Background/ Why Is This Important?
British Columbia's (BC) BC Children’s Hospital (BCCH) provides the Tier 6 pediatric sub-specialist care and expertise to children in the province. For children living outside of Vancouver, a trip to BC Children's Hospital for pediatric specialist or sub specialist care can mean significant travel, cost and disruption for the whole family, not to mention the impact on the environment due to the travel. Virtual health care through virtual visits provides an opportunity for children and their families to be seen in their own communities without even leaving home.
Child Health BC, a Health Improvement Network (HIN) of the Provincial Health Services Authority (PHSA) works in partnership with the Office of Virtual Health, BCCH and Regional Health Authorities to lead pediatric initiatives across the province. Virtual health - defined as any health care encounter that is not a face-to-face interaction - enables children to be seen in their homes or communities, seamlessly integrating specialized care into their overall plan.
Child Health BC has partnered with the Health Authorities and many divisions at BC Children's Hospital to optimize virtual care across all its patient programs and services. Virtual health has the potential to decrease the burden of travel for families, optimize scarce sub-specialists resources and to enhance access to follow-up care after hospital discharge.
What Actions Have Already Been Taken?
In 2014, Child Health BC initiated the first wave of virtual health initiatives with the introduction of Technology-Enhanced Access to Children's Care (TEACC), using technology to address gaps in equitable access to care across the province.
The work included two streams:
The launch of the Tele-Pediatric Intensive Care (Tele PICU) - a first of its kind in Canada which uses digital equipment to link local teams caring for critically ill children with real-time intensivist support and guidance; and
The enhancement of Telehealth connectivity in communities around the province, which increased the number of "pediatric enhanced" sites.
Both initiatives used Telehealth technology, a service that allows clinical experts to connect via videoconference link with patients and care teams across BC, including in remote and distant communities and First Nations communities.
In March 2020, in response to the Covid-19 public health recommendations, rapid Virtual Health training and support was required for clinicians & support staff at BC Children’s and Women’s Hospitals. Child Health BC (CHBC) was asked to develop resources, provide training and evaluate the project. 895 staff were trained in 101 live sessions during a 6 week period. To continue to provide Virtual Health Training, an online eLearning Module was developed and has been used by several hundred staff as part of their orientation to BC C&W. In 2022, the Office of Virtual Health within PHSA used the information in the CHBC module to develop an updated virtual visit training resource. You can refer to PHSA’s Office of Virtual Health website to access all virtual health training tools.
Where Are We Now?
Child Health BC is advancing a broad provincial strategy for delivering the highest quality virtual pediatric care and patient experience throughout BC. This includes exploring collaboration for virtual care initiatives in the Northern Health Authority, Rural Coordination Centre of BC and with the First Nations Health Authority.
In 2022, through the generous support from the BC Children’s Hospital Foundation, the BC Children’s Hospital Pediatric Intensive Care Unit team (BCCH PICU) and Child Health BC (CHBC) have received 3 year funding to partner with regional health authority partners, Indigenous leaders, patients & families to develop a transformed model of pediatric critical care in British Columbia. The vision of this project is to better support the critically ill child while they are in their home community and the clinicians who care for them.
A key work stream will involve the refresh of real-time support (previously supported through the TelePICU program). Virtual telehealth technologies have seen significant advancement over the past several years. This project will provide the opportunity to leverage new technology to support the development of a consistent, comprehensive and readily available interdisciplinary telehealth care to patients requiring critical care in their home community, either in preparation for transport or over the short term to allow recovery to a level managed at the local region.