Successful pandemic measures will offer much-needed relief to overwhelmed health-care system

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This article was published 12/02/2024 (669 days ago), so information in it may no longer be current.

The pandemic may be officially over, but relentless overcrowding in the health-care system seems to have become our new reality.

Hospital emergency rooms are gridlocked to the point of dysfunction with seriously ill patients languishing on gurneys in hospital hallways. Those hallway patients are kept in limbo largely because hospital wards are also bursting at the seams, unable to find enough transitional care in other facilities.

Together, these are the symptoms of a hospital system that does not have enough beds, doctors and nurses to deal with the sheer number of seriously ill patients.

There is, simply put, no room at the inn. Or in this case, hospital.

How can the new NDP government create more capacity within a system that is incredibly short on critical human and physical resources? Well, you could start by taking a few pages out of the pandemic playbook.

It appears two pandemic-era measures — alternative integrated accommodation (AIA) and the virtual COVID outpatient program (VCOP) — are poised to be expanded and, possibly, converted into permanent features of the health-care system.

Dr. Rob Grierson, the chief medical officer for Shared Health’s emergency response services, told the Free Press that an enhanced AIA program is being considered, along with a new virtual ward program that would operate much like VCOP, but which will be applied to a broader range of patients and conditions.

Grierson said both programs were essential tools to manage the huge influx of COVID patients during the worst part of the pandemic. In 2020 and 2021, Shared Health operated multiple AIA sites in Winnipeg to provide spaces for those who did not have a stable place to isolate safely. At one time, AIA was providing safe isolation for several hundred patients, allowing them to move out of hospital wards and emergency rooms and ease patient flow.

However, as COVID-19 receded, the program was pared back.

Currently, there are about two dozen AIA patients in a temporary housing facility in Winnipeg, Grierson said, declining to disclose the location.

These patients are suffering from COVID or other respiratory illness, are predominantly homeless or living in a situation where they cannot effectively be isolated, Grierson said. AIA allows to them to receive constant care and oversight from integrated teams of nurses and paramedics, who are in close contact with physicians if any complications arise.

It is very likely moving forward that plans will be unleashed to expand the number of AIA beds on a permanent basis, he said.

“There’s a number of patients throughout the system that could definitely benefit from this type of care model,” he said. “I don’t know what the realistic cap is. But definitely, there’s plans to (expand) and treat this patient population this way.”

Potentially, there could be a greater impact from the expansion and redesign of VCOP into a fully fledged virtual care program that is available to patients recuperating or living with a broad array of illnesses and conditions.

VCOP was first activated during the pandemic and focused on patients who were stable enough to finish recovering from COVID at home. They were provided with the means to be monitored remotely and to get 24-7 access to medical personnel through video conferencing.

The program was incredibly successful, allowing more than 500 patients to recover at home and freeing up more than 4,000 hospital days for more seriously ill patients. Overall, it was estimated VCOP saved the health-care system somewhere between $3 million and $4 million.

Despite the savings and success, the former Tory government shut it down in the summer of 2022 as a number of pandemic responses were being capped or wrapped up.

However, Grierson said the VCOP experience was so promising that discussions are underway on how to permanently expand care through a virtual ward.

He said there is growing awareness all over the world about the potential efficiencies that could be achieved through broader use of virtual care.

Although virtual medicine really started in Manitoba as a way of monitoring COVID patients, there is a growing body of evidence in other jurisdictions that virtual care could be used to follow patients recovering from other illnesses or surgeries, or to monitor the condition of patients suffering from chronic conditions.

“The concept of a virtual ward is being actively pursued,” Grierson said. “Understand that VCOP was very focused on one condition. I think the virtual ward is going to other conditions (such as) congestive heart failure and other kinds of underlying medical conditions that people are being monitored for.”

It’s unclear exactly when an expanded AIA or virtual ward program will be officially launched. We are now only weeks away from the NDP government’s first budget and one could assume that if these programs were to be augmented, it would be done as part of the provincial budget reveal.

The government has a tremendous opportunity to not only expand care capacity, but win back trust from health-care professionals, by showing they can be agile in adopting new ideas.

If the NDP needs motivation, it need only look at the overcrowded ER waiting rooms.

dan.lett@winnipegfreepress.com