Background/ Why Is This Important?
Ensuring equity of access to pediatric specialist and sub specialist services across BC's vast geography is challenging and gaps in access to services can occur for children and their families. Reducing patient travel, facilitating appropriate and safe patient discharge from hospital to home and preventing admission/re-admission to hospital are important to families and providers.
Child Health BC, in partnership with the Provincial Health Services Authority Telehealth, leads an initiative to enhance access to specialty and subspecialty pediatric care across the province using enabling technologies such as telehealth. The initiative is called Children's Virtual Care, or CVC. Child Health BC and collaborators have worked to provide not only the technology to reliably deliver telehealth services but also the important workflows, processes and knowledgeable people to provide the most family centered, quality clinical care possible.
What Actions Have Already Been Taken?
Child Health BC has worked over with PHSA Telehealth and health authority clinical, administrative and telehealth teams to build and integrate telehealth as part of the pediatric specialty and subspecialty service delivery.
There are three key streams of services:
Tele Pediatric Intensive Care/Emergency Department (Tele PICU/ED) - a first of its kind in Canada
Tele-PICU allows children who are critically ill to remain in their community to receive care. Teams in local communities can successfully use the technology to collaborate with the PICU team at BC Children’s or with the team at Victoria General Hospital. The teams are supported by carefully planned processes and protocols, leading edge equipment and 24/7 technical support. Early results from the small number of initial sites who assisted in carefully developing the clinical and technical aspects of this program, which service very ill children, are overwhelmingly positive.
Phase 1 sites include Bella Bella, Trail, Nanaimo, Victoria General Hospital and BC Children's Hospital in Vancouver. Phase 2 is expected to be complete in January 2018 and will add Terrace, Prince George, Kamloops and Kelowna. Providers both at BC Children’s and in the health authority sites are eager for more sites to have this service available and that work is underway.
Sub-specialty Medical and Surgical Consults
As a complement to in person services, elective, scheduled medical pediatric consultations are provided by over 20 different subspecialty teams to 16 different sites in BC. The interest is growing quickly as both providers and families experience the many benefits of providing telehealth as an alternative to either family or provider travel.
Where Are We Now?
CHBC is working with its partners and collaborators to sustain and support the 17 “pediatric-enhanced” sites as well as bring new locations on board in the coming year. Based on findings from evaluation activities, further expansion of clinical services and the addition of viable regional sites will also be undertaken. Work to explore collaboration for CVC initiatives in the Northern Health Authority, the Fraser Health Authority and with the First Nations Health Authority will continue.