BC launches new form of virtual care for chronic care patients

It’s not news that COVID-19 has significantly impacted the healthcare system and the way services/programs are delivered. What is worth noting is that the pandemic has spurred the introduction of new models of care and patient interactions that could have long-lasting, positive outcomes.

At Cloud DX we recently joined an initiative led by Curatio Inc., a digital health company headquartered in Vancouver, to support the urgent need of patients who are no longer able to take part in face-to-face outpatient programs due to the pandemic. The goal of the aptly named Stronger Together program is to safely support outpatients at home during the pandemic, especially those who are frail, vulnerable and isolated.

BC Interior Health, The University of British Columbia, Pacific Blue Cross and United Health Network are among the partners involved in the program. Stronger Together is supported by a $1.4 million co-investment from the Digital Technology Supercluster, an industry-led consortium investing in innovation projects with funding from Canada’s federal Ministry of Innovation, Science and Industry.

People living with chronic disease, the disabled and elderly typically visit hospitals and community centers for rehabilitation and disease management programs in group settings.

These programs deliver education, information, exercises, coaching and critical peer support, that address both the medical and psychosocial needs of patients and families. Often, these programs also have some form of monitoring and clinical evaluation to catch issues before they become acute and thus prevent complications and hospitalizations.

It’s not considered safe for these individuals to participate in these types of programs during the pandemic, so a virtual care solution makes sense. However, the providers who typically deliver these programs lack the technology to deliver them virtually and don’t have the remote monitoring tools to safely track patients at home.

Similarly, there is no commonly accepted standard for this type of delivery and no platform on which multiple offerings can be integrated. In fact, use of mainstream ‘consumer’ technologies and platforms are often problematic for healthcare organizations as they may not have the privacy and regulatory requirements needed, nor have they generally been designed for clinical use.

The Stronger Together initiative was developed to fill these gaps and create support for patients. Stronger Together leverages Curatio’s secure, private social network to deliver peer support, coaching from nurses and experts, evidence-based health literacy programs and daily check-ins alongside Cloud DX’s award-winning remote patient monitoring technology.

A multi-phased project, Phase I of Stronger Together was deployed within BC Interior Health to help patients prepare for joint replacement surgery. Together, patients worked through weekly evidence-based educational programs and participated in daily group discussions led by Community Coaches, all while checking and monitoring their vitals each morning from the comfort of their homes.

Prior to the program launch, research and interviews identified a gap in patients’ understanding of the power and control they have over their own health outcomes. Also highlighted was the need for information around the importance of a patient’s role in healthcare. There turned out to be a real potential for improving health outcomes by assisting with patient education and process transparency and to provide patients with immediate positive feedback for helpful behaviours.

Phase I of the program included the participation of a clinical counsellor, a social worker and a physiotherapist, with whom patients could book virtual appointments. The pre-surgical optimization information traditionally provided in person to patients was woven into the four-week program that was provided to patients in-app.

Programs consisted of various steps including videos, worksheets, links to external references and daily vital sign checks with the Cloud DX Connected Health Kit, provided to patients free of charge. Patients had the opportunity to discuss any of the steps with the peers and coaches within their groups and with the in-app community at large.

The four-week pilot program began with 22 patients who were awaiting joint replacement surgery at Penticton Regional Hospital (PRH). Nineteen continued to monitor their vitals remotely over the four-week period, and 16 were onboarded into the Stronger Together app to participate in the four-week in-app program.

Upon onboarding, patients were directed to complete a clinically validated baseline questionnaire to assess their health and wellness prior to beginning the program. At the end of the four-week period, patients were prompted to complete the questionnaire again to help assess any changes in responses and overall wellness.

Early results from the program are positive. A notably improved response in outcome measures was observed, and participants who have not yet gone for surgery appear to have increased their physical activity after the four-week program. The greatest change noted was in self-efficacy for managing chronic disease. Patient survey feedback was positive and highlighted the ability to support patients safely and remotely across social, physical, and mental dimensions of their healthcare journey.

Several participating patients reported feeling motivated and actively interested in their own self-care. Others reported feeling that they received personalized care and enjoyed the feedback from other patient participants. Providers reported feeling that the program helped patients to take a greater interest in their own health.

The Stronger Together team is now preparing to enter into Phase II of the project. This next phase will include a number of additional programs to support diverse patient populations across Canada as they work to stay “healthy at home” during the ongoing COVID-19 pandemic and beyond.

Opportunities and programs like these have propelled us into a new remote world, in spite of pandemic-related disruptions. With careful planning and consideration, new care modalities such as Stronger Together can create enduring improvements in patient outcomes, rather than being merely a stopgap solution. We at Cloud DX look forward to helping create a healthcare system where technology continues to be leveraged in unique and exciting ways to create better patient outcomes.

Robert Kaul is Founder, President & CEO at Cloud DX. The company is headquartered in Kitchener, Ont.