Virtual Care

Virtual Care at CHEO

CHEO offers a wide range of virtual care services supporting quality and timely patient care within outpatient and inpatient services. This includes video visits, telephone and direct messaging with CHEO providers through MyChart. Some of our virtual services include E-Referrals for community providers, virtual clinic appointments, virtual group therapy and virtual care meetings.

Our priority is to deliver high quality care to all patients and families. Masks, physical distancing and virtual care may have changed how we do things, but they haven’t changed our care and compassion for children, youth, families, our community and each other.  We offer virtual care services because we believe virtual care can be an equal or better way to deliver care under certain circumstances and for some patients.

Looking for a full list of virtual care services? Click here!

Virtual Patient Education

Green hexagon with text that reads virtual patient education. In the hexagon, hands are holding a tablet, cell phone and inhaler Patient and caregiver education services and appointments help to make sure patients and caregivers understand their (or their child or youth’s) newly diagnosed health condition(s), equipment or therapies. Many CHEO clinics are now offering virtual education appointments when hands-on teaching is not necessary. One example is virtual asthma education, where a nurse meets with patients on Zoom to teach them how to use their asthma inhalers

Virtual Clinic Appointments

Green hexagon showing a patient on a laptop on one side, and a doctor on their laptop on the other side Virtual clinic appointments are one-on-one video or phone appointments with your healthcare provider. Virtual clinic appointments may be offered when your care provider does not need to perform a physical exam as part of the visit. These virtual appointments allow you to get medical and rehabilitative care and guidance from the comfort of your home.

MyChart Messaging

Green hexagon with text that reads MyChart Messaging. in the hexagon, a hand is holding a cellphone MyChart, CHEO’s secure patient portal, connects patients to parts of their CHEO electronic heath record, anywhere at any time. Patients and caregivers can use MyChart to “send a message” to their health-care team directly to ask a question or make a request.

Virtual Group Therapy

Green hexagon with text that reads virtual group therapy. In the hexagon there is a laptop with people on the screen Rather than meeting in person, virtual group therapy simply means you are attending therapy group over the internet, usually via video call, although this might involve voice calls and chat room discussions, too. Virtual Group Therapy is typically used by our mental health, autism, development and rehabilitation, and complex care programs.

Virtual Emergency Department Visits

CHEO has had to suspend offering virtual visits to its Emergency Department temporarily, to keep up with an increased demand for in-person services and reduce the department’s wait times.

This suspension allows CHEO to reassign much-needed staff from virtual care to providing in-person support to kids and families who are coming to our Emergency Department.

Read our full statement for more information about CHEO's virtual Emergency Department

Family and Patient Connection

A purple hexagon with text that reads family and patient connection. In the hexagon a patient is sitting in a hospital bed on their laptop, while on the other side their family is at home talking to them through a video call. At CHEO we know how important it is for patients and caregivers to connect with their loved ones, and it’s not always possible to come to CHEO for an in-person visit. Sometimes the patient’s condition (e.g. isolation status) means in-person visitor access needs to be restricted; other times travel distance or other commitments at home make hospital visits impossible.

For inpatients that do not have, or are unable to operate their own electronic devices, we can set up virtual visits for patients and their loved ones. This was first set up for patients in the ICU during COVID-19. Our NICU received a grant from Pampers to bring in new technology that makes it possible for virtual interactions between infants and families that facilitate early bonding and attachment. In NICU, this technology also allows parents to continue to be involved in their infants’ care by virtually attending multi-disciplinary patient rounds and having virtual “face-to-face” discussions with health care providers (e.g. nurses, social workers, physicians, and other staff).

Virtual Patient Rounds

Family-centred rounds (FCR) are multidisciplinary rounds (meaning nursing, physicians and other health professionals who are part of the care team attend) that involve medical teams partnering with patients and families in daily medical decision-making. There are many benefits to FCR, including improving patient satisfaction, communication, discharge planning, medical education and patient safety. With the start of the COVID-19 pandemic, CHEO’s inpatient medicine teams transitioned to virtual family-centred rounds to minimize the number of people at the bedside and in the patient room. Virtual rounds may be used when one or more members of the care team cannot be at the bedside, or to support physical distancing guidelines recommended for optimal infection control.

