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J. Pellegrin

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  • EP02 - e-Poster Session 2 (ID 53)

    • Event: e-Health 2018 Virtual Meeting
    • Type: e-Poster Session
    • Track: Clinical Delivery
    • Presentations: 1
    • EP02.02 - Sustainable Virtual Care Systems for Children in BC (ID 107)

      J. Pellegrin, Child Health BC, PHSA; /CA

      • Abstract
      • Slides

      Purpose/Objectives: When clinicians deliver services to patients and families distant from their own clinical environment, new clinical, operational and technical systems must be designed both at the consultant site, and the patient site – a two pronged approach. For many telehealth visits, new clinical relationships between providers at BCCH and providers in community are created. In order to make the virtual clinical event as close to in-person visit as possible and meet the same health goals, there must be thoughtful and collaborative work at both patient and consultant ends. For the Children’s Virtual Care (CVC) sites across BC, the capacity and context of the system in the patient’s community must be combined with the capacity of BCCH Children’s, to meet the needs that can be unique to children and families. This presentation will describe the challenges and successes in building a system for pediatric virtual service in diverse BC communities, some of which have limited capacity and exposure to children with complex health challenges.

      Methodology/Approach: Service need for pediatric subspecialty care is the primary driver for Children’s Virtual Care (CVC). With one Children’s Hospital, about 1 million square kilometers, and 1 million children, providing equitable access to pediatric subspecialty care in BC is an ongoing challenge. Analysis of access by health service delivery area and knowledge of the child health service system helped clarify the targets for virtual care, both in location and volumes. Using the Child Health BC Tiers of Service Framework for Children’s services, including the regional health authorities’ capacity for the support of children and families having telehealth visits, a feasible plan was developed for each CVC site. Children’s Virtual Care sites are those where staff at the patient site can support a number of clinical and operational requirements of a child’s virtual visit. CHBC worked in collaboration with technical, clinical and operational teams across the health authorities to develop CVC sites in regional health authorities and with the BCCH subspecialty teams to identify and meet specific requirements are needed to provide a visit as close to one at BCCH as possible.

      Finding/Results: 19 Children’s Virtual Care sites in BC have been supported to gain the operational, clinical and equipment capacity to support pediatric subspecialty visits, and provide the specific requirements in 26 different subspecialty clinics. The CVC sites have child friendly environments, pediatric medical equipment, clerical support for reception and registration, processes for diagnostic testing when needed, nurses who can assist with assessment if required, and for some, pediatricians to collaborate with a pediatric subspecialist. Subspecialty BCCH teams are integrating virtual visits into their triage process, scheduling and booking , and workflows so that virtual visits are not a system separate from the system and processes that support in person visits. Rather the Virtual Care incorporates the multiple components within the health service system to increase effectiveness, efficiency and to ensure the satisfaction of children, families and their providers. 98% of families surveyed reported they agreed, or strongly agreed they would like telehealth for their child’s visit again. According to parents who participated in this survey, telehealth also prevented two parents from missing work, children from missing school and reduced the negative impacts of travel.

      Conclusion/Implications/Recommendations: The two prong systematic approach to support clinical telehealth visits for sub-specialty services, systems and supports, will ensure an effective children’s virtual visit that is integrated into clinical processes, and the patient, family and provider satisfaction that leads to growth in the use of virtual services.

      140 Character Summary: CHBC creates a sustainable pediatric subspecialty virtual care system for visits as close to in-person as possible, improving access care.

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