Ontario Shores HealthCheck
According to a 2015 study conducted by researchers at Toronto’s St. Michael’s Hospital and University Health Network, “the role of the patient has changed over the years from that of a passive recipient of care to an active member of the decision-making team.” The study found that a “surprisingly high number of patients are still unaware of their legal right to access their health record,” even though researchers from around the world have long reported that patients who can check their health records are empowered, and it can improve doctor-patient communication and a patient’s overall satisfaction with their care.
In 2014, Ontario Shores’ CEO, Karim Mamdani, had a vision. “He wanted to make our hospital a centre of excellence and had a mandate to improve the journey of patients and their families,” says Dr. Velji. The launch of Ontario Shores’ HealthCheck Patient Portal in December of that year was the culmination of the team’s plan to democratize healthcare and “put information about patients’ care in their hands.” The portal, which supports the hospital’s view of empowerment, recovery, collaboration, inclusion and promoting self-management, allows patients see their chart, visit history, request medication renewals, request or cancel appointments, and even send messages to their doctors. “They can get information right away. And because we’re empowering them, they are better able to articulate what they’re going through,” says Dr. Velji. “I love to see patients empowered this way. We put our money where our mouth is in recovery.” The portal has shown a host of benefits for Ontario Shores patients, including a decrease in missed appointments and improved communication with healthcare providers.
Brain Stimulation Clinic
There are currently two services offered at the Brain Stimulation Clinic — electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). The former, which involves a brief electrical stimulation of the brain while under anaesthesia, is still touted as the gold standard when it comes to treating major depressive disorder and bipolar disorder that doesn’t respond to first-line treatments (such as antidepressants).
Ontario Shores brought rTMS into their clinic in January. It’s also a good option for those who suffer from treatment-resistant depression and can’t (or choose not to) receive ECT. The treatment involves short sessions (usually less than 10 minutes per session) where magnetic pulses are directed at the brain to stimulate nerve cells. Sessions are every day (generally five days a week) for six weeks and about a third of patients end up with their symptoms reduced by half. There are currently only a small handful of hospitals in Ontario that offer rTMS, including the Centre for Addiction and Mental Health in Toronto, the University Health Network’s MRI-Guided rTMS Clinic at Toronto Western Hospital and the Linda & Donald Mair rTMS Clinic at St. Joseph’s Healthcare in Hamilton.
Dr. Velji says Ontario Shores’ interested psychiatrists who volunteered to learn about rTMS were sent for training. “Our psychiatrists stepped up to the plate and we now have four doctors who are able to treat 30 patients with one machine that we purchased,” she says. “It’s an evidence-based treatment that’s well-proven and should be accessible to more patients. The fact that people in Durham have had to go to Toronto for treatment is unfathomable.” The hospital has sent a proposal for more funding with the hopes of purchasing more machines.
“We’re using technology to transform the approach to mental health treatment in a non-pharmacological way.”
eCBT
“When it comes to mental health and addiction care, there are very long wait times to see psychiatrists and other specialists. We currently have about 3,000 patients waiting, and their wait times are in excess of 100 days,” Dr. Velji says. “We wanted to solve this issue by ensuring we’re seeing the maximum number of patients.” There were also long wait times for cognitive behavioural therapy (CBT), a common type of talk therapy that patients who suffer from a host of mental health issues (from depression to eating disorders) practice as a way to change their negative thinking and better manage stress. When Dr. Velji’s team looked through their cases, they found a large number of these patients could be seen electronically via virtual care.
Enter Ontario Shores’ partnership with SilverCloud Health in 2019. SilverCloud uses an electronic-based cognitive behaviour therapy (eCBT) program designed for people with mild to moderate depression and anxiety. The hospital has made it available to all outpatient services that provide mood and anxiety treatments; it’s accessible to patients via referral from their Ontario Shores’ physician.
“We were able to see patients sooner,” Dr. Velji says. Patients have access to weekly one-on-one therapy sessions for up to 16 weeks with a clinician via the plaform and results were more than favourable — eCBT patients fared just as well as patients in group CBT settings. As of last March, there were about 200 patients using the system and feedback has been extremely positive, Dr. Velji says. “This technology has really been instrumental in reducing wait times for mental health services,” she adds.
Electronic CBT isn’t just a service offered to patients. “When we ask staff for their biggest health concerns, mental health is one of the top of the list — it’s consistently in the top two,” she says. “As a mental healthcare organization, we should be showing leadership and supporting our staff with their own mental health.” To help employees manage stress and other issues, the hospital partnered with Beacon, a digital therapy platform that many employer or benefits plan provider covers.
Partnership with Ontario Tech
Last October marked a new partnership between Ontario Shores and Whitby’s Ontario Tech University — working together, they’d look to find solutions for dementia patients in the hospital’s Geriatric Dementia Unit. These patients have trouble remembering people, places, events and their past. The collaboration in the Clinical Demonstration Unit will include leveraging artificial intelligence with a conversational robot to detect and manage symptoms of dementia, using virtual reality (to introduce reminiscence therapy), bright light therapy (which can promote happiness and calmness) and personalized music interventions (which can evoke past memories). “We’re using technology to transform the approach to mental health treatment in a non-pharmacological way,” says Dr. Velji. “We love Ontario Tech because we share values around the ethical use of technology — its’ not a big, shiny toy to play with. It’s about being innovative, accessible, equitable and meeting the needs of the people who need it most.”
