Telehealth: Follow-up Times at a High-Risk Pregnancy (GARE) Clinic Improve by Leaps and Bounds!

Telehealth is playing an increasingly important role in the healthcare pathway. The High-Risk Pregnancy (GARE) Clinic at St. Mary’s Hospital Center is a prime example, as evidenced by Stefanie Mangel, Head of the Multisite GARE Outpatient Clinics and Catherine Higgins, Clinical Nurse at the SMHC Women’s Clinic. Below, they talk to us about the trajectory the Clinic has been on for over a decade and the gradual integration of technology aimed at improving the wellbeing of users.

The SMHC High-Risk Pregnancy (GARE) Clinic provides second-line consultation/follow-up services for women who are pregnant and develop health conditions that can pose a risk during pregnancy, such as gestational diabetes and hypertension. “In 2012-2013, test result follow-ups were done over the phone by a nurse who would call the pregnant client. However, due to the ever-increasing number of clients and the complex nature of the cases, this practice became more and more difficult to manage. Also, for some allophone users, this means of communication proved unsuitable because of language barriers. In searching for other options, email was shown to be the most effective.  It meant that users who needed help understanding the information they were receiving could turn to family members or loved ones,” explains Stefanie Mangel.

In the fall of 2015, the telehealth platform was introduced, bringing telehomecare to clients in their homes. The arrival of this new technology marked a major shift in how the Clinic operated, improving the care and services delivered to this particular clientele. Instead of it taking three days or more to do all the follow-ups, it became possible to do so in as little as a day and a half.
As a result, the care teams can now spend more time on complex cases that require additional support and closer monitoring. It should be noted that because the nursing staff assigned to pregnancy follow-ups work so closely with endocrinologist Dr. Les Meissner, they are now able to treat some 400 patients per year. A great deal more staff would be required to manage the same volume at the hospital or over the phone.  

“The team of nurses at the Women’s Clinic is driven and constantly seeks to push the boundaries and innovate, all in an effort to improve their services.  They are heavily invested in making telehomecare a success,” adds Catherine Higgins. “Being open-minded and committed to continuous improvement are key when developing new work methods. Changes to practices can result in unforeseen challenges. It is possible, however, to come up with solutions, so that the necessary adjustments can be made,” adds Ms. Higgins.  

“Thanks to telehealth, we are able to significantly increase the number of visits/follow-ups we do each year, without having to increase the number of people working on this project. In addition to having had a very positive effect on workplace well-being, it has also reduced the stressors that contribute to job dissatisfaction and burnout that were once encountered by the team of clinicians. In short, we are so much more efficient!” concludes Ms. Mangel.

This project is a tremendous success and was shared by Catherine Higgins on the Canada Health Infoway, an online digital health solutions platform, through McGill University’s Réseau universitaire intégré de santé et services sociaux (RUISSS). It is also important to mention that in 2019, the GARE Clinic team was presented with a Luminas Award during the CIUSSS’ Recognition Gala, acknowledging the advances that have been made possible as a result of the telehealth platform. In essence, it has been a decade of ongoing developments, marked by the gradual integration of technology aimed at improving the wellbeing of users.

Thank you to Marie-France Brizard, Associate Executive Director—Service Integration, Care Trajectory Management and Academic Affairs and to Dr. Les Meissner, who have supported this project from the very beginning. A special thank you also goes out to the nursing staff at the High-Risk Pregnancy (GARE) Clinic who, despite the issues, challenges and problems, never lost sight of the end goal of this project, which was to facilitate multidisciplinary follow-ups for these clients.