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Telemedicine improves discharge planning

Toronto, January 2, 2013

By Emily Holton

A patient flow coordinator from Bridgepoint Health beams into St. Michael’s General Internal Medicine morning “bullet rounds.”
A patient flow coordinator from Bridgepoint Health beams into St. Michael’s General Internal Medicine morning “bullet rounds.” (Photo by Emily Holton)

Thanks to the St. Michael’s Telemedicine Program, patient flow coordinators from Bridgepoint Health and Providence Healthcare are now taking part in St. Michael’s General Internal Medicine morning “bullet rounds.”

At 9 a.m. every Tuesday and Thursday, the patient flow coordinators log into the Ontario Telemedicine Network to interact with St. Michael’s physicians, nurses, case managers, pharmacists, speech language pathologists, registered dieticians, physical and occupational therapists, discharge planners and other members of the interprofessional team.

The meetings are called “bullet rounds” because they’re rapid fire: the team covers the entire patient roster (about 45 patients) within 45 minutes. The goal is to work together to develop an overall plan of care for each patient that’s as efficient and effective as possible.

“It’s working really well,” said Victoria Wen, a case manager at St. Michael’s. “We can plan ahead to streamline the discharge process and make sure that the providers at Bridgepoint and Providence understand the challenges that our patients face – both physically and socially.”

The group initially met in person, requiring significant travel time for Bridgepoint and Providence coordinators. It soon became clear the trips to St. Michael’s weren’t always sustainable.

“We felt it was important to find a way to keep communicating,” said Wen. “So we tried telemedicine. It takes much less time and fewer resources to share the same information.”

Traditionally, when a patient is ready to move to rehabilitation, St. Michael’s sends the patient file electronically to Bridgepoint or Providence for their teams to review. Through bullet rounds, the rehabilitation teams have much more background information: they’ve been following a patient’s journey from acute care admission to the point of transition.

For General Internal Medicine, the next step will be to use telemedicine for case conferences, allowing Bridgepoint, Providence and other hospitals to consult directly with our patients.