Reaching patients at risk of complication from COVID-19: Digital Health Tools to Support Identification and Planned Proactive Visits

2. Integrating digital health and virtual care

  • Release date: Thursday, October 8, 2020
  • Style: On demand- webcast
  • Focus: Practical (e.g. Presentation on how to implement programs and/or practices in the team environment)
  • Target Audience: Leadership, Clinical providers, Administrative staff

Learning Objectives

At the end of this interactive session, participants will be able to:

  • Describe tools to help clinicians and their offices proactively identify and connect with patients at risk during COVID-19
  • Identify how to link these digital health tools together and embed them into patient care workflows.
  • Apply the tools to support the reopening of in-person visit with the reality of practicing in the time of COVID-19


Are you concerned about your patients with complex care needs and those that are at higher risk of complications from COVID-19? Or, are you struggling with identifying patients that may not be accessing needed primary care during this time? Primary care offices are challenged with adjusting their practice to meet the needs of their patients during COVID-19 and the administrative burden of identifying patients that could benefit from proactive care can be time consuming and challenging. The eHealth Centre of Excellence (eCE) is a physician led team that works with health care organizations and providers across the continuum of care to produce better clinical value for patients, informing the development of digital health tools through patient and provider engagement, and supporting their adoption and meaningful use to enhance delivery of care.    

Our presentation will discuss:

  • The use of EMR searches to identify patients in need of a planned proactive visit (e.g., patients who would benefit from a palliative approach to care, patients with chronic diseases who have not been seen for a while, patients at risk of complications from COVID-19)
  • Digital tools to support a variety of care delivery options (such as COVID-19 assessment tools, chronic disease prevention and management (CDPM) tools, palliative care tool, virtual visit solutions, eReferrals)
  • Automation bots that can decrease administrative tasks and increase sharing of information between patient care team members    

The session will highlight how together these tools can be used to support integrated care for patients across a spectrum of needs.   


  • Dr. Mohamed Alarakhia, BSc(Hons), MD, CCFP, MSc, Managing Director, eHealth Centre of Excellence
  • Ted Alexander, VP, Partnerships and Clinical Innovation, eHealth Centre of Excellence
  • Dr. Neil Naik, Family Physician, MB BCh BAO (Hons; NUI&RCSI), CCFP, Kitchener-Waterloo Family Health Organization
  • Justin Wolting, B. COMP, RPA Developer, eHealth Centre of Excellence
  • Stephanie Chin, BSc, RPN, Dipl. HI, Change Management & Health Systems IT Specialist - CDPM Stream Lead, eHealth Centre of Excellence


  • Tricia Wilkerson, BSc, MA(Leadership), IA,  Program Manager, eHealth Centre of Excellence    
  • Michelle Cousins, Program Manager, eHealth Centre of Excellence    
  • Lirije Hyseni, MSc, CE, Quality Improvement and Knowledge Translation Practice Lead, eHealth Centre of Excellence