Hamilton hospitals launch virtual care with senior homes during COVID-19 outbreaks

COVID-19 has prompted a “game-changing” virtual care program that will help prevent more Hamilton seniors in long-term care and retirement homes from contracting the virus or spreading it to hospitals.

“I think it’s a game-changer for seniors in that they can receive treatment and know that they have access to those services without having to leave their home,” said Renee Guder, the CEO of local long-term care home Shalom Village. 

To limit the movement of seniors during the pandemic, Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare fast-tracked the launch of a virtual care program in 27 of the city’s elderly care homes. 

Up until April 6, seniors who got injured or fell sick during the night were taken out of the comfort of their rooms and transported to hospital. 

And in recent weeks, due to COVID-19, residents have travelled to hospital via ambulance with paramedics in layers of isolation gear — a situation that Guder calls “scary” for seniors. 

But now, through iPads and laptops, personal support workers and nurses in the city’s senior care homes have 24-7 access to a team of 14 on-call emergency physicians who can provide expert assessments of ill residents. 

“Our care team members will be able to actively participate in the assessment and treatment of whatever the condition is,” Guder said, adding that they can then update family members. 

She said this is especially important during a time “when (family is) not able to be present in our home or be at the bedside the way that they normally would.”

‘Bringing the care to them’

The program, which typically would have taken more than a year to put together, launched in just two weeks. 

With the majority of Hamilton’s COVID-19 outbreaks currently in long-term care homes, co-lead of the virtual care program Dr. Mohamed Panju from HHS, said they wanted to accelerate the process and reduce the risk of more seniors falling sick. 

“We don’t have to keep transporting them all over, moving them from site to site, just to provide the same interventions that we could if we kept them where they are,” Dr. Panju said.

“We’re kind of bringing the care to them as opposed to moving them towards the care.”

Prior to this program, the mobile blood-work and X-ray services that care homes relied on during the day were not available after regular business hours. For this reason, residents were forced to go to the hospital for additional care and wait for results. 

But with mobile healthcare services agreeing to work after-hours, tests can be done in the home at the request of an emergency physician and then delivered to the hospital for processing.

Shalom Village is one of many Hamilton long-term care homes able to virtually access care for residents from hospital staff. (Supplied by Renee Guder)

Long-term care homes are also receiving a supply of medications that are typically used in hospitals. 

“A frail, elderly patient who knows their surroundings, who knows their caregivers…if we can provide the same care…for an acute problem, right where they are, then they’re going to do better that way as well,” said HHS emergency physician Michelle Welsford, who was on one of the first virtual care shifts. 

“Keeping them (at the long-term care home) is not sub-standard, it’s better,” she added. 

If it’s essential that the resident go to a hospital, Welsford said that transition will happen faster because the patient has already had their consultation. 

What’s important, she added, is that the patient’s long-term care providers are now present for the hospital consult. 

“The value there is the people that are caring for them and know them can at least make sure that we’re very aware of their needs, who they are and what’s special about them,” Welsford said. 

Since the program launched, on-call physicians have received calls daily and helped residents who have injured themselves in falls or acquired an infection. 

Organizers say that the program will remain in place past the pandemic. 

At this time, all organizations involved are perfecting the process, but they say the initiative isn’t without limitations. 

Technical issues and not seeing the patient first-hand are some key drawbacks, though Guder said whether they pursue virtual care at all will depend on the severity of the resident’s symptoms.

For now, Guder thinks the program will raise the standard of care provided to seniors. 

“It’s just the level of quality (care) that I think our seniors deserve for sure.” 

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