Embracing technology amid a pandemic

The COVID-19 pandemic thrust the spotlight on telemedicine, a virtual healthcare technology set to be part of the Children’s new reality

The Montreal Children’s Hospital was forced to rethink how to provide care when the novel coronavirus pandemic hit. Its mandate of providing tertiary and quaternary healthcare meant certain appointments had to be done in-person due to the level of care required. But what about all those other appointments that were also deemed necessary but could not be performed on-site? For these, virtual appointments offered a clear solution. These virtual rendezvous began in late March and have exploded in the months since and are to continue as the hospital increases is ramping-up of clinical activities.

Telehealth appointments were mostly confined to inter-establishment communications prior to COVID-19. The numbers tell the story: There were just over a dozen virtual appointments across all 46 departments in the months of January and February. For the months of April and May, that number skyrocketed to nearly 10,000!

“Will we go back to what we were doing before? The answer is no. People understand that it’s not possible to perform ambulatory work in the same manner as we did before,” says Carole Lapierre, Associate Director MUHC Partnerships Office, who was forced to quickly pivot 85 percent of her staff onto this dossier when the pandemic struck. “We are establishing and planning around a virtual modality that will remain going forward because people see the benefit. We are convinced this is the way forward.” 

What is impressive about these numbers is that the rate of no-shows for appointments did not rise. Patients and their families are embracing this new way of working at a time when social distancing remains a constant obstacle inside the hospital, which has had to undergo several physical changes to accommodate new infection control guidelines.

Some of the units that have really embraced virtual medicine include Psychiatry (with nearly 1000 appointments), Respirology, Hemo-Oncology, Gastroenterology and Speech Language Pathology (SLP).

SLP is one of the units that has seen an enormous rise in such appointments, going from zero before March to 200 by May 31^st. Speech Language Therapists have embraced Zoom technology to create interactive lessons that utilize video in a way that was not possible prior.

“It’s a lot more work for us to prepare for these appointments, but the green screen technology allows us to create very engaging lessons for our patients, which is essential for keeping young children’s attention,” says Eugenie Prefontaine, a Speech-Language Pathologist at the Children’s. “We have also found that virtual appointments really engage parents; they are much more involved in prepping their children for our rendezvous as well as a larger part of the overall process. So, ultimately, this new initiative has provided some unexpected benefits.”

For Darren’s mother Maya, the benefits have been clear for her 3-year-old son.

“We couldn’t afford to wait – Darren needed this therapy now, so we were happy to move forward with it. This is certainly easier for accommodating our schedule and we were a little apprehensive about going into the hospital during the pandemic,” says Maya, whose son Darren was born premature and was not seen to be talking much for his age. “It’s been a positive thing to see the process and the progress, I think this will be a very encouraging method for parents.”

Patients in remote regions can maintain appointments without having to displace themselves to local health centres or performing a telephone appointment. This was crucial at the start of the pandemic when many healthcare workers returned from holidays abroad and were forced to self-quarantine, with this platform providing the ability to contribute to patient care during a frenzied time.

“Zoom arrived and brought with it a new concept in our ability to reach the patient at home and their reality, which has allowed the clinician to assess the set-up, the challenges of their environment and provide interesting new insight into how they live, which is beneficial to their care,” says Lapierre, whose department is coaching MCH professionals on best practices as clinical activity ramps up. “Effort is necessary since the demands are higher on everyone involved in the service, but the benefits and advantages are clear to everyone.”