Video connects chronic and post-surgical patients to care team

Objectives

• Implement a more integrated, patient-centred care delivery model
• Bring care closer to home
• Enhance the patient-provider relationship
• Empower patients
• Support care between visits
• Improve patient outcomes

Model

The Ontario Telemedicine Network (OTN) Partner Video Project enables providers to apply the telemedicine Ontario Health Insurance Plan (OHIP) billing code for use of a third-party service. The St. Joseph’s Health System Integrated Comprehensive Care (ICC) program, patients, and inter-disciplinary care team were selected to join the program, enabling SJHH to deliver virtual care directly through the Epic-Zoom interface for a more seamless care experience.

The program provides patients and their care team with a secure, reliable, and patient-friendly way to connect. This reduces unnecessary barriers (like travel) making it easier to receive the right care in the right place. The ability to provide care remotely also reduces the number of emergency visits to the hospital.

Patients:
Upon discharge, patients can connect with ICC coordinators 24/7 by telephone, and through this program are also able to:

• connect by audio and video through the hospital’s MyDovetale portal for support from care coordinators and other members of the team
• initiate face-to-face video visits or secure message with team members as needed

Technology Type:
SJHH’s patient portal MyDovetale (Epic’s MyChart), which features integrated Zoom video and web communications technology that enables patients to request appointments.

Outcomes

SJHH is measuring the success of the Partner Video Project against the following criteria:

1. Increased access – removing barriers to care
2. Enhanced patient and family experience
   1. Delivering care at home or in the community
   2. Patient access to their health records – adoption and use of MyDovetale
3. SJHH staff engagement and model adoption
4. Evaluation of advanced technologies to support the ICC model

Specific features being evaluated include:

• Ability to securely message with care team
• Ability to view recent lab test results (in real-time)
• Ability to request an appointment (in-person or virtual)
• Ability to submit electronic questionnaires in advance of appointments

Through increased patient access to their information and their care team, St. Joe’s is focusing on removing barriers to care (financial and time resources), reducing readmission rates, and increasing patient-reported outcome measures.

A benefits evaluation framework will be used to assess the impact of the introduction of virtual visits on health care quality, productivity and access, and to fuel any implementation adjustments and further roll-out across SJHH. It will also help demonstrate clinical value and return on investment. Preliminary findings indicate that virtual care positively effects both patient and provider interactions and outcomes. Patients acknowledged the comfort of having “extended hospital care” and, along with providers, praise being able to connect beyond the hospital stay.

Change Required to Support the Model

The launch focused on:

• targeting the appropriate patient populations and care scenarios
• ensuring appropriate use of physical space by providers for ideal audio and video quality
• seamless integration within clinical workflow, and replicating the quality of an in-person visit, to support provider adoption
• provider understanding of what information is shared through the secure patient portal (MyDoveTale)
• change management and care team empowerment

Adoption Rate

As of October 2019, across live programs, nearly 400 video visits have been completed and hundreds of secure messages have been exchanged between providers and patients through the MyDovetale portal. Currently more than 700 patients have access to virtual care through the MyDovetale portal.

Nine clinics and the ICC program, and 130 clinicians, are actively engaging patients in virtual care through the Partner Video Project.

Disclaimer

OTN is an independent, not-for-profit organization funded by the Government of Ontario. The views expressed here are the views of OTN, or the respective authors if a third-party, and do not necessarily reflect those of the Province. For further information, please note the Proprietary Rights detailed within the OTN Terms of Service available at https://otn.ca/terms-conditions/