Creative approaches solve extreme access challenges

Remote northern Canadian lands inhabited by indigenous populations, sun-soaked Pinellas Country in Florida’s Tampa Bay area, and a series of correctional facilities and residential health centers would appear to have little in common. However, each presents a challenging healthcare delivery environment, and virtual care is helping each of their distinct patient populations.

At Forum 2023, speakers from the University of Saskatchewan, Florida health system Evara Health and Wellpath, a medical and mental healthcare provider to correctional facilities, inpatient and residential treatment facilities, forensic treatment facilities, and civil commitment centers, each shared how delivering care virtually is helping them serve their patient populations.

Wellpath makes extensive use of virtual nursing, Evara Health leans on virtual care to see patients whose health or financial circumstances make it difficult for them to travel to in-person appointments, and the University of Saskatchewan developed an obstetric robotics program that is reducing infant and maternal mortality by remotely conducting ultrasounds on indigenous patients that may be 1,000 kilometers away.

“The collaboration of companies like Teladoc [Health] with academics, with healthcare providers, with governments, insurance companies and with the public is crucial, not only to establish this technology as part of the future but to learn from each other,” says Ivar Mendez, MD, PhD, Professor Emeritus, Department of Surgery and Director of the Virtual Care. “We cannot transform the world on our own. We need this collaboration.”

The Saskatchewan program does much more than to video-enable prenatal checkups. The university deployed a robotic system that allows an ultra-sonography technician to move a robotic arm and perform a full prenatal ultrasonography. Many of the patients served live hundreds of kilometers away from the nearest ultrasound facility.

Evara Health also uses a distributed infrastructure model to reach patients where they are. It has provided chronic condition and other patients with tablets, stethoscopes, otoscopes and other equipment to create what it calls “Medical Home” environments, and has also placed medical units in businesses and retail locations throughout its community, powered by Teladoc Health.

Wellpath provides care to patients in 37 U.S. states and Australia. The patients it serves are even more restricted in their ability to travel. Wellpath makes extensive use of virtual nursing—with 120 virtual nurses contributing to 60 full-time equivalents—to conduct patient triage and virtual intake, provide clinic services and perform peer review and other activities. Virtual emergency medicine coverage 24/7 is a core service and virtual care helps Wellpath serve an average of more than 300,000 patients per day.

The wide range in scope and scale of services provided through these programs highlights the flexibility of virtual care and its ability to support many different missions. Look for more use cases to keep emerging.

“I envision the future where we will have this hybrid technology where virtual care and in-person care will go hand in hand. That will improve not only the outcomes of our patients, which is what we want, but it also will improve the cost effectiveness of delivery in healthcare,” says Mendez. “We’ll be able to transfer the dollars that we need to healthcare systems rather than inefficiencies.”