Telehealth at the University of Ottawa Heart Institute comprises three programs managed by the Cardiac Telehealth department: Telemedicine, Interactive Voice Response, and Telehome Monitoring.
Through the Heart Institute’s Telemedicine Program, patients at remote sites can be seen in consultation with the Heart Institute’s physicians without needing to physically travel to the Heart Institute. The telemedicine program uses the Ontario Telemedicine Network, which provides two-way, encrypted videoconferencing technology at most hospitals and community health centres in the province. An examination camera, a digital stethoscope, and a nurse are present at every examination site allowing a full set of assessments to be made remotely. Scheduling a consultation through telemedicine can decrease the burden and cost of travel to the Heart Institute for patients in distant locations.
The Heart Institute now also offers non-physician consultations for patients at remote sites, including sessions with physiotherapists, smoking cessation experts, and prevention specialists. Patients in Barry’s Bay, Winchester, Almonte, Cornwall, and Bancroft can participate in a telemedicine-linked rehabilitation program, where they can exercise in their home community along with participants at the Heart Institute.
Referring physicians interested in scheduling a telemedicine consultation for their patients with a Heart Institute expert should refer to the specialist in question or to the Cardiology Referral Clinic and indicate the need for Telemedicine.
Interactive Voice Response
The Heart Institute’s Interactive Voice Response (IVR) system uses automated calling to monitor selected patients discharged from the Heart Institute. IVR provides a safety net and ensures compliance with best practices for post-intervention medication and self-care. All eligible patients are automatically enrolled in the system upon discharge from the Heart Institute. The referring physician is kept informed of the data collected by the automated system and alerted to any concerns that arise.
Examples of the use of IVR include:
- Cardiac surgery: All patients discharged from the Heart Institute after cardiac surgery receive calls on day 3 and day 10 after discharge. The purpose of the IVR system for these patients is to screen for symptoms and provide a safety net during the period between discharge and when the patient sees their primary healthcare provider.
- Acute coronary syndrome (ACS) and heart attack: All patients discharged from the Heart Institute after an intervention for ACS or a heart attack receive six IVR calls a year to ensure they are maintaining a best-practice medication regimen for their condition.
- Heart failure: Patients with mild to moderate heart failure receive IVR calls every two weeks for three months after discharge, to guide self-care management at home and prevent readmission to the hospital.
Patients enrolled in IVR are not expected to wait by the phone for their calls; the system generates up to six automatic calls over two days for each scheduled call. (The caller ID readout will say “Heart Check.”) If the patient cannot be reached by the IVR system after two days, they will receive a follow-up call from a nurse in the telehealth program.
The IVR system now includes diabetes follow-up questions for all patients either known to be diabetic upon admission or diagnosed while admitted to the Heart Institute for another condition. The information collected through these questions is forwarded to a diabetes specialist at the Heart Institute.
Some patients with advanced heart failure may need more intensive follow up than that provided by IVR. These patients may be enrolled in the Heart Institute’s Telehome Monitoring Program. Telehome monitoring provides patients with a suite of home health monitoring equipment and daily virtual check-ins with the Heart Institute. For more information, see Telehome Monitoring.