With B.C. citizens following the distancing protocol and request to stay home, the 8-1-1 provincial health information and advice phone line
operated by HealthLink BC became the central point of contact for trusted information, supported by BC Centre for Disease Control (BCCDC).
When the number of calls about COVID-19 spiked in early March, forty additional registered nurses were hired to support the call volumes, and physicians were brought in to provide an increased level of clinical support.
“My team recognized that having doctors available would provide an increased level of clinical support,” said Sandra Sundhu, executive director, HealthLink BC. “With physical distancing protocols in place and, at that time, clinical concerns regarding PPE supply, we knew this was one way to ensure people had access to nurses and physicians.”
In early March Sandra’s team reached out to Dr. Kendall Ho, professor in the UBC Department of Emergency Medicine, and Lead of Real Time Virtual Support Pillar of the BC Emergency Medicine Network, and suggested partnering on a virtual physician pathway that could support the call volume, deal with the complexity of each call, and determine where the patient would be most appropriately introduced into the health care system to get the best treatment.
The new virtual physician pathway was named HEiDi, short for HealthLink BC Emergency iDoctor-in-assistance.
“We disseminate information on behalf of the health sector and ensure that no matter where you live in the province, you have the same access to that quality care and information,” said Sundhu.
Launched on April 6, HEiDi is a collaboration between HealthLink BC, PHSA, the Ministry of Health and B.C. physicians and nurses.
“I think the reason why we’ve managed so well is because all the health organizations and health professionals are focused on patient-centred care. We work together towards that goal.” said Dr. Ho.
The self-assessment tool
runs the user through several questions that determine if the user has symptoms of COVID-19, and directs them appropriately – either to call 9-1-1 for medical assistance, or lets the user know they don’t have COVID-related symptoms based on their responses.
Launched on March 25 and available on a website browser or app, the tool was created by THRIVE Health, a Vancouver-based software company, and supported in partnership by the Ministry of Health, HealthLink BC and BCCDC.
The COVID-19 virtual agent is an Artificial Intelligence chatbot attached to the BCCDC website
. Launched April 9, by early December it had conversations with over 2.89 million people and answered approximately 25,000 questions a day regarding COVID-19.
“We built the digital agent with health information, and because it is attached to the BCCDC site, it is the source of truth. And we built it out to answer questions in addition to providing links to relevant websites,” said Leanne Thain, executive director, BC Ministry of Health and Lead for the Transform Primary, Specialist & Community Care Portfolio of the provincial Digital Health Initiative.
Collaboration on building the digital agent included roughly 20 patient volunteers, in addition to developers and project managers. “The feedback I’ve received from the patient volunteers is that they feel they’ve played a critical part in the development and implementation of something very important,” said Thain.
“Lab testing capacity is a critical factor within the COVID-19 response, and getting the results out as quickly as possible is absolutely critical, too,” said Oliver Thompson, director, Provincial e-Health Projects, PHSA, IMITS. “The faster you know your test result, the faster you can make other decisions.”
“I woke up feeling not so good with a few of the symptoms,” said Laura P. of North Vancouver. “I went for a drive-through test a few blocks from home and 24 hours later, results are texted back.” The results were negative. “Phew! I’m so thankful for accessibility to our health care system.”
Access to lab results online had not been consistent across B.C. – early in the COVID-19 response, the need to distribute results directly to patients quickly was paramount. By mid-April all patients across B.C. had access to their lab results through my ehealth
, with email notification added a few weeks later.
Enabling access to lab results for patients across B.C. involved all regional health authorities, BCCDC, PHSA, Excelleris, my ehealth, and the Ministry of Health.
“The level of collaboration has been phenomenal,” said Paul Payne, patient empowerment portfolio lead, BC Provincial Government. “If you want to look for a silver lining, we’ve been able to continue with that collaboration and build new partnerships across the health sector, which has been a really positive outcome.”
Remote patient monitoring (RPM) monitors a patient’s health remotely, and shares the information electronically with health care teams. RPM is being used to support patients with mild-to-moderate respiratory symptoms who are quarantined at home due to COVID-19, and to monitor the health of those who have come in contact with the virus.
Organizations involved in the initiative include PHSA, the Ministry of Health and all health authorities. Since April 6, more than 8,200 COVID-19 patients have been actively monitored by RPM and discharged due to improved status, 440 of those were COVID-19 cases.
Health care delivery in B.C is experiencing a transformation thanks to the partnership of leaders from the B.C. health sector who embarked on a provincially coordinated response in the early days of COVID-19.
“The impact that we have been able to make is due to the passion, knowledge sharing and collaboration demonstrated by all organizations and patients involved. This has strengthened our health care system to deal with emerging issues in the context of the current pandemic and beyond.” said Zen Tharani, executive director of Digital Health Strategic Initiatives at the B.C. Ministry of Health.
Beyond the pandemic, the resources will continue to be available to B.C. citizens as they evolve in innovative and new ways.