Northern BC health authority sets up online COVID clinic in two days

When a pandemic strikes, healthcare organizations need to react quickly. As a result, remarkable things can happen.

Northern Health is the health authority serving Northern BC. In March 2020, it set up an online clinic and COVID-19 information line in only two days. With thousands of callers since inception, this service has been crucial for Northerners.

“We were definitely building a plane in flight,” says Dori Pears, regional manager, Primary and Community Care, one of the leads in developing the Northern Health COVID-19 Online Clinic & Information Line.

In early March, Northern Health’s Executive tasked a small team to create a combined help line and online clinic. The service would provide information and advice, helping reduce the transmission of COVID-19 and decreasing pressure on emergency rooms and other health services.

For two days, the team “locked down” in an intense process to plan and implement the new clinic.

The first challenge was space. The Brunswick building in Prince George was chosen – but it was fully occupied by IT staffers. Thanks to Jeff Hunter, chief information officer, within hours all 200 staff were sent home to work remotely.

“I was amazed at how quickly they vacated their building so we could set up the new clinic,” said Pears.

A small team stayed behind to install equipment. Twenty-six workstations were initially created. As call volumes increased, new workstations were added.

The team used Tableau software to track wait times, call lengths, and call volume. It provides heat mapping to determine peak hours, which helped inform ongoing staffing and process changes.

“From an IT equipment perspective, the amount of effort by IT staff to move the virtual clinic from concept to production was immense,” says Joan Vanderlee, regional manager, Acute Care Solutions, Information & Technology Services.

Now that the infrastructure was ready, they needed staff. David Williams, VP of Human Resources, and his team put out a call for staff willing to be redeployed.

“There were many who stepped outside their normal roles to ensure we had success. Nobody said, ‘this isn’t my job’,” says Vanessa Kinch, regional manager, Clinical Informatics.

The pool of staff eventually grew to 250, including volunteer fourth-year nursing students and medical residents.

“A lot of staff were providing frontline care for the first time,” says Pears.

Information was changing daily. For consistency, scripts were developed using BC Centre for Disease Control guidelines. Population and Public Health leadership also provided up-to-date information and escalation procedures.

“The first week was absolutely crazy. I couldn’t have asked for a better team to support this,” says Dr. Furstenburg, Northern Interior rural medical director, and one of the leads of the project. “Everyone did a vital role in very short order.”

To keep everyone healthy, strict cleaning protocols were set up to ensure everything was sanitized between shifts.

The service, which initially operated 24/7, provides three tiers:

• Tier 1: Screens calls, provides information. Transfers medical questions to Tier 2.
• Tier 2: Nurses assess callers, transferring those with COVID-19-related symptoms or other complex medical issues to Tier 3.
• Tier 3: Physicians and nurse practitioners provide immediate help and advice.

Before launch, practice calls and tests ensured everything was working. Information technology experts also provided on-the-spot support to each tier.

On March 14, the service “soft-launched,” initially seeing a few calls. But Northerners were anxious about COVID-19, and when word got out, over 800 calls flooded in the next day.

“People simply needed information,” says Kelly Gunn, VP Primary and Community Care and Clinical Programs.

There were over 4,430 calls the first week, with 70 per cent about COVID-19.

To keep up, staff worked round the clock – some working 20 hours a day. They also balanced training new staff, managing technical requirements, and implementing evolving messaging. All of this required constant adjustments.

“There were changes every day,” says Pears. This initially strained the line’s response time, which started at 30 minutes. But after two weeks, it was only six minutes.

“It was great to provide the wraparound support until we figured out what we needed,” says Kara Hunter, Lead, Nurse Practitioners.

Since then, the Northern Health COVID-19 Online Clinic & Information Line has added other functions, including providing information on mental health and substance use; working with BC Housing and the First Nations Health Authority; and connecting local businesses with Public Health Protection.

Now that Northerners are more informed and call numbers are dropping, the service’s hours have been slightly reduced.

The service is still available for Northern communities, but with many doctors’ offices now offering virtual healthcare, Northern Health continues to advise people to call their primary care providers first.

As of June 10, the service had received nearly 14,000 calls in total – impressive for a “plane built in flight” in only two days!

Daniel Ramcharran is Communications Advisor, Planning, Quality and Information Management, Northern Health.