Delivery of virtual visits surges at St. Joe’s London
May 20, 2020
LONDON, ON – Across St. Joseph’s Health Care London, care teams are rapidly and creatively taking advantage of what they see as the COVID-19 silver lining – the impetus to fast forward and capture the benefits of virtual or remote patient care. In April, 50-60 percent of all registered visits at St. Joseph’s were virtual, a jump from about five per cent pre-pandemic.
The daily average is currently about 1,000 virtual visits compared to about 200 a day pre-pandemic.
“Our response to COVID-19 has helped us refocus our priorities to ensure our patients, many of whom have special health needs, keep connected with their healthcare team,” says Dr. Sarah Jarmain (pictured), co-chair of St. Joseph’s Quality Council and a member of the team implementing virtual care across St. Joseph’s.
The organization is just at the beginning of this journey, says Glen Kearns, integrated vice president, Diagnostic Services and CIO. “We will continue to engage patients and clinicians in planning and how we evolve and adapt to this new way of providing service to some patient populations.”
Without leaving the safety and comfort of home, many St. Joseph’s patients are receiving care, education and therapy through various virtual technologies. They include phone-based counselling and assessments, Ontario Telemedicine Network and a customized version of Cisco Webex appointments, online resources, e-newsletters, and more. All are being tapped with excellent results and appreciative feedback, “which tells us this is a model of care we must pursue post COVID-19,” adds Dr. Jarmain.
This doesn’t minimize the struggle of those patients we haven’t been able to be seen during the pandemic, says Dr. Jarmain, “but what teams have been able to do very quickly has been outstanding.”
One unique population is veterans. Psychiatrist Dr. Don Richardson is medical director of St. Joseph’s Operational Stress Injury Clinic (OSI Clinic), a program that provides mental health supports for veterans, Canadian Forces members and the RCMP. He has seen benefits of the OSI Clinic’s team of psychiatrists, psychologists, social workers and nurses in their London, Toronto and Hamilton sites incorporating virtual care into daily practice during the pandemic.
“Most of my patients have responded well to the use of both high-tech, secure, videoconferencing and the low-tech, but reliable, telephone for appointments,” says Dr. Richardson. “It’s been an important tool in ensuring we can continue to provide our patients care at a time when they are under added stress from the pandemic created by job loss, financial worries, family strain and increased isolation.”
Involving family caregivers in therapy is also enhanced when care is delivered virtually as caregivers can participate in sessions or be close at hand to answer questions and provide insight into the patient and family’s needs.
While research shows psychotherapy and mental health symptom management are effective through virtual care, Dr. Richardson admits there are challenges.
“Establishing trust with patients is key to providing effective treatment, something that’s harder to do virtually,” says Dr. Richardson. “As clinicians, most of our training and experience is in face-to-face assessment and treatment. When using videoconferencing, the quality might not always be clear, or if delivering care by phone, we have to rely on more subtle clues to what’s going on with the patient such as changes to their voice. That’s difficult to do, especially with a new patient.”
Then there are the technical and process challenges for clinicians. “Adopting virtual patient care into our physician practices isn’t as easy as opening a video chat or picking up the phone,” cautions Dr. Jarmain. “There are a lot of new processes and nuances our teams need to be mindful of such as patient privacy, technology requirements and what type of care they should or should not be providing remotely.”
Yet staff and physicians at St. Joseph’s are not only embracing the opportunities to incorporate virtual technology into care, they are excelling.
“There has been remarkable dedication and ingenuity by staff and physicians in finding new ways to serve patients at this unprecedented time,” says Tom Janzen, integrated chief medical information officer for St. Joseph’s. “And we will be stronger for it.”