For Dr. Ben Ritsma from the Department of Physical Medicine & Rehabilitation (PM&R), the mode of virtual health care has always been important, before and during COVID-19. “We have felt that the use of the virtual modality provides important opportunities in maintaining and improving the nature of and accessibility to care in our region. Prior to COVID-19, we were implementing it as a means to overcome geographical/travel and patient population factors (e.g. significant immobility) which could be barriers to care. In the context of COVID-19, this has often been an essential (and at times the only) means to provide ongoing care.”
For his part, Dr. Ritsma is involved in several virtual health care initiatives in his practice: (1) virtual regional PM&R care (stroke rehabilitation) via Ontario Telemedicine Network (OTN) to regional hospital settings; (2) eVisit Project - stroke rehabilitation (PCH) & stroke prevention clinic/stroke neurology (KHSC) done through an OTN eVisit from PCH inpatient bedside/as patient’s ‘home’; (3) virtual adult neuromuscular/ALS Clinic: multidisciplinary clinic (PM&R, Neurology, Respirology, Palliative Care, Respiratory Therapy, SLP, OT, PT), OTN (eVisit), Reacts, telephone (if patient preference); 1 virtual appointment, see all required disciplines; (4) virtual family conferences – stroke rehabilitation (PCH); (5) virtual PCH neuro-rehab clinics/PM&R outpatient care (e.g. stroke rehab, spasticity-when non-procedural; other PM&R members – acquired brain injury/ABI, spinal cord injury/SCI); (6) Kingston Peripheral Nerve Injury Clinic/KPNC (PM&R, Plastic Surgery): virtual multidisciplinary case conference rounds, to review shared patients for combined, interdisciplinary care planning.
Dr. Ritsma hopes his continued work in the field of virtual health care will look at optimizing its use and ensuring equitable access. He says, “Related to the noted clinical virtual work I have had the fortunate opportunity to collaborate with several excellent partners (namely, Dr. Ramana Appireddy and Ms. Sophy Chan from the Department of Medicine) on exploring the impacts of this mode on our patients and their care, from both a qualitative and quantitative standpoint. Qualitatively, we are using patient/caregiver/health care professional perspective to assess their experience of virtual care in order to identify themes related to both benefits and challenges/barriers to utilizing this form of care. From the quantitative side, we are seeking to extend this the analysis to include pertinent, disease-specific outcomes in given patient population cohorts. The goal of this investigation is to inform our decisions around the ongoing application of virtual care.”
According to Dr. Ritsma, the transition to significantly greater use of virtual care platforms has been key to the capacity for ongoing care delivery. “From initial results in our qualitative research, patients/caregivers receiving outpatient virtual care have noted benefits from the perspective of travel and associated impacts (e.g. patient fatigue), cost, as well as caregiver burden. On the inpatient rehabilitation front, its use has reduced missed therapy, fatigue from travel, and costs. Moreover, it has provided a means for ongoing real-time dialogue between care providers in a multidisciplinary capacity and communication/education with patients and their families amidst restricted in-person encounters.”