Health care services for people living with spinal cord injury must be a blend of traditional hands-on and virtual-based care to serve the community’s complex care needs.
The COVID-19 pandemic has changed the landscape of health care in Canada, with 33 per cent of all patient-reported visits between January 2021 and March 2022 being virtual. A study led by VCHRI investigator Dr. Andrei Krassioukov, published in the journal Disability and Rehabilitation: Assistive Technology, dives deeper into the new frontier of health care delivery, exploring the experiences and perceptions of people with spinal cord injury (SCI) who accessed teleSCI services during the pandemic.
Defined as services received via telecommunications and digital communication technologies, teleSCI services flourished during a unique moment in time when services were expanded in terms of scope and availability. The broad definition was necessary to capture the wide range of experiences with all types of virtually provided health care services.
“There had been this long-standing promise that people with SCI were a group that would really benefit from teleSCI health care services,” says Dr. Andrea Bundon, a principal investigator at ICORD who collaborated with Krassioukov on this study, providing analysis for the collected data. “The pandemic provided us with the opportunity to determine if this was true because, until now, there was not a lot of investment in telehealth services.”
Making SCI services accessible to all
The study involved 71 participants with SCI who first completed an online survey that sought to determine how and where people were accessing their services during the pandemic.
From that initial group and based on their survey responses, the research team interviewed 12 participants from both rural and urban B.C. communities about their teleSCI experiences. According to Bundon, the 12-person sample provided adequate data sufficiency to generate facts and understandings about people’s experiences with – and perceptions of – teleSCI services during the pandemic.
The qualitative interviews were recorded and transcribed, then coded and analyzed.
"TeleSCI services can increase access and equity, but they do not work for every kind of health care service. You cannot, for instance, get a botox injection virtually, which is critical for managing SCI for many people.”
Data from the qualitative interviews was summarized into three themes — potential of teleSCI services, pitfalls of teleSCI services, and opportunities for teleSCI services to improve upon in a post-pandemic world — and eight sub-themes, including convenience and accessibility, need for in-person health care, opportunities to try new health care services, and mitigating safety concerns regarding the transmission of COVID-19.
After the analysis was complete, the finding that surprised the research team focused on accessibility. While travelling to appointments was, indeed, a barrier for SCI patients who lived rurally, travelling to appointments was also a barrier to those who lived within relatively close proximity to SCI services.
“COVID-19 put us into unusual circumstances where even people who lived near and in Vancouver couldn’t travel to their appointments because they were afraid,” says Krassioukov. “In the future we must think about how we will organize services for people who live not only in Prince George or Kelowna, but also in suburban communities near where SCI health care services are available.”
In conclusion, the study recommends that, in a post-pandemic world, individuals with an SCI would benefit from blended models of health care delivery that leverage telecommunication technologies to increase accessibility to healthcare, while still providing in-person care for those requiring ongoing treatment and management of secondary conditions associated with the patient’s SCI.