Michael Garron Hospital launches virtual ED

TORONTO – In March, Michael Garron Hospital (MGH) opened its Virtual Emergency Department (ED) for clients and families in the East Toronto community. The new service is available for patients over three months of age and offers individuals virtual medical consultations to address health concerns, especially for those who may be hesitant or uncertain about visiting the Emergency Department (ED).

The architects of the program are emergency physicians Dr. David Rosenstein (pictured on left) and Dr. Megan Reynolds (pictured on right). Dr. Reynolds brings additional experience from long-term care and family medicine, while Dr. Rosenstein spent over 10 years as the hospital’s chief medical information officer.

Dr. Reynolds and Dr. Rosenstein, along with their ED team, felt compelled to address a growing area of concern: patients avoiding ED care as a result of the COVID-19 pandemic. MGH’s virtual ED is supported by Canadian virtual care platform Maple.

During the first wave of COVID-19, emergency room volumes in Ontario dropped by nearly 50 percent between March 11 and April 30, 2020. MGH and hospitals across the GTA continue to see a decline in emergency room visits between 25-30 percent in 2021.

“We are seeing people come to the emergency room quite late with their injury or illness because of concerns over leaving their home and getting COVID-19,” says Dr. Reynolds. “These are cases where early antibiotics or speedier assessment of acute conditions could have supported healthier outcomes or prevented delays in surgery or other forms of care.”

The goal of the Virtual ED is not to replace in-person care but rather reduce barriers to accessing medical attention for health concerns that can be managed virtually.

“We can do more than we expected in a virtual setting,” says Dr. Reynolds. “I can talk to my patients and get a sense of how they feel just by listening to their voice and hearing how they are breathing. When we also have access to a screen, I can see their overall well-being.”

In some cases, following a virtual ED appointment, the physician may explain why it is advised for a patient to come to the hospital in-person for additional tests and care. Therefore, it is important to note that MGH’s ED is open 24 hours a day, seven days a week and always available to those who require urgent care.

The hospital has put extensive measures and protocols in place to keep patients as safe as possible during in-person visits with large waiting rooms to allow for physical distancing and masks for all patients and visitors.

Dr. Rosenstein highlights the value of accessing virtual ED appointments, especially for those who live in East Toronto and consider MGH their community hospital.

“When you access health services at your own hospital, we already know you – we have readily available access to your medical records, medications and history; this is especially important in an emergency situation,” he says.

“If your virtual appointment results in an in-person visit to the ED, it means you can be at the hospital quickly. We can help arrange follow-up care or provide access to specialists in the community that you live to make your personal healthcare experience local and more seamless.”

MGH’s virtual ED is powered by Maple; this technology will enable patients to use their smartphone or computer to securely receive advice, diagnoses, prescriptions and support from MGH ED physicians.

The hospital covers the cost of the platform and visits are covered by OHIP, so the service is free for patients. Patients must sign up through the custom registration page on MGH’s website to access covered program visits.

“It’s important that throughout this pandemic, urgent care patients can continue to be seen by a healthcare provider to receive the medical attention they need, when they need it,” says Dr. Brett Belchetz, practicing physician and CEO of Maple. “We’re proud to partner with Michael Garron Hospital, which has embraced innovation to provide patients and their families in the East Toronto community with effective and convenient care.”

Dr. Kyle Vojdani, MGH’s chief and medical director of the ED adds that the virtual ED will be especially useful for clients and families that require access to care during times when other community and primary care services may not be readily available; MGH’s virtual ED appointments are available seven days a week from 5-11 p.m.

Dr. Vojdani sees the virtual ED program as a stepping-stone to next phases of exploring more innovative ways of providing support to the hospital’s community partners, for example having MGH ED physicians offer online consultations to healthcare providers in long-term homes or to family physicians.

This may help reduce unnecessary visits or wait times in the emergency department for those who can be supported virtually.

Finally, understanding that not everyone in the community may have access to a reliable internet connection or a computer, MGH is also working with its community partners to help these patients access virtual care.

The “PHONE CONNECT” program was recently launched in the MGH ED with the intent of providing smartphones to patients who do not have a working phone so that they too can access follow-up or specialist care by phone.