Nova Scotia·Analysis

From virtual visits to emailed test results, COVID-19 has modernized health care in Nova Scotia

From the outside looking in, you wouldn't think the pandemic should have such an impact on normal health-care operations. But for those on the inside, there has been a tectonic shift in the way services are planned for and how they've been delivered since last March.

We've seen more change in health-care delivery in the last six months than in the last 20 years

The need for physical distancing during the pandemic gave the province a push toward telemedicine. (Steve Bruce/CBC)

Editor's note: Mary Jane Hampton is a health consultant and columnist. She was Nova Scotia's former health reform commissioner.

I get this question a lot: "If we have a few dozen people in the entire province diagnosed with COVID-19, and not a single one of them in hospital with it, why does everyone in the health-care system seem so stressed out?" 

It's a reasonable thing to ask. 

From the outside looking in, you wouldn't think the pandemic should have such an impact on normal health-care operations. But for those on the inside, there has been a tectonic shift in the way services are planned for and how they've been delivered since last March. 

And to be blunt, the health-care system isn't known for changing quickly. 

Relatively simple things like being able to book a service online, virtually visiting your doctor without going to their office — or just getting rid of fax machines in medical clinics — are about as difficult as turning around the Queen Mary in the Bay of Fundy.

Health care does not pivot.

Rapid COVID-19 testing sites email the results of the swab to patients, a new way of delivering care also brought on by the pandemic. (Robert Short/CBC)

Overwhelming change

In fact, the pace of change we've seen in health care since March is akin to being placed into a slingshot and hurled a couple of decades into a brave new world. Patients and providers alike have seen more change in the last six months than we have in the last 20 years.

It's as impressive as it is overwhelming.

At the stroke of a pen, doctors who once had to physically touch a patient to get paid were suddenly able to use the telephone to provide clinical care. Since the state of emergency was declared, more than one million visits to doctors have happened virtually, without a patient stepping foot in a clinic or hospital.

While the phone has proven to be the favoured technology, video platforms like Zoom are making cautious inroads. 

In normal times, it would have taken several years, committees and working groups to create these complex pathways.- Mary Jane Hampton

But, like the rest of us, doctors have to huddle in their hastily repurposed spare bedrooms, basements and broom closets to create office space for this work. And, like the rest of us, they have had to figure out all the new tricks of linking, lighting and etiquette for virtual encounters with patients who are often also first-time users. It's nothing that anyone is used to.

Now, we can book many health services online, something that every other industry figured out years ago. We can even wander into a pop-up testing site and get results by email. In normal times, it would have taken several years, committees and working groups to create these complex pathways. In a pandemic, the Nova Scotia Health Authority pulled them together in a matter of weeks — and the design, testing and launch went pretty smoothly.

The same health professionals who are transforming the delivery of health care are also running day-to-day operations at the same time, Mary Jane Hampton writes. (Communications Nova Scotia)

More remarkable is that all of this, for the most part, has fallen on the shoulders of the same people who are also tasked with running the all the other parts of our health-care system and providing care. 

On top of their regular jobs, they have been transforming and adapting to new processes. Put another way: they were building a plane while flying it, with passengers onboard.

Mass immunization campaign

And while the rest of us fret about the last potential exposure location, anguish over skipped family traditions and complain about how masks fog up our glasses, everyone working in the health-care system lives in quiet terror that we are always just 14 days from the potential disaster of a superspreader event. It's no wonder that nearly every health-care provider, manager and bureaucrat is stressed out or exhausted.

And, remember, this is far from over.

The pandemic is going to be with us for at least another year, even with a vaccine rolling out. And that vaccine? Orchestrating the biggest and most complex mass immunization campaign in history will make the changes we've already seen pale by comparison.

Usually, health-care workers take care of us. But now is the time for us to show empathy. Now, we also need to take care of them.

This is the first pandemic for all of us so let's be patient.

And for those who are concerned that we've seen too much change far too quickly, you can relax: it's 2020 and doctors still use fax machines.

About the Author

Mary Jane Hampton

Health-care consultant

Mary Jane Hampton is a health consultant and columnist. She was the province's former health reform commissioner.

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