Virtual Patient Care Meeting

A virtual patient care meeting is any meeting between patients, caregivers and members of their circle of care, that happens virtually using telephone, video or other technologies. Our goal when offering a Virtual Patient Care Meetings is to make sure the care is as effective as possible. You might be offered a virtual meeting with one or more of your specialist providers when a physical exam is not required. Virtual Patient Care Meetings can also make it easier for off-site caregivers or providers to participate in patient care meetings with the on-site care team. If the virtual meeting is happening via secure video platform (e.g. secure Zoom), patients and/or onsite caregivers can use their own device to connect to the Zoom meeting or be provided with an iPad by the unit.

Virtual Inpatient Visits

Some consults, follow-ups and patient care meetings may be conducted virtually to reduce the risks associated with COVID-19 and other communicable diseases, and preserve PPE. This means, when appropriate for the patient and the care they require, some physicians may schedule a consult or follow-up for an admitted or emergency department patient by telephone or secure video platform (e.g. secure Zoom). Virtual inpatient visits may also be scheduled to happen virtually to allow offsite providers and caregivers to participate. In these cases, patients and/or onsite caregivers can use their own device to connect to the Zoom meeting or be provided with an iPad by the unit.

Pediatric Virtual Critical Care (PVCC)

A purple hexagon with text that reads pediatric virtual critical care. In the hexagon there are two hospitals with chat bubbles over top, to show they're talking to each other

CHEO’s pediatric intensive care unit (PICU) provides telemedicine support to referring centres in Ontario and Nunavut to assist in the care of critically ill children. This 24/7 service uses our own Critical Care Response Teams (CCRT) comprised of Medical Doctors (MD’s), Respiratory Therapists (RT’s) and Registered Nurses (RN’s) to bring specialized multidisciplinary knowledge to the bedside. This approach to providing acute care support has led to enhanced care to patients at other hospitals, facilitated transport to CHEO when necessary and helped keep some patients home with remote support avoiding transport to CHEO when appropriate. This project is conducted in collaboration with OntarioHealth and the pediatric team at Qikiqtani General Hospital in Iqaluit, Nunavut.

E-Referral

A blue hexagon with text that reads eReferral. In the hexagon is an envelop CHEO has launched EpicCare Link, a secure web-based portal that allows community providers to electronically refer to CHEO and SickKids as well as have direct access to their patient’s CHEO chart.

Referrals submitted via EpicCare Link will be automatically routed to CHEO or Sick Kids. EpicCare Link replaces paper referrals submitted via fax or mail. PDF referrals will remain available on our website as we transition to this new system.

E-Consult

A blue hexagon with text that reads eConsult. In the hexagon is a laptop, on the screen is an envelop E-Consult offers a quick, easy and intuitive way for family doctors and pediatricians to request a virtual consult with a CHEO specialist about their patient’s condition.

Virtual Care Research

A blue hexagon with text that reads virtual care research. in the hexagon there are papers, charts and a magnifying glass. COVID-19 has led to a surge in virtual care services and tools and there is a lot to learn about how we can use virtual care to best support our patients, caregivers and providers. Evaluating, developing and improving virtual care services to ensure CHEO is delivering high quality care equitably is very important to us.

A number of CHEO clinicians and service areas are engaged in local, regional and provincial research projects looking at how virtual care is delivered and linked to patient care outcomes. Many of these projects involve collecting feedback from providers, patients and caregivers. CHEO’s Virtual Care Evaluation Project — a partnership between CHEO and CHEO Research Institute — is focused on the development of an inclusive virtual care evaluation framework and tools to support virtual care program design and delivery at CHEO and beyond our walls.

How do we decide when to offer virtual (vs in-person) care?

Your care provider decides what kind of appointment you are offered based on a number of factors, including whether care can be effectively delivered virtually. Virtual Visits are appropriate when an in-person visit is either not required or not possible. Some of the reasons to choose virtual instead of in person include:

No hands-on assessment or procedure necessary
Infection prevention: patient/provider is isolated/quarantined
Patient or caregiver is homebound
Travel restrictions, e.g. patient lives far away
Patient/family preference

How can you indicate your preference for virtual or in-person care?

