Healthy Living in the North

Screening & follow-up care to prevent cardiovascular disease in women in Prince Rupert

This article was co-authored by Justine Derksen and Janice Paterson


Doctor in scrubs

Evidence has shown that pregnancy is a great place to evaluate cardiac risk. In Prince Rupert, Dr. Marius Pienaar has developed a screening program and software to identify and support women with cardiovascular risks.

Scientific evidence has shown that pregnancy is a great place to evaluate cardiac risk. In Prince Rupert, Dr. Marius Pienaar, a gynecologist, has developed a screening program and software which uses the data collected during a woman’s pregnancy to assess for cardiovascular risks and to coordinate referral and follow-up to prevent cardiovascular disease.

During the pregnancy, some basic measurements such as blood pressure and weight are recorded and a panel of blood tests are performed, including blood lipids and glucose. This data is then entered into the program to calculate a risk score for future cardiovascular disease. Women with elevated risk are then offered interventions, and their primary care provider is informed of this risk.

We have a golden opportunity to evaluate pregnant women with cardiovascular risk and this should not be missed. -Dr. Marius Pienaar

Dr. Pienaar explains that if a woman has diabetes in pregnancy, she is at a higher risk of having diabetes later in life and should be tested 6 weeks to 6 months after pregnancy. Currently, only about 20% of women are tested after pregnancy. Dr. Pienaar’s new software actively follows his patients and has created a referral and reminder system where every patient can be contacted and given opportunities to attend the North Coast Maternal Health Clinic for evaluation.

Walking in snow with mountain background.

Dr. Pienaar is hoping to make this unique program and software available across the province.

Currently, Dr. Pienaar’s clinic seeks to intervene by providing clinical care to at-risk women as well as offering smoking cessation resources, on-site dietitians and diabetes nurses, and more. 100% of postpartum patients who are screened and are identified as having increased risk are offered the postpartum health clinic visit. The program is expected to increase patient awareness of their own risk of cardiovascular disease and support women to access additional health care services to help reduce their risk.

I am very appreciative of the care and information I received in the North Coast Maternal Health Clinic. This program provided me with valuable information/assessment regarding future health risks. Such insight allows me to intervene early in order to improve my modifiable risk factors and ensure my future health and well-being. -Cherie Harvey-Malthus

The clinic has been a success so far and is very efficient and cost effective. Dr. Pienaar has seen success with this quality improvement project and hopes to make the program and software available across the province. There has already been interest from Fraser Health and the Lower Mainland to emulate the clinic model at other hospitals. This is the first such clinic in B.C. and the first rural clinic in Canada specifically geared to evaluate cardiovascular risk in postpartum patients.

Check out the full version of this article: An Innovative Program in Prince Rupert is Screening and Providing Follow-up Care for Women with Risk for CVD

Justine Derksen

About Justine Derksen

Justine works for Northern Health in Medical Affairs as the Coordinator, Physician Engagement Initiatives in Prince George. Justine loves the north and enjoys the seasonal activities with her husband and adorable Bernese Mountain dog any chance she gets. Justine is currently pursuing her masters of Public Health degree, which she was inspired to pursue through her work with Northern Health. When not at work, Justine enjoys cooking, outdoor recreational activities and crafting.

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TeleHealth: Bringing kidney care to remote communities

Health care team watching a monitor around a table.

TeleHealth care allows the Kidney Care Team to reach more patients in remote communities!

Within Northern Health’s vast geographical area, residents in rural and remote communities have limited access to specialist care. The vision of the Kidney Care Team (comprised of a physician, nurse, dietician, pharmacist, social worker and unit clerk) is to address this challenge by regionalizing a team-based TeleHealth kidney service, investing in technology, and providing services closer to home (similar to the face-to-face model of care) where patients no longer need to travel long distances to larger centres.

The team recognizes that TeleHealth care will not completely replace face-to-face consultations, but that there is potential to reach more patients in remote communities, including First Nations, and to increase patient engagement with specialist health care services.

Why TeleHealth?

Dr. Singh, a nephrologist on the kidney care team, recalls one patient’s experience:

A new immigrant worker was urgently referred from a remote rural community with very advanced kidney disease. The referral letter stated that he was adamant he was not leaving his community to go and see a specialist. I was able to see him the next day via TeleHealth and after meeting the renal team and receiving education about his condition, he was convinced to come to Prince George on the Northern Health Connections bus for surgery to prepare for dialysis. This gentleman is now doing home dialysis at night and is able to work and earn a living during the day without moving from his community. This is a great example where, connecting via TeleHealth, the kidney team was able to alleviate his fears, avoid unnecessary travel and stress but, above all, deliver the education about his kidney disease and motivate him for home-based dialysis. As a provider, this is immensely satisfying as timely intervention to address an urgent clinical and educational need was met to provide the best care for this patient.

What does “Tele-Kidney-Care” look like at Northern Health? Click the infographic below to download a full-size PDF.

Check out the full version of this article: Northern Kidney Care Team Leads the Way in Expanding Access to Specialist Care in Northern BC

infographic

Tele-Kidney-Care at Northern Health

Justine Derksen

About Justine Derksen

Justine works for Northern Health in Medical Affairs as the Coordinator, Physician Engagement Initiatives in Prince George. Justine loves the north and enjoys the seasonal activities with her husband and adorable Bernese Mountain dog any chance she gets. Justine is currently pursuing her masters of Public Health degree, which she was inspired to pursue through her work with Northern Health. When not at work, Justine enjoys cooking, outdoor recreational activities and crafting.

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