Ever since it was ushered into widespread use during the pandemic, virtual healthcare has become a much more common tool — including for virtual urgent care.

Sunnybrook Health Sciences Centre partners with University Health Network (UHN) to provide Toronto’s Virtual Emergency Department.

The service offers same-day appointments seven days a week for adult Torontonians with an urgent medical concern that is not life threatening (e.g. body aches, rash, nausea), and who are unable to make an appointment with a family doctor or nurse practitioner.

At Sunnybrook, roughly 6,000 patients have been seen through the virtual urgent care program since it began in December 2020. Most express appreciation for the convenience, privacy, and flexibility it offers.

“Virtual emerg is a great idea…It’s convenient, efficient and it’s working well. Thank you for seeing patients in virtual ER!” – Patient

For patients from equity-deserving groups – i.e. communities that face barriers to opportunities, resources, or services such as healthcare – virtual urgent care is seen to provide additional benefits.

At the latest Sunnybrook Speaker Series, Dr. Sander L. Hitzig, Program Research Director and Senior Scientist at the St. John’s Rehab Research Program at the Sunnybrook Research Institute, spoke about why that is the case.

“The number one benefit of virtual urgent care is that people from equity-deserving populations feel more control over their care experiences,” he said. “They feel safer in terms of their physical and mental health compared to past in-person encounters where they felt prejudiced against.”

Examples of underserved or equity-deserving populations include people who are low-income, people with disabilities, refugees, Indigenous or racialized persons, or members of 2SLGBTQIA+ communities.

Dr. Hitzig, whose research often evaluates new technologies and models of care, began examining the use and impact of Sunnybrook’s virtual urgent care program shortly after it was launched, in partnership with Dr. Justin Hall, Emergency Department physician and Program Lead of the Virtual Emergency Department.

Initial data suggested people from equity-deserving populations faced barriers accessing the service, such as not having reliable Internet access or a private space for their online appointment. Low digital literacy or English fluency were also common barriers.

Drs. Hitzig and Hall, and their colleagues, decided to dig deeper to learn more. Together with Access Alliance, a multicultural health and community services partner, they designed a qualitative study with the goal of better understanding how virtual urgent care met the physical, emotional, and social care needs of equity-deserving patient populations.

The researchers interviewed patients over the age of 18 who self-identified as belonging to equity-deserving groups. Many identified aspects of virtual care that could be improved – such as technical requirements that could be challenging for people with a learning disability.

But most of the patients who were interviewed also had favourable things to say about the service.

“One of the things that came out loud and clear was that people really welcomed the convenience and flexibility of virtual urgent care,” Dr. Hitzig said. “And they appreciated not having to wait a long time to be seen.”

The option to avoid a long wait in a crowded emergency department was especially appealing to people with chronic illnesses who might be immuno-compromised, Dr. Hitzig added.

Some patients who were interviewed also noted the financial benefits of virtual urgent care, such as not having to pay for transportation or parking.

Many also liked the focus and attention they received from staff during virtual appointments and the professionalism of the care providers, Dr. Hitzig said.

He added that several patients said they preferred virtual urgent care to past experiences at physical emergency departments when they had felt belittled or discriminated against.

“There is more work that needs to be done to better understand how virtual models of care can be better tailored to people from equity-deserving populations,” Dr. Hitzig said. “But overall, it is seen as a compassionate tool that is making healthcare more accessible.”

Asked what makes him most excited about the future of virtual urgent care, Dr. Hitzig said it is the sense of empowerment that patients described after accessing the service.

“Having more options to give people greater control over how and when they access healthcare is important because we want to be partners with the patients we are treating,” he said.

“If people have more positive experiences, that will lead to better outcomes for the patient and the healthcare system.”

The post How virtual urgent care works – and where it fits in the future of emergency medicine appeared first on Your Health Matters.

But, did you know that bacteria and agar plates can be used to create art, too?

In the hospital’s Microbiology laboratory, samples taken from patient specimens are grown on agar plates, producing unique colonies and colours. Those culture plates are used to determine the kind of bacteria causing a patient’s infections, helping the care team select the most appropriate treatment.

Often, those colonies and colours can end up resembling art rather than a lab test. In fact, “agar art” is its own art form: for the past three years, the American Society for Microbiology (ASM) has held an agar art competition, accepting submissions from around the world.

This year, Sunnybrook laboratory technologist Linh Ngo entered that competition after finding inspiration in the Disney film Finding Nemo. “I was amazed at the similarities between the coral reef and the bacteria I work with in the lab, and I wanted to recreate that on agar plates,” she says.

Linh made the agar art in the six steps described below:

Start planning early

Linh says she first had the idea to create agar art of a coral reef last year, but missed the deadline. In November 2016, she started coming up with a concept for her submission. She also loves to draw, so she started sketching ideas. For example, Linh found inspiration for how to draw the brain coral (at the bottom of the image) in an online photo. Once she created a drawing she was satisfied, she was ready to start sketching it onto the actual agar plates.

Keep an eye out for colourful bacteria

Now that she had an idea of how she wanted the finished product to look, Linh and several of her colleagues started keeping an eye out for organisms that produced the vibrant colours she was looking for. For example, “some strains of Serratia marcescens produce a pigment called prodigiosin, which give the colonies a dark red/purple appearance, so when I finally came across a strain with that colour, I froze it for a few months,” Linh says.

Paint with a steady hand

After finding the organisms that would produce the colours she wanted, Linh used the tip of a pipette to “paint” with the bacteria on a series of five agar plates. “I had to be careful not to have any overlap of the different bacteria because if there was, it would alter the image. There was a lot of trial and error,” she says. When the original drawing she wanted to use as a guide didn’t work, she ended up painting freehand.

Be ready to experiment…

Finding the right organisms to work with was a time-consuming process. “Every time I used four to five types of bacteria on the same agar plate, the bacteria would grow into each other, and the colours and image would be ruined. So I had to figure out how to work with just two bacteria per plate,” Linh says. The colours she ended up using were derived from Serratia marcescens (purple), Staphylococcus aureus (pink, and a little green), Candida tropicalis (white) and Klebsiella pneumonia (grey, mucoid).

…and keep experimenting!

For the next step in the process, which involved putting the agar plates in an incubator, Linh also had to experiment with the incubation times. This is because different organisms are capable of lowering the pH in the medium and can cause a change in colour, especially when multiple organisms are present on the same plate. “By the time some bacteria produced the colour I was looking for, the colour of the other bacteria would have changed. It took several tries to get the timing right,” she says.

Don’t give up

In all, Linh estimates that she made about eight revisions to her original drawing, and went through dozens of test plates before perfecting her submission. Looking back, Linh says she should have given herself more time to prepare her agar art. “I had two months to make the agar art, but a few more weeks definitely would’ve been helpful. I almost ran out of time!”

Linh named her stunning image of a coral reef “Finding pneumo” (named after the movie that inspired her and one of the bacteria she used, Klebsiella pneumonia). The result far exceeded her expectations: she won second place in the ASM competition, beating out 264 submissions from 36 countries. Congratulations, Linh!

The post How it’s made: agar art appeared first on Your Health Matters.