One Step Further

Initial brainstorming notes for the COVID-19 Clinic

Built by the team at the Peter Munk Cardiac Centre,
the COVID-19 Clinic is supporting patients across University Health Network.

Much like “unprecedented” or “social distancing,” few words have been spoken more frequently in the past six months than the word “virtual.” Workplaces, schools and happy hours have all gone virtual, where traditional experiences are recreated in an online setting.

At the Peter Munk Cardiac Centre, “going virtual” was just the start.

After a few weeks, it was clear that in Ontario, most patients with confirmed or suspected cases of COVID-19 were mildly symptomatic and could be cared for at home. Their cases were not severe enough to be admitted to the hospital, yet they still needed to be monitored closely. Virtual care on its own, such as a one-time videoconference appointment, wasn’t going to be enough to keep these patients and their community in good health. For these patients, a new system was needed.

The team at the Peter Munk Cardiac Centre developed the COVID-19 Clinic, which has allowed for a continuum of care through remote patient monitoring for those with confirmed or suspected cases of COVID-19. Led by Dr. Heather Ross, Division Head of Cardiology at the Peter Munk Cardiac Centre and site lead for the Ted Rogers Centre for Heart Research, and Dr. Yas Moayedi, heart failure cardiologist at the Peter Munk Cardiac Centre, the Clinic has an interdisciplinary team of nurse practitioners and physicians from a wide range of specialities, including family medicine, hepatology, infectious disease, respirology and cardiology, monitoring each patient.

“Central to this new Clinic is the fact that it’s not simply a quick interface with a patient,” explains Dr. Moayedi. “There is a ‘circle of care,’ where patients can be seen virtually by any subspecialist given the uncertainties associated with the virus.” Furthermore, parameters such as oxygen saturation levels are monitored on an ongoing basis, so treatment is based off vital trends in a patient’s health.

Patients with suspected cases of COVID-19 are those who have tested negative, yet still show symptoms. Elizabeth MacLeod, a marketing professional who moved to Canada three years ago from Scotland, tested negative at the beginning of June, yet to this day, still has a compromised sense of taste and smell, along with chest pains and heart palpitations. There are multiple specialists monitoring her case, including Dr. Moayedi and Dr. Lea Harper, a respirologist at UHN. “I didn’t expect to hear anything when I was discharged,” said Elizabeth. “But it’s comforting to know there is a whole team following up on me – even with all this uncertainty, I don’t feel alone.”

To date, the COVID-19 Clinic has had more than 6,000 patient visits.

William Mitchell, another patient of the COVID-19 Clinic, remarked, “When we spoke, I genuinely got the sense Dr. Moayedi was not only caring for me, but doing everything she could to keep the community safe.” Mr. Mitchell, who works in the field of technology and healthcare management, commended the COVID-19 Clinic, citing it as a prime example for how to reimagine healthcare delivery.

The COVID-19 Clinic has helped reduce admissions to UHN’s Emergency Departments for stable patients and through an interdisciplinary team of specialists, ensured that deteriorating patients are identified quickly for appropriate treatment. The new clinic will continue to serve as a tremendous asset to patients and healthcare teams across UHN during this next phase of the virus, but also as we plan for the new way patients will receive high-quality care in the years ahead.