Health apps, virtual care could help solve hallway medicine: Report

Premier Doug Ford’s top health-care adviser is warning that “tough decisions” will have to be made as the Progressive Conservative government looks to redesign and modernize Ontario hospitals.

Dr. Ruebin Devlin, who chairs an advisory panel on health care and hallway medicine, delivered his first report today, suggesting the province use health apps and virtual appointments to care for patients.

Much of the report focuses on the causes and effects of hallway medicine across the larger heath-care system, which became a political hot potato for the former Liberal government.

Ford pledged to end hallway medicine during the election campaign and tasked Devlin to be the province’s health transformation czar, paying him $348,000 annually.

Hospital Overcrowding

The advisory panel spoke to 340 patients over four months and said many complained about a “lack of dignity” as they were cared for in a hospital hallway and had their medical history discussed within earshot of other patients.

The report says over the past six years, visits to emergency rooms increased by 11 per cent to 5.9 million people in 2017-18.

“On an average day in 2018, there were approximately 1000 patients waiting for a hospital bed in an unconventional space or emergency department stretcher,” Devlin’s report stated. “This should not happen.”

Devlin’s report noted emergency rooms became overloaded because patients either found it difficult to navigate the health-care system or grew impatient with long wait times or inconvenient hours.

The volume of patients was often so high that hospitals found it difficult to transfer patients to a bed within 8 hours of arriving at the emergency room, per ministry expectations. Patients waited an average of 16 hours.

The hallway crunch also took its toll on frontline doctors and nurses who reported feeling burnt out and stressed, which led to staff shortages at many hospitals.

Friends and family members of patients also told the advisory panel they were feeling stressed out, with some reporting feeling flashes of anger and bouts of depression over the situation.

Costs related to aging population

The report also warned that Ontario’s aging population will only make matters worse, adding a financial strain to the health-care system in the next 20 years.

The number of senior citizens is expected to double to 4.6 million by 2041, meaning one-in-four Ontario residents will be over the age of 65.

Devlin estimated that dementia alone, which is expected to afflict over 430,000 residents in 2038, could cost Ontario close to $325 billion over a period of 30 years.

Digitization and modernization

The report suggested that centralization, digitization, and efficiencies would help eliminate the thorny political issue of hallway medicine.

“Simply adding more hospital or long-term care beds to the system will not solve the problem of hallway health care in Ontario.”

While it left out specifics, the report highlighted 21 government health agencies which it said are not “well-alighted,” leaving them unable to coordinate their resources.

The council will look at using technology to make access to health care easier, including using health apps, virtual care appointments and booking appointments using email.

The report is the first in a series that are set to be delivered over the next four years.

Read the full report below: