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Canadian health network addressing inequity by prescribing phones to patients

The University Health Network (UHN) in Toronto, Canada, has taken a tech-based approach to tackling health inequity by prescribing mobile phones for patients who need better access to services.

Entitled PHONE-CONNECT, the study and programme focuses on addressing issues such as poor COVID-19 outcomes for members of the public from ‘vulnerable populations’, noting that, “as a response to the COVID-19 pandemic, many health care services have adopted new digital solutions, which rely on phone and internet connectivity” – with some people who are currently experiencing poverty or homelessness potentially unable to access these.

The approach used in the project attempts to “improve patients access to health care, information, and social services, as well as improve their ability to adhere to public health directives (social isolation and contact tracing).” The phones are utilised as a point-of-care healthcare intervention in an emergency department, with the aim of ultimately improving these health outcomes.

A pilot, where prepaid phones were provided to vulnerable patients who had recently been discharged from an emergency department, took place after 50 smartphones and 200 SIM cards with unlimited talk and texts, were donated by a telecommunications company. This was followed by further donations from members of the public, all of which were cleared of past data, disinfected and checked for compatibility with the SIM cards.

So far, around 180 devices have been distributed to patients in Toronto, across two different sites. The finished packages provided to patients included the mobile devices, SIMs, phone chargers and a handout explaining the purpose of the pack, with a list of health and care phone numbers.

Eligibility to take part in the programme was based on patients not having an existing phone number and focused on those who may require further health or care communication about test results and pending appointments, who may need to self-isolate, or who may be called for follow-up of care, either virtually or in-person.

The new numbers were added to patients’ health records, with people advised to keep them turned on, charged and available, although they were also ultimately able to use the devices however they wished.

A study of the initiative is currently ongoing, with researchers contacting phone recipients to conduct interviews and find out how their devices are helping in regards to health equity. Quantitative data in areas such as levels of appointment attendance and COVID-19 testing is also being collected. Meanwhile, health providers involved in the programme are being asked to answer questionnaires about the project, too, to assess the impact on staff.

Since the programme began, PHONE-CONNECT has expanded to include additional Greater Toronto Area sites (St Michael’s Hospital and Michael Garron Hospital) and academic medical centres (McMaster University), although the need to match the level of technology with how comfortable patients are with phones, to avoid any stress and anxiety over the ability to use the devices, is noted as a need going forward.

To find out more about the project and the study, click here.