Virtual platform gives spinal cord injury patients access to home care

The VIRTUAL Integrated Platform for Spinal Cord Injury (VIP4SCI), a two-year-old pilot project for Spinal Cord Injury Ontario (SCIO), recently received the go-ahead for a rollout across Ontario.

Developed by ForaHealthyMe Inc., a virtual care solutions provider, VIP4SCI allows spinal cord injury patients to communicate more easily with doctors and social service providers. Instead of travelling for their in-person appointments, which can involve difficult wheelchair transport, patients can stay home and see their care providers using videoconferencing.

Other useful features are integrated into the system, including email, scheduling, a medication management system, spinal cord injury assessment tools, a journal to help track goal setting, along with telehealth services, which are critical for spinal cord patients who need to access health expertise remotely.

“We wanted to offer better support to our clients, allowing them to live independently while providing improved access to Primary Care,” said Dr. Stuart Howe, CEO of Spinal Cord Injury Ontario (SCIO). Access to care providers in-home has many benefits, like reducing the need for unnecessary travel.

Over 36,000 Ontarians are living with and managing a spinal cord injury. For patients living in remote regions of Ontario, a virtual consultation with their healthcare provider can save three or more hours of driving and eliminate 250 km or more of travel.

As well, family members and regional community support staff who accompany patients are also spared from a day of travel.

The technology was fully customized to the patient’s needs. “ForaHealthyMe built it keeping in mind how a person with an SCI can interact with software,” said Dr. Howe. “Some have limited mobility and use sip/puff or a joystick to navigate screens.”

By understanding a patient’s circumstances, the solution was designed to be as accessible as possible. “This demonstrates the flexibility of the technology we’ve developed – that we can work with a client, understand the problem they’re trying to solve and how technology can help to address those gaps,” said Courtney Cole, CEO of ForaHealthyMe. “Then we work with the partners to develop the solution and deploy.”

There are many patients with similar mobility and communication challenges that can also benefit from in-home patient/provider tele-consultation. Patients with ALS or multiple sclerosis are two examples.

And thanks to changes in government legislation, Ontario is helping physicians make better use of remote consultation, and to be able to bill the province for payment.

For the pilot in 2018, 50 patients with a spinal cord injury were selected in different regions of Ontario where a regional service coordinator was close by. For patients to participate, they had to be tech-savvy enough to use a computer or tablet and manage the connectivity.

On average, the SCIO and the company provided about three-hours of training for each person. Overall, it took about eight weeks to complete the training.

And according to Cole, 100 percent of those patients said they wanted to continue using it. Based on some of the data and user feedback, further improvements were made to the solution and it’s now even easier to use.

“We added a new component, access to tools for family caregivers,” said Cole. “That includes community-level support, engagements with other family caregivers through messaging and discussion boards, but also through use of video tools for peer-to-peer engagement.”

Now, with the go-ahead for expansion, the technology can be extended to more patients. “Over the next year we’ll be recruiting more of our clients and encouraging them to use this technology,” said Dr. Howe.

Both the Centre for Family Medicine in Waterloo, Ontario – a group that coordinated the patient-provider appointments during the pilot, and Toronto Rehab Institute – that conducted research on the platform will be re-engaged as the technology is rolled out.

In addition, SCIO is now working with the Parkwood Institute in London, Ontario to look at how VIP4SCI can be used to support in-patients as they transition back into the community. Parkwood Institute specializes in the treatment of patients with spinal cord injuries.

Unfortunately, in-home consultations can’t resolve every patient problem, such as a non-routine check-up where a primary care provider requires physical examination. For this, patients and their families would need to make the drive to their doctor. “The main benefit is it reduces the difficulty of going for routine healthcare. It also reduces wait times to see a specialist or primary care provider; saves transportation costs, and improves the doctor-patient experience,” said Dr. Howe.