Lakeridge Health quickly pivots to virtual care during COVID

Faced with the unpredicted challenge of the COVID-19 crisis, Lakeridge Health, a healthcare provider to hundreds of thousands of Canadians in a large catchment area just east of Toronto, quickly enacted its pandemic response plan.

This included the creation of new solutions capable of offering an 800 percent increase in virtual care, limiting patient and staff exposure to the virus.

By creatively adapting multiple Microsoft 365 and Microsoft Power Platform solutions to work in new and innovative ways, the organization has met its goals, simultaneously creating a nearly entirely new electronic medical record (EMR) platform.

Lakeridge Health, comprised of five hospitals and 11 clinical outpatient facilities, provides primary healthcare to more than 750,000 people in the Durham region of Ontario. As a crucial and integral part of the region’s medical system, Lakeridge Health played a significant role in the local response to the COVID-19 crisis.

“COVID-19 was something that took the entire healthcare system by surprise,” said Dr. Ilan Lenga, Chief Information Officer and Chief Medical Information Officer at Lakeridge Health. “And the realization that it had gained a foothold in Canada required an immediate response.”

Thankfully, after the 2002–2004 SARS epidemic proved how rapidly viruses can spread across the globe, Lakeridge Health had formulated an emergency operations plan. Key leaders were placed in pandemic-response roles, and the organization began developing plans to draw down regular activities in preparation for a projected surge in patients. The organization’s communications team worked to rapidly build out new channels capable of managing interactions between hospital staff, their external partners, and regional leadership.

Lakeridge Health next identified three major changes that would need to be enacted to meet the challenge of the COVID-19 virus. “We needed to cut down face-to-face interactions for the safety of our patients and our employees, we needed to create a system that would allow for the rapid deployment of multiple new clinics, and we needed to ensure that we were providing a safe environment for our patients and staff during in-person care scenarios,” said Andrew Kelly, Director of IT Strategy and Innovation at Lakeridge Health. “We relied heavily on Microsoft 365 to create solutions for each of those needs.”

Though Lakeridge Health had been using a number of Office 365 components for years, Lenga admits that very few users would have considered themselves highly proficient prior to the COVID-19 crisis.

“It’s the expertise that we’ve developed over the last few months that took us from Microsoft 365-aware to Microsoft 365 experts,” he recalls. “That’s what’s great about the solution. There are multiple easy-to-understand tools that make up Microsoft 365, which you can pick up, learn a little about, and use as building blocks for almost any kind of infrastructure you might require.”

The first of these building blocks Lakeridge Health turned to were Microsoft Forms, Power Automate, and SharePoint Online. “At the very beginning, we knew we needed a solution capable of keeping track of a massive influx of patients,” said Lenga. “Right away, we began creating an intake form in Microsoft Forms, which we then fed to Power Automate so that it could extract patient information and populate a SharePoint site for us.”

This SharePoint site quickly became the standard patient-tracking solution for Lakeridge Health. Adding a small amount of analytics to this site, the organization effectively triaged patients based on their reported symptoms. This was especially important during the early days of the pandemic when testing supplies, swabs, and even personal protective equipment (PPE) faced national shortages.

For patients requiring assessment, but not yet in need of testing, Lakeridge Health turned to Microsoft Teams. Using Teams for virtual assessments, medical personnel could better understand the state of each patient’s symptoms, keeping those who likely did not have the virus safer by allowing them to stay at home.

As time went on, testing supplies became more available, allowing Lakeridge Health to test everyone who felt the need to be tested. This created other issues, however. “If you switch to a universal testing approach without a clear-cut appointments schedule, you run the risk of potentially infected people congregating in long lines outside your facilities,” said Lenga. “That’s why we used Power Automate and the calendar in Office 365 to create a new booking system.”

Similar to the patient triage system, Lakeridge Health’s booking system allows patients to provide their data in Forms. Power Automate then identifies a number of key factors within that data and triages them accordingly, ultimately referencing an Office 365 calendar populated by prearranged appointment slots based on staff availability and scheduling the patient.

Patients are then sent automated appointment confirmation emails, and the appointment is made visible to receptionists via SharePoint Online.

To further track patient interactions, Lakeridge Health also built nurses and physicians role-specific apps with Microsoft Power Apps. These apps not only help with patient data entry into the system following screenings, but they have also sped laboratory diagnostic requests compared to the organization’s traditional requisition system.

“By tying our SharePoint sites to Power Apps and Power Automate, we’ve been able to take all the information that patients give us and use it to generate a requisition,” said Lenga. “We can even produce a label for our swab and produce a requisition for our laboratory requests right from SharePoint.”

Scalability has also been a crucial part of Lakeridge Health’s pandemic response. The early stages of the COVID-19 crisis saw an 800 percent increase in patient visits compared to an average year. Lakeridge Health handled many of these visits through virtual care and, as demand for these services steadily increased, leadership saw a dire need for increased virtual care capacity.

In years past, the process of creating a virtual clinic within an existing department or ambulatory space at Lakeridge Health took between three and six months. Thanks to a combination of cooperation from the health ministry and its newly minted solutions, the organization was able to speed that process dramatically.

“We used a combination of our Microsoft 365-powered bookings app and Teams to spin up over 30 new virtual clinics in just weeks,” said Kelly. “We were creating a new clinic every couple of days.”

These new clinics also quickly benefited from other solutions Lakeridge Health created. “We started by testing our new Microsoft 365-based apps at one clinic, and then a second,” said Kelly. “Thanks to the intuitive nature of these solutions, we’ve since gone on to offer them to multiple community sites and clinics, where we’ve seen our clinical teams take to them very rapidly.”

Lenga agrees, adding that the organization’s overarching goal in offering virtual services has always been top-quality care. “We had a lot of clinicians who were hesitant about the virtual care experience,” he said. “This has since transformed into glowing recommendations. One of the most prevalent things we hear from our personnel today is confidence in the idea that virtual care is here to stay – that this isn’t a stop-gap in a time of crisis, but a transition to a new standard of care.

“We have been truly amazed by what we’ve been able to accomplish in a relatively short amount of time, and we’re equally excited to see what we’ll be able to accomplish with Microsoft 365 in the days to come.”