Sara Mitchell

Neurologist, Sunnybrook Health Sciences Centre

“I specialize in patients with complex brain diseases. At the beginning of the pandemic, I was scrambling to meet their unique needs. My patient population was at high risk for Covid-19 exposure if they left their homes, but often lacked the technological access or know-how to participate in virtual appointments. To tackle the issue, my colleagues and I developed educational tools for patients and caregivers to instruct them on virtual care.

“I’ve also had to adapt neurocognitive assessments to the virtual realm. We’ve used screen-sharing technologies to replace paper tests. Often, patients have trouble manoeuvring their cameras appropriately, and in those cases we collected verbal responses rather than written or motor ones. To help standardize our approach, I participated with a group of experts at U of T to create a set of training videos on virtual neurological examinations. For example, instead of physically testing a patient’s muscle resistance, we would ask them to roll their forearms to look for asymmetry in movement.

“Ultimately, I think the hybrid approach will endure. I’m approaching virtual care as a triage tool, to determine whether patients need to be seen in person. I split my days between virtual and in-person visits.”