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Report outlines solutions to tackle the backlog in healthcare and ensure all Ontarians have access to timely and appropriate care

 A recent report from Ontario’s Auditor General has put the spotlight on virtual care.

 And although telemedicine sites have been in place for decades in Canada, the COVID-19 crisis has accelerated the adoption of virtual care in Ontario.

“In primary care, upwards of 80% of visits were conducted by phone or via video virtual platforms in the first wave,” says Dr. Sharon Bal, Primary Care Physician Lead for the Cambridge-North Dumfries Ontario Health Team.

Dr. Bal, who also took on the role of tri-chairship for the Health Sector Control Group which has been co-ordinating a five-hospital response to pandemic, has seen firsthand how virtual care has assisted patients throughout the crisis.

“In long-term care and retirement homes, virtual visit pilots allowed physicians to liaise with staff more easily. And in area hospitals, tablets facilitated ‘visits’ with family members and caregivers, and were essentially to ensure compassion and humanity in the face of COVID-related restrictions.”

Virtual visits have enabled more and more Ontarians to continue accessing quality health care while not exposing themselves to the virus. The latest report by the Ontario Chamber of Commerce (OCC) network, which includes the Cambridge Chamber of Commerce, Realizing the Full Potential of Virtual Care in Ontario, underscores the need to permanently integrate virtual care into Ontario’s health-care system.

The Chamber network believes permanent integration of virtual care – which saw temporary measures used during the SARs crisis - into the health system will ensure all Ontarians can access timely and appropriate care, plus alleviate some of the pressure facing the system, such as reducing unnecessary visits to the ER.

According to Canada Health Infoway’s September 2020 survey, 60% of health care visits with primary care physicians and specialists were conducted virtually at the onset of the pandemic.

The report notes that given the uptick in virtual care usage, the resurgence of the pandemic in a second wave, and an uncertain timeline for a vaccine, a more permanent and comprehensive solution is needed.

“Long before COVID-19, Ontario’s health-care system faced numerous pressures and growing costs. By empowering patients to manage their health while at home, virtual care has the potential to reduce the strain on primary care providers and hospitals, lessen the backlog in care, and protect frontline workers from exposure to the virus,” says Cambridge Chamber of Commerce President & CEO Greg Durocher. “We are calling on the Government of Ontario to consider urgent policy reforms such as modifying the existing fee code system to allow for the permanent and effective delivery of virtual care in Ontario.”

The report explains that, while the implementation of temporary billing codes in March 2020 allowed physicians to conduct virtual visits, these temporary codes were a stop-gap measure and have limitations.

The report provides the Government of Ontario with four recommendations to ensure virtual care is not only permanently integrated in our health-care system, but is more equitable, accessible, and widely adopted:

1. Develop a comprehensive framework for virtual care in Ontario.
2. Modify the existing fee code system to allow for the permanent delivery of virtual care, and provide physicians with training and knowledge supports to allow care to be delivered virtually.
3. Focus on equity to improve access to virtual care, including ensuring all Ontarians have internet access so that the expansion of virtual care options does not exacerbate inequities for patients in rural, remote, northern, and Indigenous communities.
4. Support employers’ continued investment in virtual care for their employees that expand beyond care delivered virtually though the health system.

These recommendations were developed with the OCC’s Health Policy Council, a group of expert practitioners and industry representatives.

The report explains how virtual care is not solely about convenience for patients, but it also benefits the health-care system as a whole. Further, virtual care should be viewed as one modality in which health care can be delivered, and should continue to complement, not replace, in-person care.

“Primary care recognizes that a ‘new normal’ with options that include both virtual and in-person visits will be ideal,” says Dr. Bal, noting innovations like these need to become a permanent part of health care delivery in Ontario with the correct supports.  “Technology as a barrier will need address and future focus should be integrated solutions across the community and acute sector, as well as ensuring health quality.”

For more on the virtual care report, visit: https://bit.ly/3oJtIcw

Depression. Anxiety. Addiction.

These issues have intensified over the course of the last few months as COVID-19 continues to take its toll on our mental health, just ask Angela Englander, a registered psychotherapist and trauma specialist who operates Ways to Wellbeing Therapy in Cambridge and Tillsonburg.

“I’ve had clients who were perfectly stable pre-pandemic and now have completely fallen apart,” she says, noting some are in the healthcare profession which is facing much strain as this health crisis continues. “I’ve talked to a lot of doctors and nurses who want to go on leave. These people are the webbing of our health system and if their mental health crashes, everyone is going to fall through that gap.”

