handling routine check-ins virtually. Their main concern was that virtual care should add to in-person care rather than replace it.
-
A nurse navigator would help. Patients were enthusiastic about a nurse who coordinates their care, arranges local tests and lets a clinic or emergency department know they are coming.
What clinicians and health system leaders told us
-
There was strong interest in the proposed model across every province and territory, with the greatest enthusiasm in jurisdictions with no established IBD program.
-
Regions that depend on visiting or locum specialists saw a national network as a way to finally offer their patients continuity.
-
Several stakeholders urged a broader definition of "underserved", one that includes people who live near a hospital but face long waits, limited mobility, no transportation, or the cost of taking time off work.
-
Building on the virtual care platforms provinces already support was seen as a major advantage. There would be no new system to learn and no new technology to fund.
-
The multidisciplinary approach was widely described as the ideal way to deliver care, particularly if team members can be drawn from across jurisdictions where local specialists are scarce.
What this means for CaNVAS-IBD
Together, these findings do two things. They identify the specific communities across Canada that stand to benefit most from virtual IBD care, and they set out what a national program has to get right: a coordinating IBD nurse navigator, a multidisciplinary team, flexibility in how patients connect, and a definition of "underserved" broad enough to include everyone who struggles to reach specialist care. This is the foundation the CaNVAS-IBD network is being built on.
Last updated: September 3, 2026