Program overview :

Zoom for Healthcare (Z4HC) delivered via Single App iPads

Hospital at Home Program – Island Health

Island Health, responsible for delivering health and care services to a large population across Vancouver Island in British Columbia, has introduced a groundbreaking initiative with its Hospital at Home (H@H) program. This program brings hospital-level care to patients in the comfort of their homes. The average age of H@H patients is 80, with some admitted patients being as old as 110 years. Many of these elderly patients are home alone, without a caregiver.

By leveraging technology, particularly video visits, Island Health aims to enhance the quality of care from admission through discharge. The Zoom for Healthcare (Z4HC) program enables virtual visits, increasing staff efficiency and reducing costs by replacing traditional home visits and telephone check-ins. Continuous care is maintained without adding operational costs or inefficiencies.

Objective and purpose of the promising practice 

The primary goal of this initiative is to improve therapeutic connections, visual assessments and discharge planning for patients. Eligible patients admitted to Victoria General and Royal Jubilee Hospital through the H@H program receive a single-use iPad to facilitate daily virtual appointments with physicians and nightly virtual check-ins with the responsible nurse.

Approach 

Engagement

Patient partners have tested new equipment and evaluated quick reference guides and resources to ensure a patient-centric approach. Personal feedback opportunities and patient surveys were employed for continuous improvement.

Monthly project progress reports are emailed to staff with printed copies posted in communal workspaces. Weekly virtual care updates and animated videos highlight staff achievements. Success stories are shared during morning team reporting sessions.

Outcomes

The introduction of virtual video check-ins has significantly enhanced patient care by enabling nightly check-ins, ensuring more consistent and personalized attention. A patient who is deemed appropriate for a virtual check-in (no cognitive impairment, sufficient dexterity, and strong enough cellular connection in their home) is added to a roaster for a nightly check-in. Once the nightly check-in is complete, the nurse confirms whether the call was successful.

Eligible patients now receive evening virtual visits, enabling more involvement from allied health team members, including occupational therapists and pharmacists. With virtual check-ins, patients receive evening visits lasting about seven minutes. Increased physician uptake of virtual visits was noted. Occupational therapists and pharmacists are using the iPads for compliance reviews and medication check-ins. The implementation team also found that there was a five percent increase in access to care for H@H patients.

Over a seven-month pilot, an increase in the quality of care provided was noted as a result of the second patient visit being changed from a telephone check-in to a visual virtual check-in.

Visual virtual check-ins provide access to visual cues, environmental context and visual demonstrations to support care providers and patients receiving care in their homes. Care providers can observe patient body language, facial expressions, living conditions and other non-verbal cues. Furthermore, certain assessments may require the individual to demonstrate physical movements or reactions which the care provider can observe and evaluate through video. These visual elements are absent during a telephone check-in.

Impacts and learnings

Key takeaways 

• Triaging family and caregivers along with the patient are crucial for navigating new technologies.
• Caregiver burnout is a significant concern that must be addressed.
• Digital literacy varies among staff, requiring additional support.
• Elderly patients can successfully manage technology for virtual visits.
• Engaging staff and supporting new workflows is challenging, but essential.

Facilitators

• A patient advocate helped to improve digital literacy, usability of iPads, and revising the quick reference guide to use language that was more patient friendly.
• Providers and clinicians were provided Zoom for Healthcare accounts to initiate video calls to patients’ iPads using either their desktop workstations or Island Health mobile phones.
• A manager engaged with staff to encourage technology adoption and workflow integration.
• A clinical nurse educator worked with staff to enhance the team’s computer skills for providing patient care.
• The Virtual Care Services team worked to find solutions to uncovered technical issues.
• The Collaborative Lead collected data and operationalized project changes.

Island Health’s H@H program demonstrates a successful integration of technology into patient care, offering enhanced access, efficiency, and continuous support while addressing the challenges of digital literacy and caregiver engagement.

For more information:

Laurie Flores
Innovation and Virtual Lead  
Island Health
virtualcare@islandhealth.ca