Identifying what mental health is, as well as trauma and therapy, will form the base of her discussion at our YIP Growth Learning series event on November 19.

“People have such a small amount of knowledge they’re working from when it comes to mental health,” she says, adding the amount of stress people are under right now is skyrocketing as the second wave of the pandemic appears to be escalating.

According to a CTV report, a recent federal study has highlighted a jump in alcohol and drug use during COVID-19, as well as an increase in opioid deaths. Also, according to that same CTV story, overdose calls in Waterloo Region have spiked higher since August and 68 people have fatally overdosed so far this year compared to 63 deaths in 2019.

Angela says at the start of the pandemic in March adrenaline was high as people went into ‘crisis mode’, putting their emotions on the backburner as they adapted to this new reality.

“But the bigger risks will be over the next year because that excitement and adrenaline has started to wear out,” she says. “People are starting to feel more hopeless and facing depression and anxiety.”

Angela says the approaching winter will only add to that negative situation since unlike the past few months, many won’t have the option to go outdoors and enjoy the sunshine and nicer weather.

“I’ve already talked to people who say they’re experiencing SAD (seasonal affective disorder) and are already getting their winter blues and we’re only in October.”

Besides current concerns such as increased addiction issues and a rise in suicides, Angela fears the ripple effect of COVID-19 could manifest in other mental health problems over the next several generations.

“Many people may become germaphobes or even become agoraphobic,” she says, adding people must learn to accept the negative emotions they may be facing now in order to deal with them in a healthy way.

“We are a very emotion-phobic society. The truth is you have to be willing to step towards those emotions and feel them and accept the reality that is.”

During her YIP presentation, Angela hopes to break down how the brain functions into several categories pertaining to mental health and outline how trauma works.

She intends to provide participants with some valuable takeaways.

“They’re going to get a lot of self-awareness and coping skills,” says Angela, noting more typical coping skills such ‘date nights’ with a partner or hanging out with a few family members may not be sufficient enough for some during this pandemic.

She says self-care and emotional awareness will play key roles in the presentation in hopes of giving people more understanding.

“No one is above this virus,” says Angela.

Our YIP Growth Learning series virtual event ‘Mental Health for Young Professionals’ sponsored by Deluxe will take place Thursday, Nov. 19, from 9-10 a.m. For more, visit: https://bit.ly/34OBryG

Self-isolation. Social distancing.

These are terms that have now become part of our daily life in the wake of the COVID-19 crisis, which is causing anxiety worldwide both socially and economically.

But ensuring we maintain good mental health amidst this trying time is vital, says Angela Englander, a registered psychotherapist and trauma specialist who operates Ways to Wellbeing Therapy in Cambridge and Tillsonburg.

“We need to be reaching out to each other now more than ever,” she says. “We really need to be connecting with our community.”

Angela, who specializes in the treatment of all of types trauma, including PTSD (post-traumatic stress disorder), says what we’re dealing with is very similar to what the world experienced during the First and Second World Wars.

“We’re getting isolated and starting to get scared of each other,” she says, adding that in the years following the COVID-19 crisis we may be faced with a large number of people dealing with PTSD and a variety of mental health issues. “Many people appear to be having an acute traumatic stress response right now in that they're hypervigilant and full of adrenaline and flooded emotionally.”

Angela says nightmares and trouble sleeping are just a few of the common reactions to trauma people may be experiencing.  She has, however, noticed that some of her clients who are dealing with PTSD seem less concerned since many already often live in self-isolation.

“They’re saying, ‘the rest of the world is living like us now, and that’s kind of validating’,” she says, adding there are others who fear society will break down as a whole.

“People are concerned about becoming ill, experiencing pain, suffering, starving and having their neighbours and people around them turn on them, with riots in the streets.”

Angela says the long-term effects of PTSD could include headaches, flashbacks and mood swings.

“I think there will be a lot of mental health fallout but I hope the government will step up to fund psychotherapy so people can heal,” she says.

Currently, OHIP does not cover the cost of psychotherapy.

To combat these fears and anxieties surrounding COVID-19, Angela recommends not only reaching out to a professional for coping strategies and support but by creating a daily routine of self-care.

“Maintain routine and focus on your accomplishments,” she says. “Stay connected to others through social media or Skype or by phone.”

She says deep breathing, stretching and yoga are also good methods to boost good mental health.

“And now that we may not be distracted as much by our work, we can start connecting with more of the community,” says Angela. “This could be our golden opportunity to turn things around.”