While air travel and border restrictions have been in place for several months to protect the health and safety of Canadians, permission to enter Canada is still granted to Canadian citizens, permanent residents and protected persons, and Temporary Foreign Workers
(TFWs), all of whom are subject to the mandatory 14-day isolation period.
Ensuring all people entering Canada understand the requirement for isolation is critical, especially for those who may have come into contact with COVID-19.
To facilitate this, the BC Centre for Disease Control
(BCCDC) created the COVID-19 Surge Office in March, in alignment with the Canadian Border Services Agency (CBSA) and the Public Health Agency of Canada. The role of the COVID-19 Surge Office has evolved since its inception. Initially the Surge Office contacted repatriated travellers to ensure they understood the isolation protocol and notified passengers who had been exposed to the virus on incoming flights. Then the COVID-19 Surge Office began monitoring the health of workers returning to B.C. from work camps in Alberta
and TFWs coming into B.C. from foreign countries. The nature of the COVID-19 Surge Office has always been dynamic, so while it is currently focused on monitoring the health of TFWs, it is also awaiting its next assignment of work.
Given the rapidly changing needs for COVID-19 contacts requiring daily monitoring, it became clear to the COVID-19 Surge Office that a Virtual Health solution was needed to increase the monitoring capacity. Aligning with all the regional health authority public health units, it was determined provincially that remote patient monitoring was the solution to efficiently monitor COVID-19 cases and contacts by having them complete an online questionnaire every day.
The rapid implementation of remote patient monitoring by the COVID-19 Surge Office underscored the power of programs uniting to achieve a single goal in the pandemic response. "Our ability to respond to the needs of clients and the regional health authorities was dependent on creativity, innovation, flexibility and quality improvement," said Jillian Arkles-Schwandt, public health manager at the BCCDC.
"Leveraging digital technologies and partnerships equipped us with the tools to move quickly and rapidly deploy our resources."
In under two weeks, the BCCDC prioritized resources and workflows, the PHSA Office of Virtual Health (OVH) provided guidance, support and facilitation with stakeholders; PHSA IMITS expedited access for the COVID-19 Surge Office staff, and TELUS Health delivered rapid and comprehensive training to staff on the remote patient monitoring solution. Vancouver Island Health Authority shared workflows and implementation experience, enabling the BCCDC to move quickly towards launch over the course of one weekend.
"During this pandemic, everyone understands the urgency of supporting the response effort. But the swiftness with which all the teams worked together to achieve success was truly impressive," said Devon Haag, manager, Digital Public Health Services, BCCDC.
One valuable lesson learned from this project is that Virtual Health solutions may not be appropriate for everyone. Some individuals chose not to register for the remote patient monitoring solution to report their symptoms checks online. Among work camp contacts undergoing daily monitoring, one third opted to register for remote patient monitoring; the remainder preferred to receive a daily call from a nurse or to communicate with a nurse via e-mail. For TFWs, all daily symptom checks have been performed in person with the aid of an interpreter.
The COVID-19 Surge Office believes several factors have impacted uptake of remote patient monitoring among daily-monitoring clients:
- the age of the clients being monitored
- inter-provincial differences in self-isolation requirements
- lack of urgency in messaging from employers
- English language proficiency
- literacy levels
"Early in the pandemic, individuals were much more open to our check-ins and the daily monitoring process," said Lindsay Barton, nurse supervisor, COVID-19 Surge Office, BCCDC. "We noticed a difference in peoples' attitudes and beliefs around continued self-isolation the longer individuals were asked to self-isolate as restrictions were being lifted overall across the rest of the province."
A remote patient monitoring solution was implemented to provide an option for daily monitoring of larger numbers of individuals who may have been exposed to COVID-19 through travel, work or in their home country. Collaboration, driven by a common goal of keeping B.C. residents safe and healthy, led to the rapid successful deployment of a Virtual Health solution in the pandemic response.
The Office of Virtual Health leads and provides strategic direction for the overall Virtual Health initiative across PHSA. For more information, please visit the OVH webpage
or send an email to email@example.com