There’s a new innovative service available for individuals seeking support for substance use and getting help is as easy as walking through the “digital front door.” It couldn’t have come at a better time. Recent findings show Rapid Access Addiction Medicine (RAAM) clinics improve outcomes and reduce opioid- and alcohol-related emergency department visits, related emergency department visits, hospitalizations, and deaths. Transitioning the RAAM clinic to a virtual environment will help address the growing need for substance use treatment.
Before the pandemic, The Royal’s RAAM clinic followed a traditional “walk-in” model. Services at the clinic include assessment and triage to appropriate level of care, substance use and mental health treatment, withdrawal management, harm reduction, connection to primary care, and navigation to community services.
At the beginning of the pandemic in March 2020, clients were not permitted to walk-in to the RAAM clinic due to COVID infection prevention measures. Staff quickly changed gears and offered appointments by telephone and videoconference, as well as in-person if needed.
“Our processes we put in place due to COVID created delays and barriers to access, which is not ideal when someone is ready do to something about their substance use,” says Dr. Melanie Willows, addiction medicine physician, clinical director with the substance use and concurrent disorders program at The Royal and co-creator of the RAAM clinic. “We knew we had to find a solution.”
The answer came in the form of a new “digital front door” to improve rapid access to care and expand reach.
Developed by a team of clients, service providers, clinicians, scientists, researchers, and administrators, this new virtual model enhances the delivery of virtual care and essentially replicates the experience of an in-person visit, but virtually, from wherever the person is at.
“This is now one of the easiest, and most accessible health solutions in the city,” says Dr. Kim Corace, vice president, innovation and transformation, and co-creator of the RAAM clinic in the substance use and concurrent disorders program at The Royal. “RAAM saves lives,” says Corace, who adds that the virtual model supports individuals at a critical time no matter where they are.
All that’s needed is an Internet connection and a device with a camera, such as a mobile phone, computer, or tablet.
"This is now one of the easiest, and most accessible health solutions in the city."Individuals connect with the RAAM clinic by “checking in” at theroyal.accessRAAM.ca during clinic hours. (If it’s after hours, they’re redirected to other resources.) After check-in, individual answers a few preliminary questions and submits health card information for validation. After “entering” the digital front door, they meet virtually by video with a clinician who assesses their needs and goals. Individuals may also be connected virtually with other members of the health care team which might include an addictions counsellor, social worker, nurse, nurse practitioner, or physician, among others. The RAAM digital front door also allows the individual’s family member, friend or support worker to attend the virtual appointment.
Virtual care is a key part of the provincial plan to maintain health services while preventing the spread of COVID-19. With a catchment area that includes Ottawa and surrounding areas, the virtual RAAM clinic casts a wider net and can help more people than the typical walk-in model. This is especially needed in rural areas, and with over 50 RAAM clinics across the province, it’s an idea that is also scalable.
This initiative received provincial funding to enhance the pandemic response through appropriate virtual care options, which are key in ensuring continuity of health services while preventing the spread of COVID-19.
During this pandemic, digital health services are frequently equated with video calls, but Corace calls for a wider definition, one that encompasses more than “in session” work with clients.
“What digital health really is, is the solutions and tools that we use to support clients through their journey, everything from access, to their care received, to post care, to evaluation,” she explains. “Digital health is much broader than the face-to-face interaction. It’s about thinking outside the box and how we use technology to improve the overall care experience. It’s about access, care, and outcomes, rather than just a single session.”
The soft launch of the virtual RAAM clinic took place in early June, and so far, feedback has been positive.
Although it’s too early to say, Corace and Willows speculate the RAAM clinic of the future may eventually be a hybrid of in-person and virtual walk-ins, one that gets help to more people, in the way that suits them the best.
For more information about The Royal’s substance use and concurrent disorders program go to theroyal.ca/patient-care-information/clinics-services-programs/substance-use-and-concurrent-disorders.