Virtual Programs are Improving Access to Care

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BrainMatters Story
According to a survey by Canada Health Infoway, the number of virtual healthcare visits with primary care physicians and specialists jumped from 10-20 per cent before the pandemic to 60 per cent in March and April 2020. As digital health solutions continue to expand, 76 per cent of Canadians said they are willing to use virtual care after the pandemic ends.
 
Before in-person visits came to a grinding halt last year, Baycrest was already looking at virtual technology as a way to reach more people in need of its services, particularly those who can’t easily travel to its campus. In some instances, the pandemic accelerated the adoption and expansion of virtual care at Baycrest; in others, it motivated its development entirely.
 
Perhaps one silver lining in this devastating crisis is that it has improved access to Baycrest’s expertise so that older adults at home, in acute care hospitals and in long-term care and retirement homes can live their best possible lives.
 
VIRTUAL COGNITIVE ASSESSMENTS
The Sam and Ida Ross Memory Clinic is a perfect example of this. People experiencing memory problems, cognitive issues and signs of dementia are referred to the Memory Clinic for assessment and treatment. A pilot project was conducted in 2018 to offer virtual patient follow-up visits using video conferencing over the secure Ontario Telemedicine Network, and plans were underway to test virtual cognitive assessments for new patients.

When the pandemic struck, Dr. Morris Freedman, a behavioural neurologist who heads the clinic, and his team had to quickly pivot to offer all patient visits virtually. Enormous effort went into adapting the assessment for a virtual platform, developing virtual visit guidelines for patients and their families, and training virtual volunteers to provide technical support to patients. Virtual care has been such a success that in-person Memory Clinic visits are likely to become the exception rather than the norm. This means people across Ontario will have access to this much-needed service without having to travel to Baycrest.
 
REMOTE ACCESS TO SPECIALISTS
A new virtual pilot program now being offered by the Sam and Ida Ross Memory Clinic also ramped up speed to launch in April 2020. The Virtual Behavioural Medicine (VBM) Program is a collaboration between the Memory Clinic and the Toronto Central Behavioural Support for Seniors Program (TC-BSSP). It offers rapid response virtual assessment and treatment for people with challenging responsive behaviours caused by dementia, such as verbal and physical aggression, who are at risk of being transferred to acute care emergency departments. These individuals would usually require admission to an inpatient Behavioural Neurology Unit, which have wait times of up to one year.
 
Since it began, the VBM Program has seen a steady increase in referrals from acute care, long-term care and the community, and the wait time for an assessment ranges from 5 to 15 days. Based on the data to date, it is anticipated that the need to admit patients to the Behavioural Neurology Unit at Baycrest can be reduced by 65 to 80 per cent. That means more people can be more quickly assessed and treated in familiar surroundings to improve their quality of life.
 
DONOR SUPPORT FOR E-VISIT TECHNOLOGY
Another constructive outcome of the required restrictions on in-person visits at Baycrest has been the introduction of eVisits and virtual social and recreational programs for Baycrest residents and patients, as well as seniors living in the community. Donor support for the successful Safeguarding our Seniors fundraising campaign allowed Baycrest to purchase laptops, iPads, headsets, smart TVs, digital stethoscopes and webcams, in addition to crucial personal protective equipment (PPE). Numerous Baycrest staff were redeployed to mobilize and activate the use of technology for virtual care with health professionals; eVisits with family and friends; and virtual recreational and social-engagement programs.
 
The long-term impact will be improved access to Baycrest services to help older adults who are aging in place in the community stay healthier longer.
 
VIRTUAL SUPPORT FOR FAMILY CAREGIVERS
The new Baycrest@Home initiative is evidence of this impact already being felt today. Begun as a pilot project in 2019 thanks to generous donor support, Baycrest@Home was testing virtual programs and services for physically and cognitively frail older adults and their families in the community when the pandemic hit. The team quickly launched a pilot Virtual Day Program for 50 members of Baycrest’s adult day programs, including those with dementia, who could no longer attend the on-site program for psychosocial support. As a result of this pilot, Baycrest@Home debuted a website in June 2020 offering virtual social and recreational programming for older adults with dementia and support for their family caregivers.
 
REACHING OUT TO FRAIL SENIORS AT HOME
At the end of 2019, Baycrest became a core partner in the North Toronto and North York Ontario Health Teams (OHTs) announced by the Ministry of Health. These OHTs bring healthcare providers together to work as one team to coordinate and provide care for frail seniors in the community. At the start of the pandemic, Baycrest worked swiftly to lead a COVID-19 Community Response Team to provide primary healthcare services to seniors in 10 Toronto Community Housing buildings. The team is now also providing virtual care, wellness calls and food delivery to help keep over 3,000 senior tenants safe, and prevent unnecessary emergency department visits.
 
For more information about these virtual programs, please visit www.baycrest.org. To support the Baycrest Foundation’s fundraising efforts in Safeguarding Our Seniors, visit www.baycrest.org/sos.
 
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