The Plague-Ground – “In Spain people are renting out their dogs for walking.”

I heard this from Heather Ross who was speculating why fewer people seem to be having heart attacks during the pandemic than before.

Maybe it’s because we exercise, get more sleep, spend more time with our families and less time getting to and from work.

I say ‘speculating’ because Dr. Ross doesn’t do that. She’s driven more by data.

She’s the Division Head of Cardiology at the Peter Munk Cardiac Centre, a big reason Toronto General Hospital was rated 4^th best hospital in the world earlier this year. She’s also director of Toronto General’s cardiac transplant program, the largest organ transplant centre in North America.

What she does know is that people with heart conditions are at a much greater risk of dying of coronavirus.

That’s one reason Toronto General moved so fast to turn its ambulatory heart clinics into virtual ones. Today, 90% of face-to-face visits at those clinics have been eliminated.

But when the pandemic lifts, don’t expect things to go back to normal.

As Dr. Ross said: “The silver lining in this tragedy is that virtual medicine is transforming how medicine is practiced.”

“We’re already running our online clinics in the evenings and on weekends. You don’t have to get to downtown Toronto to do that. You don’t have to sit forever in a crowded waiting room. Technology has completely redefined the meaning of ‘house calls.’”

“Some procedures will always have to be done in person, like bloodwork or diagnostic imaging, or angiograms. But certain conditions lend themselves to virtual care, like heart failure. So not only can future heart clinics include virtual care, they must.”

“But what if you live in Timmins and need your meds adjusted? Until recently, you’d have to fly or drive to Toronto for a symptom check and bloodwork. Now, we can collect all your data through remote monitoring and you can get the blood work done in Timmins.”

One reason online medicine is moving so fast – and won’t move back when we’re given the all-clear, is a smartphone app developed by Heather Ross and her colleagues called Medly.

It not only monitors things like blood pressure, heart rate and body weight, it helps doctors offer the right kind of care – including medications, diet and exercise – to avoid you having to go back to the hospital.

Especially in an ambulance.

Is this a big problem?

One of the biggest, it seems.

The main reason we’re admitted to the hospital is because of heart failure – where the heart can’t pump enough blood for your body to stay healthy. Well over a million Canadians (including 300,000 Ontarians) live with it, and far too many of us die from it.

It’s early days yet for Medly. But patients rave about it because they can monitor their symptoms and adjust to stay out of worry-range, while doctors can quickly assess patients who may be a world away and triage them virtually. In fact, a recent six-month study found Medly cut re-hospitalizations for heart failure by 50% and cut re-hospitalizations for any reason by 24 percent.

So here we have a made-in-Canada telemonitoring app with a world of potential. It’s part of a generation of virtual medical tools that are being developed, often in fits and starts, because early-stage funding for ideas like this is usually slow, small and fitful.

Heather Ross reminded me that the original funding for Medly came from a  2013 trip she took heart transplant patients and donors on to climb the Vinson Massif, the highest mountain in Antarctica.

She just wanted to show that having a heart transplant doesn’t mean you can’t get out and about.

She also believes that when it comes to medicine, private donors can create massive public good.

Even if you have to go to the end of the earth to make it happen.

Now that’s a benefit of exploration.

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Get your tickets to our upcoming RamsayTalks Online: May 14^th  with Jared Diamond, “one of the deepest thinkers of our time”.