Videoconferencing technology bridges gaps in mental healthcare

By Peri Elmokadem

For a patient with an problem, timing is everything. The sooner their health care professionals can get them on their way to recovery, the higher their chance of success. With their very specific care needs and the unique set of challenges they face, patients suffering from addiction require extensive support and resources from professionals trained to manage addiction throughout their treatment journey.

However, there are very few physicians in Ontario who specialize in addiction. This means that Ontario hospitals—with the exception of those with addiction centres—don’t have specialists who can help patients with their treatments on-site. It also means that specialists in the hospital’s surrounding areas are scarce.

(MSH) is a leader in recognizing and bridging this gap in mental health and addiction care. Through establishing a partnership with Addiction Services of York Region (ASYR), the mental health team at MSH is now able to provide addiction assessments with a specialized physician to its patients — without actually having one in the building.


In June 2014, MSH collaborated with ASYR to streamline addiction consultations using Ontario Telemedicine Network’s (OTN) Personal Service (PCVC). Dr. Ivan Perusco, Consulting Addiction Physician at ASYR, and leading addiction specialist in Canada, conducts assessments over OTN/PCVC for patients with substance abuse problems who were screened by MSH staff. Any patient within the hospital—either inpatient or outpatient—can be referred for this addiction assessment. By utilizing the OTN/PCVC system, real-time consultation can occur even though the addiction physician is not in the hospital, increasing the chances of successful addiction recovery.

“Before we started this at MSH, we knew we could not get our patients with addiction issues the consultation they needed in a timely fashion,” says Paul Cappuccio, Director of Mental Health and Family Medicine at MSH. “When they left us with a referral, we were never confident they would follow up with the addiction services they needed.”

Cappuccio believes that patients’ fear, uncertainty and discomfort guide their reluctance to reach out to the addiction specialists on their own. OTN Addiction Services at MSH were built on the foundation of empowering patients to take the next essential step in their care by helping them create the connections they need. “Now we say hey, just before you go, we would like to conduct an addiction assessment with Dr. Perusco to get you on the right track for recovery,” says Cappuccio. “When you already have a connection, you’re not scared to walk up to addiction services to start your journey.”


Another benefit patients experience when they are offered OTN Addiction Services at MSH is a significantly shorter wait-time between their initial recognition of a substance abuse issue and their consultation interview. “This new technology gives patients a timely intervention that would not have been possible in the past,” says Cappuccio. “This makes a big difference as it increases the chances of successful entrance into and completion of an addiction recovery program.”

Patients have been pleased with their care at MSH using OTN Addiction Services. They are finding it a less intimidating process and a more progressive delivery of care. An MSH patient who greatly benefited from having a consultation with Dr. Perusco via videoconferencing expressed his satisfaction with the service: “I found it very user-friendly. I felt safe and open…you are on the right track using this type of service. I was given several options by Dr. Perusco for my care at the click of a button, which was validating and engaging.”

The challenge MSH faced in the past was the need for an addiction specialist to consult the patients who needed it in the hospital, and the scarcity of addiction specialists in the region made that very difficult. By utilizing OTN/PCVC, partnering with ASYR and having Dr. Perusco on board, MSH has managed to overcome this barrier. “This collaboration works extremely well because each party brings their strengths to ensure patient safety and best practices,” says Cappuccio.


By bringing this service right to MSH patients—instead of the other way around—they experience a holistic and patient-centered approach to their care. “The future of health care isn’t solely about the innovation of medicine,” says Janet Wilson, Patient Care Manager of Mental Health at MSH. “It is equally about the innovation of delivering it. We have to get very clever now about how we deliver care, and how to build on existing technology like OTN/PCVC to solve the current problems we face to provide excellent patient care.”

With these valuable partnerships, MSH is looking to pave the path for new initiatives like this one that find unique ways to provide patients with the right care, in the right place and at the right time. This is the future of healthcare.

Peri Elmokadem works in communications at Markham Stouffville Hospital.