Dr. Payal Agarwal consults with a patient during a virtual appointment


Dr. Payal Agarwal consults with a patient during a virtual appointment

Fast Forward to the Future of Healthcare

Accessible, responsive and equitable healthcare for the digital age

Walking around the waiting rooms at Women’s College Hospital (WCH) these past few months, you would be hard pressed not to wonder where the patients were. The number of people checking in or waiting for their appointment was a far cry from the typically busy clinic areas. It wasn’t a scheduling mistake and the hospital hadn’t drastically reduced its patient volume – the vast majority of appointments had been converted to virtual visits.

“COVID-19 forced all healthcare institutions to rethink how they provide care practically overnight. In a matter of weeks, we were able to shift our model of care to one that was virtual first. Leveraging our virtual infrastructure, developed as a part of our Women’s Virtual program, allowed us to act decisively and quickly,” said Dr. Danielle Martin, executive vice president and chief medical executive, WCH.

Launched at the end of 2019, Women’s Virtual – Canada’s first virtual hospital – is utilizing digital health tools and virtual models of care to re-envision the healthcare experience, making it more accessible, responsive and equitable.

“Healthcare will always be a human enterprise and we will always offer in-person care. But under Women’s Virtual, if we are asking a patient to come into the hospital, it is because face-to-face care is the best way of dealing with their specific health issue. It’s not because we have no other model of care to offer them,” Dr. Martin added.

Virtual Visits

Video visits integrated into WCH’s electronic medical record were first piloted in the mental health program, with practitioners completing roughly 20 visits a month. By May alone, providers across all hospital departments completed more than 1,200 video visits.

Group video visits were launched shortly after. In fact, WCH is the first hospital globally to implement group virtual visits into its electronic patient record, Epic.

“Our team in mental health prioritized those patients most at risk with the highest need for group therapy,” said Dr. Lori Wasserman, WCH psychiatrist. “While we have had to modify some of our groups to better suit virtual, patients have appreciated the opportunity to connect with people who relate to what they are going through.”

Dhara Desai, manager of clinical applications for IM/IT at WCH.

“Each digital tool selected as part of the Women’s Virtual initiative was done with an eye to sustainability and broad usability, ensuring that it would be beneficial across multiple areas,” added Dhara Desai, manager of clinical applications for Information Management and Technology (IM/IT). “As a result, IM/IT has been able to partner with Women’s Virtual and roll-out both video visits and group visits in record time.”

While this rapid acceleration of virtual visits provided care for existing patients, COVID-19 precipitated the need for new virtual care programs directly addressing the needs of those patients most impacted by the pandemic.


“With most symptomatic yet stable COVID-19 patients self-isolating at home, we knew we needed to develop a program that would offer them real-time virtual care,” explained Dr. Payal Agarwal, a WCH family physician and the medical director of COVIDCare@Home. “Working with our existing partners, we created COVIDCare@Home, a program providing support to both primary care providers treating such patients, as well as direct support to those with COVID-19 through virtual visits and remote monitoring.”

L-R: Dhara Desai and Dr. Payal Agarwal

COVIDCare@Home applies a team-based approach rooted in family medicine, which includes mental health and social work supports, as well as access to WCH’s Acute Ambulatory Care Unit (AACU) should a patient have more complex needs requiring in-person care.

“We serve a diverse patient population, with many patients from communities who traditionally face barriers accessing care. Many are dealing with financial pressure, language barriers or are living in cramped housing. We know that when we treat the full patient, including their medical needs, social needs and mental health needs, they do better. We are also better positioned to escalate their care should their health deteriorate,” Dr. Agarwal highlighted.

Patient outcomes and response to COVIDCare@Home has been overwhelmingly positive, with one patient saying it “made me feel more reassured and I knew that I was never alone. Even though I was self-isolating, I wasn’t alone in this.”


As many of us now know, older adults living in long-term care (LTC) have been disproportionately impacted by the pandemic. In fact, LTC residents account for roughly 81 per cent of all COVID-19 deaths in Canada. Given the glaring need to provide enhanced supports to LTC, WCH fast-tracked its LTC+ program.

Developed in partnership with LTC homes, acute care hospitals and community service organizations, LTC+ provides physicians and nursing staff in LTC with one number to call. They can either connect virtually with a specialist 24/7 who will help them troubleshoot a patient problem or an advanced practice nurse who will assist them in assessing the patient’s needs, provide advice and refer them to outside services. 

“The care requirements for older adults living in LTC residences are often very complex. It only makes sense to provide additional care supports to enhance quality of care. By enhancing the care that LTC providers are able to deliver onsite and avoiding a transfer to the emergency department, we are helping to reduce their risk of exposure to COVID-19 and simultaneously reducing the volume of patients in our acute care hospitals,” explained Laura Pus, administrative director for Women’s Virtual.

L-R: Dr. Danielle Martin and Laura Pus meet to discuss the LTC+ program

“LTC+ is the first step in our Aging in Place program. Over time, we plan to expand our offering so that more older adults can receive the care they need either in the community or at home, where they want to be,” Pus noted.

The digital revolution is underway in healthcare and there is already a significant uptake of digital solutions. “At WCH, we developed a program like Women’s Virtual because we are committed to ensuring that the digital revolution happens in a way that is consistent with our vision of creating a healthier and more equitable world. The virtual care that we are offering aims to improve health and close the gaps in care many patients experience,” Dr. Martin said.

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