"This has been such a gift to our Northern family. Our awesome kid has eight and counting medical specialists, whose services at BC Children's are more than 2,500 kilometres away from our home," says Natasha Phillips, mother of Kyle, a BC Children's patient receiving care from multiple programs.
"Not having to get on a plane multiple times a year for check-ups, which often require a week's stay every time, has given us a sense of normalcy – and time for real vacations that we haven't had in more than eight years. It also means we have actually been able to save money this year and pay down our debt. Rare disease and a pandemic have thrown our world into disarray, but we are so grateful for the changes that can happen when crisis hits."
Many programs at BC Children's quickly implemented or expanded virtual care during the first wave of the pandemic as non-urgent hospital appointments and surgeries were postponed. Some programs increased virtual health offerings from five per cent to nearly 100 per cent. One year later, some programs report their waitlists have shrunk and, in a survey of outpatients, 73 per cent of patients rate virtual care as the same or better than in-person care.
"One of the silver linings of the COVID-19 pandemic is that it has fast-tracked adoption of virtual care throughout our health system," says Dr. Jana Davidson, chief medical officer for BC Children's and BC Women's.
"This is particularly true at BC Children's and BC Women's hospitals. The speed with which our medical staff transitioned to providing virtual care was remarkable. Currently, we are determining a triage process to identify which patient visits can be managed virtually and which require an in-person appointment. Virtual care is here to stay and will be used in combination with in-person care to best meet the needs of our patients and their families, while maintaining the high-quality care that they expect from our services."
Most (79%) BC Children's patients and families, who participated in a survey following a virtual health appointment, reported an overall positive experience with virtual care and 92% would recommend virtual care to others in the future.
Patients surveyed say they found virtual care more convenient and punctual. They also said it saved travel time, costs, and sibling childcare.
98% surveyed felt their cultural beliefs/traditions were considered in their care and 94% felt their language needs were considered in their care. (Virtual care even extends to Remote Interpreters, who are now available in the Emergency Department as well as other acute areas. The service is expanding to sign language translation, as well.)
The Endocrine Division has gone from five per cent pre-pandemic to nearly 100 per cent virtual appointments today. At least 72 per cent of patients surveyed in a peer-reviewed study want continued virtual care, even after the pandemic.
The Gastroenterology Division has increased virtual visits by nearly 40 per cent. This has resulted in increased efficiency so that the overall patients seen in this clinic is up 26% from the previous year.
The Eating Disorders Program has been providing nearly double the number of outpatient and virtual appointments since the pandemic broke out (1,420 from April to September last year, compared to 717 the same time the year before). With this quick transition, they have been able to ensure children and youth with serious eating disorders can continue to receive timely care during the pandemic.
Nearly 60 per cent of BC Children's patients who require the hospital's specialized services live outside the Vancouver Coastal Health region. Recognizing that commuting and travel logistics are often a challenge for patients and families, a physician-led group is developing a plan for the future of virtual care at BC Children's, post-pandemic.
"In a matter of just a few weeks last spring, we shifted much of our care to virtual platforms so that we could safely reach our patients during the pandemic," says Pediatric Dermatologist Dr. Wingfield Rehmus. "Not only was virtual health enormously helpful during the height of the pandemic, but it has also brought us new ways to connect with our patients that we will continue to utilize even after our clinics are fully operational again. It is a tremendous time saver for families who do not live close to the hospital and allows us to connect with them more often and more quickly than we could in person."
Several programs at BC Children's are working on virtual health initiatives with Child Health BC (CHBC) and PHSA's Office of Virtual Health to ensure clinicians can continue to deliver virtual care to their patients and clients beyond the pandemic, including in Shapedown, Sunny Hill Health Centre, the Renal program and Kelty Mental Health. CHBC played a significant role in the BC Children's virtual education and training at the beginning of the pandemic, developing the education and training curriculum, and training hundreds of BC Children's health-care providers in less than two months.
While BC Children's has expanded virtual appointments during the pandemic, it is still safe for patients and their families to seek care at the hospital. Additional safety measures are currently in place, including active screening for COVID-19 symptoms by hospital staff at each entrance, following the provincial mask policy (for care providers, staff, patients, families and visitors), physical distancing on campus, and using personal protective equipment when necessary.
Dr. Brenden Hursh, BC Children's Pediatric Endocrinologist who led a study on how well remote/virtual visits were working for families of children with diabetes:
"This unusual time, with all its significant challenges, has provided us with a unique opportunity to align our health care with what families clearly want — care that's closer to home. A majority of families would like us to provide care in a dramatically different way to how it was provided pre-COVID. Going forward, we need to consider how we can adapt to this new paradigm of care over the long term."
Kim Williams, clinical operations manager with Looking Glass Residence in the BC Children's Eating Disorders Program:
"Some patients mentioned that it was easier to share and contribute to the group discussion as it felt safer behind a screen. We also found it helpful to use some of the Zoom for Healthcare features, such as 'hide self' so patients don't have to look at themselves onscreen, and 'breakout rooms' if we wanted to break the group into smaller group discussions or smaller group meal support."
BC Children's Hospital, a program of the Provincial Health Services Authority, provides expert care for the province's most seriously ill or injured youth, young adults, and children, including newborns. Child and Youth Mental Health provides a diverse range of specialized and one-of-a-kind tertiary mental health and substance use services for children, adolescents and young adults across the province. For more information, visit bcchildrens.ca or follow us on Twitter @BCChildrensHosp.
Child Health BC, a program of Provincial Health Services Authority, is dedicated to building an integrated, accessible system of health services that supports the one million children and youth in British Columbia to achieve the best possible health outcomes, wherever they live in the province. Our network links child health leaders and physician leaders from all of B.C.'s health authorities, Government of BC ministries, and academic partners, and is committed to excellence in the care of children and youth province-wide. Child Health BC is generously supported by the BC Children's Hospital Foundation. For more information, visit Child Health BC.
The Office of Virtual Health is a service of the Provincial Health Services Authority. It leads and provides strategic direction and innovation for the overall virtual health initiative across PHSA. It works collaboratively with clinical, operational and corporate partners, and leads organization-wide planning, and facilitates transformation, including process redesign, change management, project management, education and reporting. For more information, visit the Office of Virtual Health webpage.
The Provincial Health Services Authority plans, manages, and evaluates selected specialty health-care services across B.C., working with the five regional health authorities, the First Nations Health Authority, and the Ministry of Health to deliver province-wide solutions that improve the health of British Columbians. For more information, visit phsa.ca or follow us @PHSAofBC.
Provincial Health Services Authority
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