Digital Health Week: Bella Bella’s connection to BC Children’s Hospital tele-PICU a life saver

When a 10-year-old girl arrived febrile, lethargic and coughing up blood at R.W. Large Memorial Hospital in Bella Bella recently, it’s unlikely her parents knew about the recent expansion of telehealth service connections to facilities such as B.C. Children’s Hospital.

They just knew their daughter needed immediate medical attention.

Compounding the patient’s acutely ill state was a CPT1 deficiency, which is more prevalent in First Nation’s populations. Patients who are CPT1 deficient do not have the enzyme needed to convert fat to energy, which means they are at high risk to go into hypoglycemic shock and possibly a coma unless they receive rapid sugar replacement therapy.

Following a rapid assessment, it was deemed the patient needed to be medevaced to Vancouver. But it was too late in the day.

Dr. Nicole Redding, the physician on duty, and Sian Carter, Patient Care Coordinator/Educator at the Central Coast Hospital, immediately mobilized the Bella Bella team to connect with the tele-Pediatric Intensive Care Unit (PICU) team at BC Children’s.

“Within 90 minutes of arrival, the family, the patient, MD and nursing team were face-to-face consulting with the Pediatric ICU intensivist and a Nurse Specialist at BC Children’s,” explains Sian.

Celebrating Digital Health Week

Digital Health Week is November 13-19 and this story highlights how telehealth is especially relevant for rural and remote communities, such as Bella Bella (pop.1,500). On a regular basis, hospital staff encounter challenging issues including high acuity patients, limited access to resources and a strong reliance on transferring patients to a higher level of care in urgent/emergent situations. Inclement weather or the time of day often make a transfer impossible, however.

In emergency cases, telehealth is transforming the delivery of care – and saving lives.

“With the recent telehealth connection, we now have the ability to liaise with other professionals, who can support us during times when patient transfer is not possible,” says Sian. “It’s very reassuring to know we have this option.”

Tele-PICU a Canadian first

The first program of its kind in Canada, tele-PICU was established in 2016 and allows teams at BC Children’s to assess children closer to their community through real-time, two-way videoconferencing. Tele-PICU teams use high resolution cameras and digital stethoscopes that enable physicians and nurses to see patients as well as to listen to and amplify sounds of the heart and lungs of seriously ill or injured children. The teams are supported by carefully planned processes and protocols, leading edge equipment and 24/7 technical support.

“Through Child Health BC, a partnership with the province’s health authorities, we’ve had the opportunity to work with multi-disciplinary teams in some of BC’s most rural communities to connect them to very specialized care, and even critical care, closer to home,” said Dr. Maureen O’Donnell, Executive Director, Child Health BC, BC Children’s Hospital. “The continued expansion of tele-health services allows teams to collaborate across the province to help children receive diagnosis and treatment sooner.”

As health care providers determined to pull out all the stops for their patients, Sian and the Bella Bella team are thrilled to have these new tools at their disposal.

“I am proud to say our team was able to make a huge difference in the life of a child and a family,” says Sian. “This is a great example of client and family-centred care; the outcome was positive and many lessons were learned through this experience. Our team worked efficiently and it was amazing to feel the high level of support from the BCCH team as well. The patient was transferred to BC Children’s the next morning, and the Telehealth equipment remained setup for instant consultation or observation of patient at any time during the night.”

Children’s Virtual Care Initiative

Tele-PICU is part of Child Health BC’s Children’s Virtual Care initiative that integrates tele-health and other technologies to enhance services to children throughout BC. These sites include technology and tele-health equipment as well as equipment to support pediatric visits with trained nurses and support staff.

William Findlay, Vancouver Coastal Health Director for the Central Coast area, calls this “the tip of the iceberg.”

“As our technology advances we are now able to have clinical assessment from specialists like pediatric intensivists,” says William. “This kind of service is especially crucial for rural and remote areas such as the Central Coast. It will help us better serve our patients and families.”

This photo is an example of what the tele-PICU team sees when a connection is made remotely.