Yukon virtual care action plan
1.0 Overview of areas of focus
1Health Yukon consists of a number of initiatives that leverage technology to increase access to care, provide opportunities to bring care closer to home, improve delivery and coordination of care and improve both the client and provider experience in Yukon. This initiative supports or directly responds to 30 of the recommendations in the Putting People First Final Report, and it is the foundation for a more collaborative, person-centred health and social services system.
One of the early recommendations from the Independent Expert Panel on the Comprehensive Health Review presented to Yukon Government in November 2019 was to develop virtual care options that allow individuals to receive care and monitoring remotely, and this was solidified in the final report.
The Department has committed to use funding from the Canada-Yukon Bilateral Agreement for Pan-Canadian Virtual Care Priorities in Response to COVID-19 (signed in December 2020) to not only offset some of the base costs related with the 1Health initiative, but also to:
- support additional planning and work on expanding virtual care platforms and equipment
- review existing platforms and services, and
- develop a more comprehensive and long-term plan and how to best deliver and manage all virtual care-related services in the territory.
As such, Yukon is now uniquely positioned to move forward with the development of a more comprehensive and robust virtual care strategy that will integrate seamlessly into the work on the 1Health initiative.
Research shows that the use of virtual care technologies including telehealth and videoconferencing has been growing every year since 2010, and significantly since the onset of the COVID pandemic. Canada Health Infoway research estimates that over 1.4M virtual appointments took place in Canada in 2019.
By November 2020, there were nearly 1500 Zoom or Doxy.Me sessions delivered by clinicians in Health and Social Services alone, with approximately 150 clinicians having an account. This is in part due to rapid adoption funding by Canada Health Infoway to accelerate acquisition of hardware, equipment, and licenses required to support virtual visits in sites that do not have ready access to telehealth equipment.
The number of telehealth sessions per year in Yukon, however, has remained relatively low at a range between 450 sessions and 892 sessions per fiscal year from 2010 to 2020, and 584 in 2020. There are 45 telehealth units in Yukon.
The following table shows preliminary data relating to visits to physician clinics in 2020-2021:
|Visit Type||Fiscal Year 2020-21
April 2020 - December 2020
|Yukon TelehealthFootnote 1||15|
|In Person Visit||143,675|
|Virtual Visit (phone and video)Footnote 2||25,532 (15%)|
Source: Yukon Claims Processing System
Very early in the COVID-19 pandemic response, Yukon determined that physicians providing care virtually would be paid at the same rate as in-person visits, and that a comment ("VV") would be inserted into the claim, irrespective of modality. It is recommended that specific codes by modality are developed so that meaningful insights can be generated on virtual care usage and outcomes.
Yukon also has potential to deploy remote patient monitoring kits (tablet with peripheral devices to measure temperature, oxygen, blood pressure), and work needs to be done to understand how these devices could be deployed in a collaborative care model (including physician payment).
1Health Yukon will offer a suite of virtual care tools, and when implemented in the Ambulatory environment, these will directly link to the patient chart - offering seamless integration into the electronic health record. We anticipate that the integration of these virtual tools will improve access to care in our rural communities, in particular those that do not have full-time physician presence.
2. Initiative under the Bilateral Agreement
Yukon Government, Yukon Hospital Corporation and Yukon Medical Association are collaborating to design a common medical record for every Yukoner, enabling a more collaborative approach to care, and ensuring that care is based on the most up to date and comprehensive information. Once fully implemented, the 1Health initiative will give Yukoners access to modern health technologies, including a patient portal, which provides them with direct access to their health information. The patient portal will enable virtual visits with and between providers, secure message exchange, remote client monitoring and telehealth services, which all drive toward our objective of accessible care regardless of location. Once implemented these tools can be launched directly from a patient's chart, and the visit can be documented accordingly by the provider.
The funding from Health Canada is being used to accelerate this initiative through the purchase of platform licenses and supporting the human resources costs required for planning and design of functionality.
Figure 1 - Text description
- Wave 1 – Spring 2021 – 1st
- Inpatient Yukon Hospitals
- Acute Care
- Digital Imaging
- Outpatient Yukon Hospital Corporation (YHC)
- Visiting Specialists *(front office only)
- Diabetes Education
- Outpatient Health and Social Services (HSS)
- Chronic Conditions Support Program (CCSP)
- Lab, imagine, all sites
- Inpatient Yukon Hospitals
- Wave 2 – Summer 2021 – 2nd
- Long Term Care, 4 homes (June to September)
- Wave 3 – Fall 2021 – 3rd
- Community Nursing rollout begins
- Soft launch of patient portal
- Wave 4 – Winter 2021 – 4th
- Mental Wellness and Substance Use
- Yukon Communicable Disease Control (YCDC) / Health promotion
- Home care
- Wave 5 – Spring 2022 – 5th
- Data management and reporting tools
- Home care
- Primary care physician clinics
This work with the territorial electronic health record is foundational and essential to the safe and coordinated expansion of virtual tools. It is expected that the adoption rates and use of these tools will increase over the longer term to assist in reducing medical travel costs and the social and economic costs incurred by rural Yukoners who at times need to leave their homes to access health and wellness care in major centres.
We are also pleased to collaborate with Canada Health Infoway and the Canadian Partnership Against Cancer in the implementation of 1Health Yukon. Many Yukoners receive cancer care out of territory, and this work will improve information flow across jurisdictions, and enable use of virtual tools where possible and will help advance the priorities of the Canadian Strategy for Cancer Control, 2019-2029 Yukon will deploy the oncology module of Meditech Expanse, and once the 1Health platform is implemented across all health care settings, Yukon will initiate work needed to exchange health information (EHR to EHR) with our key out of territory partners.
|Item||Fiscal Year 2020-21|
Note - this does not include investments by Yukon Hospital Corporation
Performance measurement and expected results
Figure 2 - Text description
Vision: A seamless care journey enabled by one health information for all Yukoners
- New Meditech Expanse
- Client in centre circle of care
- Near real time information for care providers
- Physician Clinics
- Community Health Centre
- Long Term Care
- Home Care
- Yukon Hospitals
- Mental Wellness
- Client Portal
- Community Wide Scheduling
*Simplified for discussion
Government of Yukon
YK will collaborate with CIHI in its work to identify a set of pan-Canadian indicators and where possible, provide jurisdiction specific baseline data that will be used by CIHI to measure progress on virtual care implementation.
|1Health Yukon||Territorial electronic health record in place across most care settings in Yukon.||Increase the number of providers/care settings and those in circle of care having near real-time access to patient's health information.|
|Virtual tools||Virtual tools (video visits, secure messaging) effectively deployed to improve access to care and decrease the need to travel within, and out of territory for health care.|
|Patient portal (health records, lab results, virtual visits, secure messaging)||Increase the number of patients accessing their health record via the patient portal|
|Virtual care strategy||Yukon health care providers have a common vision, deploying a common set of video visit and secure messaging tools to improve access to care, and Yukoner's care experience.|
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