Background/ Why Is This Important?
The geography of BC can be challenging and sufficiently impact the access for children to pediatric specialist and sub specialist services. Telehealth makes it easier for children and families to see their BC Children’s Hospital (BCCH) sub-specialist team while remaining in their local community. Reducing patient travel, the impact on families and improving health outcomes for children discharged from hospital to home while preventing admission/re-admission to hospital are important to all.
Child Health BC (CHBC), in partnership with the Provincial Health Services Authority (PHSA) IMITS Telehealth, British Columbia Children’s Hospital (BCCH) and regional Health Authorities (HA’s), is leading an initiative to enhance access to specialty and sub-specialty pediatric care across the province using enabling technologies such as telehealth.
The initiative is called Children's Virtual Care (CVC), which includes two streams:
- Tele-Pediatric Intensive Care Unit/Emergency Department (Tele PICU/ED)
- Pediatric Sub-speciality Telehealth
What Actions Have Already Been Taken?
CHBC and HA collaborators are providing advanced technology, training and revised workflows to deliver telehealth services for children and families across BC. We are creating the safest possible environment for children to have the best care experiences for families with evolving digital technology.
Tele-Pediatric Intensive Care/Emergency Department (Tele PICU/ED) - a first of its kind in Canada
The Tele-Pediatric Intensive Care Unit (PICU)/Emergency Department(ED) initiative helps support local teams with stabilization of critically ill children, facilitates well-informed clinical decisions, and enhances collaboration between BCCH PICU and local providers about care and transport decisions. The Tele-PICU/ED initiative, through telehealth equipment and sub-speciality and speciality clinician expertise that currently exists in the nine patient sites, provide real time access to BCCH ICU and Victoria General Hospital (VGH) specialty and sub-specialty clinics.
Care for children is provided and coordinated in collaboration with Patient Transport Network (PTN) and HA’s, the health care providers across BC using the latest digital equipment. . Patients and their families participate in a meaningful way in the assessment and decision making during the Tele PICU/ED telehealth consult.
There are currently 9 Tele PICU/ED sites across BC:
Tele PICU/ED site hospital list by Health Authority:
|Vancouver Coastal Health||Interior Health||Northern Health||Island Health|
|R.W. Large Memorial Hospital (Bella Bella)||Kootenay Boundary Regional Hospital (Trail)||University Hospital of Northern BC (Prince George)||Victoria General Hospital|
|BC Children’s Hospital (Vancouver)||Royal Inland Hospital (Kamloops)||Mills Memorial Hospital (Terrace)||Nanaimo Regional General Hospital|
|Kelowna General Hospital|
BCCH Speciality and Sub-specialty Pediatric Telehealth
This initiative focuses on connecting BCCH services to children in their local communities through enabling technology to optimize wellness. Virtual Health can occur at any point during a patient’s journey: on diagnosis, to provide follow up, or as part of ongoing treatment and care.
There are over 140 clinicians in 40 different sub-specialty teams at BCCH that regularly participate in telehealth events. These events can be hosted by an individual clinician or an interdisciplinary team. A variety of healthcare professionals use telehealth as part of their evolving care of children, including Physicians, Nurses, Dietitians, Psychologists, Social Workers, Physiotherapists, Speech Language Pathologists and Nurse Practitioners.
Many communities in BC have telehealth equipment, however some of the locations do not meet the clinical needs for children. CHBC has created 17 sites, (see the above map), which enable families to participate in telehealth appointments for the specific needs of children. The designation of the CVC site reflects a collaborative process between Child Health BC, BC Children’s Hospital, the Health Authority and the local site (Hospital/Wellness Centre/Public Health Unit). This process produces a child and family friendly virtual care space as well as the organizational and procedural workflows and training to provide clinical support during virtual care events.
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.