If you would prefer a virtual or in-person visit, please let your provider know.

At the end of a visit, when your provider reviews next steps and follow-up, you can indicate your preference for virtual or in-person visits and discuss options together.
Ask the booking clerk when they call to schedule an appointment
Contact the Scheduling Hub if you would like to request a change to an already booked appointment, Monday to Friday from 8:00am to 4:00pm: 613-737-7600, ext. 1011.

Virtual clinic appointments

Preparing for your virtual clinic appointment

Many clinics at CHEO are offering telephone and video appointments. Sometimes when we call families, it shows up as a private number. If you receive a call from a private number, at a time close to when you have a scheduled CHEO appointment, consider answering as it may be your care team calling.

For MyChart users:

Before your scheduled clinic appointment, you will receive appointment information in MyChart that outlines how to connect to your care provider. Please read this information and make sure you are able to login to MyChart and you have the correct app/recommended browser installed on your computer/device before your appointment.

If you are not a MyChart user:

You will receive information about how to connect by email 24h before your appointment.

If you do not receive the email please check your junk mailbox before calling the Scheduling Hub at 613-737-7600, ext. 1011.

Privacy and security

All virtual video appointments at CHEO are done using secure, encrypted telehealth networks (Ontario Telemedicine Network or Zoom). CHEO is not recording these visits but they will be documented in the patient chart.

CHEO uses a Zoom license that is secure and compliant with the Patient Health Information Protection Act (PHIPA). Our staff take additional steps to increase security, including making sure we are using the most up-to-date version, are conducting meetings in private rooms and not sharing the teleconference link with anyone else.

For the most secure connection, we encourage you to connect for your virtual appointment using the latest version of the Zoom app on your desktop, laptop, tablet or mobile device.

Tips to get the most out of your virtual clinic appointment

Make sure you are in a quiet, private place where you can speak comfortably. Please ensure your child/the patient is present for the appointment.

Please follow any pre-appointment instructions that were provided to you. This could include having a list of current medications readily available, ensuring a photo of your child’s condition is uploaded via MyChart in advance of the appointment, etc.

Plan to be in one location (i.e. not walking or in a moving vehicle) throughout the appointment.

Prepare any questions you have for your CHEO clinician, and have them in front of you during your appointment.

Be in full view of the camera and try to sit in a location without windows or bright lights behind you.

Try to raise your device so it is at eye level during the visit by placing it on top of a stack of books until it's at the right height. Make sure that the camera and speakers aren't being blocked.

Testing your computer/device before your video appointment

Test the device you will be using before the appointment. You can test your device with Zoom at this link https://zoom.us/test. This will help you troubleshoot audio and video issues ahead of time and ensure that your appointment starts on time. If you are not able to connect, contact our Scheduling Hub at 613-737-7600, ext. 1011.
Before your appointment, close any unnecessary programs on your device/computer.
Try to use your own device or that of a trusted adult so that others cannot access or interrupt your appointment.
If possible, use an Internet connection (wired or WiFi) or if not, be prepared to use cellular data.

For MyChart users, confirm that you are able to login to MyChart.
Five to ten minutes before your appointment, join the meeting. This will give you a few minutes to make sure the audio and video are working.

Emergency Department virtual visits

As of December 1, 2021 CHEO has had to suspend offering virtual visits to its Emergency Department for at least 90 days, to keep up with an increased demand for in-person services and reduce the department’s wait times.

This suspension allows CHEO to reassign much-needed staff from virtual care to providing in-person support to kids and families who are coming to our Emergency Department.

Read our full statement for more information about CHEO's virtual Emergency Department

Need help?

If you experience technical difficulties preparing for, connecting to or during your CHEO clinic appointment please contact the Scheduling Hub Monday to Friday from 8:00am to 4:00pm: 613-737-7600, ext. 1011.

After hours, please contact Emergency Department Registration at 613-737-7600, ext. 2337

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