At eHealth22 in June, André Picard, Globe & Mail’s health columnist interviewed Teladoc Health’s Joby McKenzie, PhD., Managing Director in Canada, and Dan Trencher, SVP, Corporate Strategy for a session titled “Virtual Care IS Care”. Teladoc Health is one of the largest and oldest global virtual healthcare companies. The following is an excerpt from their conversation.

André:

Joby, you have a personal experience with the health system and some frustrations, which have led you to reimagine the delivery of healthcare. Can you tell us how an integrated, interconnected system could have changed your family’s experience?

Joby:

My son Calvin was diagnosed with leukemia in 2017 at five years old, and he had chemotherapy every day for three and a half years. He spent about 20 percent of his life in hospital and missed half of his school from kindergarten to grade three. First and foremost, he is two years post his treatment and a thriving ten-year-old. My first observation is that every appointment happened in person, and Calvin missed school and we missed work.  Secondly, every time he had a fever, we had to go into the ER. He had a VIP pass at the hospital, it’s a pass nobody wants, and with that pass it still took us five hours to get assessed and discharged. Those doctors and nurses were working so hard, yet I’m left wondering if there would have been other ways to work with those clinicians. Thirdly, I carried around a three-inch binder for years that had his labs, prescriptions, consultation notes and I always think about data and how important that is to help people live healthy. Point four, his GP called me often to check in to see how he was doing because the data didn’t flow from the hospital to the pediatrician, and lastly, through that journey, both Calvin and his two siblings and my husband and I required mental health support which was hard to find and make time for.

André: What I’m hearing from your story is something I hear from patients all the time. They want the right care at the right place at the right time. People are often frightened of digital healthcare if they think “we’re not going to get to see our doctor anymore.” Can you talk about getting that mix right and how important that is?

Joby:

Digital care isn’t “in place of” in person, it’s bringing care to where the patient is or needs to be, and that can mean physically and that can mean emotionally, and it comes in different forms. One of the big themes is bringing care into the home. Imagine if more of those specialist visits could have occurred by beaming in the specialist to observe and talk with Calvin and his dad and I, monitoring when there is a post-discharge situation and not having to go in to get checked. Finally, mental health care can happen at home where Calvin was most comfortable.

André:

Another big challenge I’ve found, especially in the Canadian health system but we’re not unique, is that systems don’t talk to each other in Canada. We have a row of hospitals in downtown Toronto, some side by side physically, yet information doesn’t flow easily. How can that change?

Dan:

It is a critical point because a key factor in health outcomes is continuity of care and whether it’s a transition in care from a facility to the home or to another type of care setting, sharing of data is critical and I think it starts with, how are the systems built? Our approach is to build with openness and open architecture in mind and that’s how we built our Solo platform, so that data is interoperable and shareable with common legacy systems such as electronic health records or imaging or lab ordering systems, and also compatible with new solutions such as devices that might be put into place to allow for home monitoring as an example.

André:  What does virtual care mean to hospitals and health systems in the big picture?

Dan: Teladoc Health has a large and growing business providing virtual care platforms to enable healthcare providers and systems to manage their patients, extend provider capacity and expertise. A use case that’s gotten a lot of prominence recently is virtual nursing. We have a huge staffing challenge and we’re working on solutions that can allow nurses to cover a greater range of rooms in a hospital by putting in a virtual care endpoint in every room. So how can we use the monitors to have a quick chat from the nursing station about what the need is, whether it’s more medication, to speak to the doctor or a glass of water.

Joby: Those types of tools are certainly important but the other thing that’s important in this vast country is how to use technology to bridge where specialists and physicians are versus where patients are, because everybody deserves access to the specialists, not just people who happen to live in downtown Vancouver or downtown Toronto.

To watch to the full session click here: www.youtube.com/watch?v=bXp-cK889Ag