Significant work is underway at St. Joseph’s to establish virtual care as a sustainable, safe and effective tool for health care teams post COVID-19.
Virtual patient care has been fast tracked with the pandemic, but where does it go from here?
Building upon what has been learned from the speedy implementation during the urgency of the pandemic, there are important next steps underway at St. Joseph’s Health Care London.
“Thinking about the scale of serving hundreds of patients per week virtually, there is much to do if we are to provide reliable, safe and appropriate care to some patient populations using virtual technologies,” says Glen Kearns, Integrated Vice President, Diagnostic Services and Chief Information Officer. “While the pandemic was certainly the catalyst for advancing virtual care, there are many challenges and opportunities to build a fulsome corporate wide strategy.”
Among key considerations for planning are:
- Integration strategies of virtual technologies with other clinical stakeholders across the South West region - primary care, other agencies, other hospitals
- Patients’ comfort with, and access to, virtual technologies
- Continuity of care - how various communication systems interact with patient health information systems (electronic health record), follow up care, and the sharing of care plans among team members and with patient and family members
- Privacy and cyber security
- Education and support for health care providers, patients and family caregivers
- Research to better understand the benefits of virtual care and potential limitations
It may also be an issue for patients with language and cognitive barriers, or physical disabilities. While virtual care is burgeoning as an additional tool at the disposal of clinicians, it will not be a replacement for all instances of face-to-face care. For example, says surgeon Dr. Brian Rotenberg from Otolaryngology - Head and Neck Surgery at St. Joseph’s, “virtual care may be more difficult for some specialists like surgeons to integrate into their practices, and some initial consults with specialists done by virtual care may not provide the needed information for decision making. Additionally, virtual care offers challenges to resident training that will need to be understood within the teaching hospital environment.”
“Whether virtual care is a fit for a patient is less about the patient’s diagnosis but more about care needs, level of acuity and complexity,” says Dr. Sarah Jarmain, Co-Chair of St. Joseph’s Quality Council and a member of the team implementing virtual care across St. Joseph’s.
Developing a sustainable approach to virtual care across St. Joseph’s beyond the pandemic will be part of the organization’s COVID-19 recovery plan. Tools and technology, teaching, research, work flow, privacy, evaluation – growing virtual care will be complex, but at the core of this work will be patients and their families, says Dr. Jarmain
“We will be engaging patients and families to understand their needs and preferences at different points in their care journey. For example, do we need a digital navigator role to assist with technology setup and comfort with the virtual care process for patients. Patient preference is a very important consideration and will be front and centre.”