The healthcare system is at a turning point. Do we go back to the way things were before the pandemic? Or do we harness all we have learned and revolutionize care? Women’s College Hospital has chosen to revolutionize.
“The pandemic has forced every hospital and healthcare provider in Canada to dramatically expand their virtual care capabilities,” said Laura Pus, director of Women’s Virtual at Women’s College Hospital (WCH). “This is an important step towards a more modernized health system, but we believe we can push further.”
Launched in 2019, the Women’s Virtual program at WCH recognized the value and potential of virtual care and began investing in the technological infrastructure, processes and resources to support a more modern and accessible system.
Little did they realize how quickly this foresight would pay off. When the pandemic shifted how care was provided, Women’s was ready to scale up virtual options. Beyond a switch to phone or video appointments, Women’s Virtual focused on both access and integration while striving to create a more seamless patient journey. Efforts were further augmented thanks to a boost of $1M from the TD Ready Challenge and additional support from Scotiabank and other Women’s College Hospital Foundation donors.
“Virtual care is not just about digitizing or replacing in-person care. It’s about reshaping the entire care journey so that virtual is infused into each person’s experience from beginning to end,” Pus added “When we leverage virtual models of care and digital health tools and rethink and retool how we provide care, the clinician, patient and health system benefit.”
The pandemic has also unearthed broader population-level public health data revealing the need to better address underlying sources of inequity.
“Not everyone has access to the internet or a smartphone. Not all patients can take time off work for their virtual appointments or have access to a private space for their appointment. For virtual care to enhance healthcare, we need to consider the impacts on health equity,” Pus explained. “For some patients, virtual visits may mean they don’t have to take time off work to see their provider, for others virtual care may never be an option.”
“Ultimately, virtual care is not just about digitizing in-person care or replacing in-person care.”
Teams across Women’s are working to further equitable access to virtual care services. In the Department of Psychiatry, the Reproductive Life Stages Program is working to better understand the patients the program serves using the Ontario Marginalization Index. The Index covers four distinct areas of marginalization which can impact a patient’s health and wellbeing, including residential instability, material deprivation, age-based dependency and ethno-racial concentration.
“Patient postal codes help us gain a better understanding from an equity perspective,” said Dr. Lori Wasserman, clinical lead of the Reproductive Life Stages Program. “It can indicate that they live in a low-income area or that they need to travel significant lengths to access our in-person services. As we incorporate more patient-specific data and partner with other organizations, we will be able to better tailor healthcare services to our patient community’s needs,” Wasserman shared.
An example of this is the General Psychiatry Program at Women’s, which is currently leading work with the YMCA’s Elm Centre and their affordable housing program in Toronto. Each week, a WCH psychiatrist connects virtually with case managers and community engagement workers at the YMCA to provide guidance on complex clients and lead seminars for mental health topics.
“We are also working with Inner City Health Associates (ICHA), who have been providing housing services throughout the pandemic to those who are housing insecure,” said Dr. Deanna Bruno, lead of the General Psychiatry Program “A WCH psychiatrist provides weekly virtual services to ICHA’s clients and collaborates with the onsite nurse practitioner While we are in the early stages of this work, the opportunities are significant.”
As we take stock of the pandemic experience and its learnings, we remain committed as an organization towards furthering the depth and scope of our Women’s Virtual program.