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S. Maley

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  • OS03 - Geography and Telehealth: It's Not Always Distance (ID 6)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
    • OS03.02 - Enhancing Homecare in Remote and Rural Areas Through Virtual Visits (ID 63)

      S. Maley, Care and Community, Government of Yukon; Whitehorse/CA

      • Abstract
      • Slides

      Purpose/Objectives: Yukon government’s Home Care program supports individuals across the territory to live independently in their communities. Approximately one quarter of Yukon’s population live in rural or remote communities spread out over a large geographic area, and service delivery to these communities is an ongoing challenge. Whitehorse-based Community Liaison Coordinators (CLCs) coordinate care and provide direct service to clients via home visits to rural communities every 4 to 6 weeks. Home Care CLCs, with support from the Territorial Health Investment Fund (THIF) team, have initiated a trial where clients or Home Support Workers (HSWs) in rural and remote communities can meet with them via video. ‘Virtual visits’ are not intended to replace home visits, but evidence suggests that a combination of virtual visits with in-person visits can result in improved health outcomes. The objectives of the trial are to promote social inclusion and reduce feelings of social isolation for clients, and to explore how more regular contact with clients may support symptom management and avoid acute care interventions.

      Methodology/Approach: Clients or HSWs were provided with a tablet enabled with a video conferencing app connected via the cellular network. Client selection was completed by the CLCs, from an existing caseload. Enrolment was based on client need, established functional goals, and perceived ability to benefit from increased contact. Virtual visits are available during regular working hours, and scheduled weekly. Ad hoc virtual visits are also available during regular working hours if needs arise. Clients participating in the program are asked about their comfort with technology, and are assessed using the interRAI Home Care Assessment System (RAI-HC).

      Finding/Results: While the trial is still in its early stages, there have been multiple instances where client needs have been effectively addressed via virtual visits with CLCs. The technology has, in some cases, allowed rapid assessment of a client in their home, preventing a short-notice and costly face-to-face visit by a CLC. An unexpected outcome of the trial has been increased support for and involvement of HSWs in rural communities, who in some cases operate the tablets with the clients and liaise with the CLCs. Preliminary impressions of the CLCs include improved connection with their rural clients, increased support for client social interaction, and overall, a positive client experience in the use of technology. Quality of video and audio continue to be challenges for a network such as Yukon’s, where connectivity can be limited in some rural and remote areas. More positive outcomes and lessons are expected as the program continues over the following months.

      Conclusion/Implications/Recommendations: Yukon Home Care and the THIF team have demonstrated how innovative use of technology can empower clients to stay at home, and improve access to health care services for rural and remote communities, while still working within existing resources. Evaluation of the virtual visits trial will continue and is expected to inform decision-makers on possible applications, outcomes, and areas for improvement.

      140 Character Summary: Despite Yukon's remote landscape, virtual visits are improving access and care to rural clients who depend on the vital support of home care for health improvement.

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