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By Willa Black

In July 2018, leaders from the Centre for Addiction and Mental Health (CAMH) and Cisco Canada gathered together to begin drawing a roadmap for pioneering telemental health delivery. Little did they realize that in two short years a pandemic would have clinicians and physicians delivering nearly 3,000 virtual visits a month.

What inspired this vision of care and how was CAMH able to scale up so successfully and rapidly?

While CAMH has been delivering some form of virtual care for a number of years, there was slow growth in this area until a few years ago, when a number of big changes took place in provincial policies. Changes such as an increase in the platforms available to deliver care and home care, the ability to see patients, virtually, at home and not just at clinical sites.

I sat down with three key figures from CAMH to answer these questions, and find out what the future holds, post-COVID-19. Joining me for this conversation were Dr. Damian Jankowicz, CIO, Dr. David Rodie, Medical Head, TeleMental Health, and Dr. Eva Serhal, Director, Virtual Mental Health and Outreach. Here are some of the highlights.

Watch the full conversation here 

Deploying virtual care throughout the entire organization required careful consideration of the technology that would underpin this delivery. When choosing the platform for their virtual care vision, Dr. Jankowciz had three primary considerations:

1. It had to be easy to use.
2. Privacy and security. People might be lax about their privacy and security in their personal lives, but when it comes to healthcare, they are very much top of mind.
3. Policy management. As policies were developed around care, IT needed a platform that could be centrally managed to turn features on or off to meet those policies.

The platform is foundational, but it isn’t everything. It is a tool to be used by the people delivering and receiving care. So how did CAMH make such a massive cultural shift – from in-person to virtual care – relatively smoothly? People. Process. Product.

People

This was a clinical initiative, not an IT project. A cross-functional team was created to drive the project and working hand-in-hand with the clinicians, the end users, made it easy to understand the requirements.

Process

Clarity was key – understanding how virtual care would be deployed and how it would work within the clinical workflows. This was even incorporated into the supports and training provided to clinicians, such as easy visual guides to schedule virtual appointments.

Product

Years of literature and research have shown that virtual care has positive outcomes. From the outset, the CAMH team thought about how to understand and interpret outcomes, knowing that the more successful the program, the more it would expand.

As COVID-19 took hold and virtual care expanded, unexpected use cases for and side effects of virtual care and the Cisco Webex platform came out of the woodwork. Dr. Rodie shared that virtual care has reduced the number of no-show appointments and increased the flexibility of who can participate in appointments. If the patient would like a family member to join, it was often only a matter of going into another room or sending a video invite.

Virtual care was also used internally at CAMH – clinicians or physicians who have been working in an isolation unit with COVID-19-positive patients could consult with other units, without going there in person. Cisco Webex enabled weekly virtual events with CAMH employees, helping to ensure that thousands of participants were able to join remotely, versus the 100-200 people that previously attended in-person Town Halls.

As for what the future holds for virtual care? All three agreed that it isn’t going away post-COVID-19. Dr. Jankowicz shared his vision for a virtual hospital, where patients experience a true virtual and in-person continuum of care from pre-screening to recovery. For Dr. Serhal, it’s a holistic look at a patient’s information and potential outcomes, feeding that info into their planning, and scenario planning to ensure patients benefit from continued virtual care, while ensure it remains inclusive. And, for Dr. Rodie, it’s a way to lower the barriers to care – patients can access care from their home.

The expansion of telemental health capacity builds on CAMH’s long-standing record as a leader in this area. With strong groundwork in place, the hospital – in partnership with Cisco Canada – is well-positioned to rapidly adapt policies and transform service delivery for the future.

Willa Black, Vice President of Corporate Affairs and CSR for Cisco Canada.