Grant: Operating Grant: Spread and Scale of Existing CBPHC and eHealth Innovations

The Canadian healthcare system faces many challenges. Some of these are rising healthcare costs, barriers to accessing outpatient care, and long wait times. Providing health care consultation between two hospitals by video conferencing is called telemedicine. This needs special equipment and needs the patient to travel to the local hospital. It addresses some of the above challenges but does not go far enough. Nowadays, personal devices like smartphones, tablets and computers with high-speed internet are widely available. They are capable of high-quality video conferencing. The use of these devices to provide telemedicine through a secure connection is called Home Video Visit (eVisit). This allows the patient to stay at home and receive medical consultation. eVisits are ideal for routine outpatient health care. We did a 6 month pilot of the eVisits in the Stroke Clinic in 2018. The experience from the pilot was very positive. Patients find them convenient, easy to use, comfortable, and economical. They are very helpful for people with driving issues or physical disabilities. They are also quicker to do and can be more efficient for physicians and hospitals. Following the successful pilot, eVisits are routinely available in the stroke clinic and some other neurology clinics at Kingston. We plan to further expand this service to all 14 specialties (125 physicians) within the Department of Medicine at Kingston Health Sciences Center. We aim to convert 20% of out-patient visits to eVisits in the next 2 years. We will measure the patient and physician experience using surveys, semi structured interviews and focus groups. We will also measure the economic impact on the healthcare system, patient out of pocket costs and impact on hospital resources. With the experience gained, we will expand this to other departments in the hospital. The data and experience from this degree of expansion will help inform digital health policy in Ontario and Canada.