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Collaboration of PHSA leaders with B.C. health sector leaders contributes to transformation of care delivery: Part 1

2020 may be a receding vision in our rear view mirrors, but the value of virtual health tools now available to B.C. citizens will carry on into the future.
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​Did you know that many of the virtual health tools that you may have accessed during the pandemic are a result of a collaboration of leaders across the B.C. health sector?

In the early days of the pandemic, health care leaders across B.C. acknowledged a simple truth: the best way to support health care providers, patients and the provincial health system, was to work together. In early March they embarked on a provincially coordinated response that saw an unprecedented level of resource and information sharing that resulted in the rapid development of tools and resources.

“Due to the urgency of the pandemic, traditional processes were accelerated, enabling the delivery of innovative solutions in record time,” said Corrie Barclay, assistant deputy minister, Health Sector IMIT Division, BC Ministry of Health.

Here are a few examples of the resources that were developed:

  • HealthLink BC’s 8-1-1 health phone line was augmented to support increased call volumes and determine where the patient would be most appropriately introduced into the health care system to get the best treatment.
  • COVID-19 Virtual Agent: An artificial intelligence chatbot that provides quick answers to questions related to COVID-19.
  • COVID-19 symptom checker, available on an app and on website browsers.
  • Electronic access to lab results for patients across B.C.

Now, data and feedback show the tools have served the vital purpose they were designed for -- to support health care providers, keep patients informed and safe, and preserve capacity of the provincial health care system. Beyond the pandemic, the resources will continue to be available to B.C. citizens as they evolve in innovative and new ways.

COVID-19 virtual and digital health resources in B.C.: COVID-19 virtual agent; Self-assessment tool; Remote patient monitoring; HealthLink BC; Cloud-based EMR; Virtual toolkit; and 24/7 virtual support

The first stage in the collaboration saw the formation of provincial working groups to establish clear governance, understand clinician and patient needs, share information and identify solutions. The working groups were comprised of digital and virtual health leaders from PHSA, the Ministry of Health, regional health authorities, Doctors of BC, Rural Coordination Centre of BC and others from the community care delivery sector.

Resources to support health care providers

Toolkits for health care providers

One of the first initiatives to result from collaboration was a provincial digital health toolkit.

“We gathered clinicians from across the primary and community care sector, the B.C. health authorities and PHSA, and led sessions to understand what they needed and what immediate solutions could be implemented to provide support,” said Shannon Malovec, chief digital innovation officer, PHSA.

The PHSA Office of Virtual Health (OVH) and Doctors of BC (PDF) followed suit with their toolkits, enabling users to choose the most appropriate virtual tool based on what would best meet the needs for their local requirements.

Virtual health visits

Clinicians made it clear they needed a secure and easy-to-use platform for virtual health visits. Zoom for Healthcare, the clinical version of Zoom, was identified as the platform that would work best. The OVH entered an agreement with Zoom, and by the end of March, began provisioning thousands of licences for Zoom for Healthcare to clinicians across PHSA, Vancouver Coastal Health, Providence Health Care, Doctors of BC and HealthLink BC.

The collaboration that went into developing the toolkit and provisioning licences was “the most efficient and effective process I’ve seen in my career,” said Kathy Steegstra, senior provincial executive director, Virtual Health and Trauma Services BC. “We were one team with one goal and it was to help our providers continue to deliver care to patients across B.C.”

B.C. embraces virtual & digital health resources: Virtual health visits - 1,800 a week in March to 21,000 a week in December; OVH website traffic - 100 times more traffic from March to December 2020; Self-assessment tool - 4.87 million uses since March 2020; BCCDC Digital Agent - 2.89 million sessions since April 2020; Remote patient monitoring - more than 8,200 monitoired since April 2020

Real-time virtual support for people in rural communities and First Nations

In anticipation of COVID-19 cases and a surge in urgent cases in rural emergency departments, several rural health organizations in B.C. collaborated on the development of Real Time Virtual Supports for rural patients, BC First Nations citizens and rural primary health care providers.

The First Nations Virtual Doctor of the Day program was developed by the FNHA in partnership with the Rural Coordination Centre of BC to make virtual primary care readily available to all First Nations people and their families across the province, and to support community-based nurses and other health professionals to deliver primary care. Clients call a toll free number to book an appointment with a doctor in their region. Each visit is triaged and scheduled by a responsive group of Medical Office Assistants (MOAs) and is hosted by Zoom for Healthcare. MOAs can arrange for phone appointments for clients who prefer to have their appointments via phone or have limited access to internet or video conferencing tools.

Support for rural health care providers

The following pathways were initiated prior to the pandemic and augmented for COVID-19 to provide rural health care providers access to just-in-time advice and culturally safe, compassionate support:

  • RUDi (Rural urgent doctor in aid): Virtual urgent care and support
  • ROSe (Rural outreach support): Virtual critical care support
  • CHARLiE (Child health advice in real time electronically): Pediatrics support 
  • MaBAL (Maternity and babies advice line): Maternity and newborn support
  • UBC Dermatology Rural and Remote Service: UBC Dermatology is operating a service for physicians and nurse practitioners in rural and remote settings (including First Nations Virtual Doctor of the Day) by phone, text, photo, teleconference, and a combination of these
The partners on these initiatives include Rural Coordination Centre of British Columbia, the Joint Standing Committee on Rural Issues (JSC), First Nations Health Authority (FNHA), PHSA, Providence Health Care, UBC Department of Emergency Medicine and the BC Emergency Medicine Network.

BC Centre for Disease Control; Office of Virtual Health; patient experience; virtual health
SOURCE: Collaboration of PHSA leaders with B.C. health sector leaders contributes to transformation of care delivery: Part 1 ( )
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