Video clinic visits save time for patients, physicians

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University Health Network (UHN) and St. John’s Rehab Hospital are taking a 21st-century approach to patient care by introducing virtual clinic visits for organ transplant patients attending rehabilitation.

The two Toronto hospitals recently embarked on a pilot program called Urban Telehealth, which uses videoconferencing technology to give patients easier access to follow-up care during their rehabilitation from surgery. Rather than travelling to UHN’s Toronto General Hospital (TGH) for medical consultations, patients at St. John’s Rehab can meet with physicians at TGH and other remote sites during a virtual clinic visit.

The system lets physicians and patients interact via wall-mounted videoconferencing screens at both hospitals. The Northern Ontario Remote Telecommunication Health (NORTH) Network technology evaluation project funded the purchase of the units.

The first phase of Urban Telehealth involves follow-up care for lung and kidney transplant patients. On June 13th, St. John’s Rehab and TGH participated in the first clinical follow-up visit using the system. By the end of July, three patients had participated in the pilot project, and approximately 20 lung-transplant patients are anticipated in the first year.

“The exact numbers are difficult to forecast, but it is our hope to see 60 patients participating in the program each year,” says Dr. John Patcai, Director of Medical Services at St. John’s Rehab. “We expect between ten and 15 consultations per month.”

Transplant rehabilitation patients at St. John’s Rehab generally participate in weekly follow-up visits at TGH. Travel between the two hospitals can often be a significant barrier to patient care. “Each routine visit generally involves two ambulance transfers,” says Joanne Shlanger, Telehealth Coordinator at St. John’s Rehab. “This can take up a patient’s whole rehab day.”

With Urban Telehealth, time saved from each virtual visit can mean an additional day for rehabilitation. This ultimately speeds up the recovery process and frees up resources at both hospitals to treat additional patients. The time saved can also mean significant cost efficiencies for both hospitals, as visits at more than one hospital with multiple clinicians can be combined into a single session.

The Urban Telehealth videoconferencing equipment will also be used for patient care consultations. St. John’s Rehab plans to expand the program to include all patient populations. Eventually, this will allow teams at multiple hospitals to collaborate in education and patient rounds to enhance the seamlessness of care.

Project staff at St. John’s Rehab are now working on attaining components such as a computerized stethoscope to provide more complete doctor-patient interactions. This component would allow consultants to complete auscultations over the Telehealth network.

“Urban Telehealth is a leading-edge program that will help us achieve better patient outcomes,” says Malcolm Moffat, President and CEO of St. John’s Rehab. “Leveraging the benefits of technology in partnership with University Health Network, we’re helping patients access the best in transplant care where and when they need it.”

Dr. Gary Levy, Medical Director of TGH’s Multi Organ Transplant Program, says the new program and the integrated model of rehabilitation and acute care “is unique and only the beginning of a promising array of improvements we can achieve together for transplant patients. The integrated model of care achieved in this partnership will allow our transplant patients to return to better health sooner.” The Multi Organ Transplant Program at TGH, UHN is the largest program in Canada and fifth largest in North America and aims to increase transplantation surgeries from 319 to 350 in the next year.

Urban Telehealth is a natural extension of an innovative model of transplant care created in partnership with the Multi-Organ Transplant team at UHN. The partnership was designed to speed up and improve patients’ recovery while reducing health care costs. Under the partnership, transplant patients at UHN are transferred to St. John’s Rehab for specialized rehabilitation. St. John’s Rehab’s organ transplant rehabilitation program was unveiled last November and is the first of its kind in Canada.