Reshma Amin, MD, FRCPC, MSc
The Hospital for Sick Children and University of Toronto, Toronto, ON

The COVID-19 pandemic has been an unparalleled threat to the Canadian health care system. Users of home mechanical ventilation (HMV) were at an increased risk of worsening respiratory failure and death secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), given their ongoing chronic respiratory insufficiency. The COVID-19 pandemic presented a pressing need for an innovative, virtual telehealth program for home mechanical ventilation users to keep these patients well and in their homes.

The Long-Term In-Home Ventilator Engagement (LIVE) program was a new virtual care program, rolled out during the coronavirus disease 2019 (COVID-19) pandemic to enable specialized centres to provide virtual support to people using HMV. 251 patients from 8 hospital HMV programs (pediatric and adult) in Ontario were participating in this program. The LIVE program is an intensive clinical management program delivered via an e-health platform (aTouchAway, Aetonix), creating a circle of care that includes HMV clinical teams, ventilator technology support specialists (the Ontario Ventilator Equipment Pool [ON-VEP]), the patient and their family caregivers. The LIVE program was codesigned by patients, families, health care professionals and clinical academics, in collaboration with our e-health partner. By bringing the expertise of HMV specialists virtually into the home, LIVE overcomes barriers related to distance and travel for patients who are often fragile and dependent on complex equipment that is hard to transport, as well as the risk of exposure to SARS-CoV-2.

This presentation will provide a high-level review of the LIVE program as well as the results of the program’s mixed methods evaluation. In addition, lessons learned as well as the unintended consequences of the LIVE program’s rapid rollout will be discussed.

Learning Objectives:
At the end of this presentation, attendees will be able to:

  • Describe the development and implementation of the LIVE program, a virtual care program rolled out to pediatric and adult home mechanical ventilation users in Ontario, Canada, during the pandemic;
  • Understand and appreciate the LIVE program evaluation results. In addition, lessons learned from the virtual care program rollout will be reviewed and opportunities for future virtual care collaborations will be discussed; and
  • Learn about the unintended consequences of the LIVE program’s rapid rollout as well as potential health disparities resulting from virtual care.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar