Overlapping social issues and additional uncertainties – not to mention a global pandemic - have led to a massive spike in people seeking mental health support. Much of that extra demand has been absorbed virtually.
Canada’s Centre for Addiction and Mental Health, for example, has seen its monthly demand for virtual mental health care services explode over the past year. Prior to the pandemic, CAMH conducted approximately 300 virtual visits per month. In March 2021 alone, the organization recorded 10,000 virtual visits. Many of those virtual interactions are with patients outside of CAMH’s major service areas, which include Toronto and the neighboring communities. In fiscal year 2020-21, 15 percent of patients were from outside of the Greater Toronto Area, representing around 3,200 patients.
CAMH is the first academic hospital in Canada to achieve HIMSS Stage 7 (Healthcare Information and Management Systems Society). This stage is designated to hospitals that have almost fully automated and paperless medical records that are available across most of the outpatient care settings. In addition, CAMH is the first and only Canadian hospital to achieve HIMSS level 6 in analytics for its advanced use of data and analytics in program planning.
We recently sat down (virtually) with CAMH’s interim CEO Tracey MacArthur to talk about how the organization is handling the increased demand for virtual care and how it plans to expand its services.
Q: You took on the role of interim CEO last month, replacing outgoing CEO Catherine Zahn who accepted a position as deputy health minister with the government of Ontario. What are your primary goals as you've taken on this role?
A: I’ve been at CAMH for the past decade and I’ve had a couple of executive roles, starting as the Vice-President of Performance Improvement and the Chief Information Officer. Then I went on to become the Chief Operating Officer, which was my most recent position before taking on this role. I’m always interested in improvements and advancements in care, so that’s really been the driving force for me. And given my background that includes hospital operations and clinical information, I’m very interested in the marriage between data and clinical judgments. I'm looking at how we can continue to advance our understanding of the system through data and analytics combined with all of the great experience and judgment of our clinicians. This has been a common thread through a lot of the work that I’ve undertaken.
Q: What data is helping you and your team at CAMH make decisions right now?
A: We’ve looked at patient flow inside our organization - how patients come through our emergency department and get admitted to an inpatient unit. We’ve been looking at how we can streamline that process. We’re trying to reduce wait times for our patients and reduce their length of stay where it’s appropriate. We’ve also looked at data on outpatient service wait times and are trying to reduce our wait times for outpatient care. Right now, we’re looking at the impact of virtual care and its impact on our resources. We’re realizing that many more patients accessing virtual care through CAMH are based outside of the GTA [Greater Toronto Area]. This data is important for us in planning the delivery of our services and how we allocate our resources, how we establish partnerships in other regions to develop support systems and follow-up care resources.
CAMH uses SAS Advanced Analytics. Learn more here.
Q: How much more demand has CAMH been experiencing when it comes to virtual patient care?
A: We've gone from approximately 300-400 visits per month to more than 9,000. In March of this year, we recorded 10,000 virtual visits. Many of those interactions are with patients outside of CAMH’s major service areas, which include Toronto and the neighboring communities. In fiscal year 2020-21, 15 percent of patients were from outside of the Greater Toronto Area, representing around 3,200 patients.
Q: How are you handling this sudden jump in demand for virtual resources?
A: It's a work in progress. One thing that’s really important for us to keep in mind is that when you’re providing a service to a community, it’s not just about the hospital and the hospital visits. You actually have to have the coordination of services around patients to support them when they’re discharged from the hospital. So we have to look at when we have patients who come from outside of the traditional communities that we have been serving, we need to make sure we establish resources in their communities so they get access to good follow-up care.
Q: How are frontline workers handling this increased demand?
A: We've certainly been worried about our staff as the amount of work that they've been taking on during the pandemic has gone up. And because there is a shortage of nursing staff in many hospitals, many of our nursing staff have worked overtime hours. The data is also showing that many of our frontline workers have had to take additional sick time, which could be related to many factors. It's something we're analyzing more closely.
We've implemented additional wellness support systems in place for staff that has been very well used during the pandemic, such as free counseling through a third-party provider that we provide to our staff. The service goes above and beyond their insurance benefits. We have a wonderful Wellness Centre and they were able to pivot to great virtual programs. And they're not just physical fitness programs, they deal with other activities as well. I will say I've talked recently with most of our staff and although healthcare workers are tired and have been working a lot, their level of commitment to CAMH and patients is extremely high.