An Evaluation of the Structure of an Integrated Regional Remote Care Management Program for Patients with Selected Chronic Diseases in Canada

Background: Since the onset of the COVID-19 pandemic, the number of Remote Care Management (RCM) programs in Ontario has increased; however, many have not been objectively evaluated based on their structure and performance.

Objective: This study demonstrates how the core structure of the RCM model, developed by the Connected Care Halton Ontario Health Team (CCHOHT) with Halton Healthcare Services and Ontario Health atHome, aligns with the RCM recommendations and evaluation tool from the Ontario Ministry of Health (OMH). The focus is specifically on the CCHOHT’s RCM program for chronic diseases.

Method: This study presents the CCHOHT’s RCM model to demonstrate the degree to which it is consistent with the recommendations for developing RCM programs forwarded by the OMH. It also evaluates the CCHOHT’s current chronic diseases RCM program using the OMH’s RCM evaluation taxonomy tool and an amended version of this tool proposed by the authors. The taxonomy is based on four foundational criteria: technology, touch, integration and equity.

Results: The CCHOHT’s chronic diseases RCM program meets the OMH’s four RCM taxonomy criteria. The program is a digital solution that remotely manages patients, provides follow-up communication, and escalates critical cases through a more patient-centred, connected clinical pathway of services and care partners.

Conclusion: The CCHOHT’s RCM model and its chronic diseases RCM program are built on intersecting principles of RCM and integrated care as articulated by the OMH. The adaptable nature of the RCM model allows it to be extended to other clinical conditions.