ER physician's project uses donated cellphones to connect vulnerable with ongoing medical care

For years, Dr. Andrea Somers has seen patients come to the hospital emergency department because they weren't able to attend followup appointments.

She remembers one man who came to the ER with his wrist in a cast "that was not supportive or doing anything" and in a lot of pain.

When she asked why he didn't follow up with a doctor, he said his housing situation changed, he moved and he didn't have a cellphone. So he came to the ER for help.

"If you don't have a phone and you don't have stable housing where someone can contact you or leave a message, you're stuck. So what do you do? You go back to the social safety net, which is the emergency department, and you seek help there," said Somers, who is an emergency physician at Toronto's University Health Network (UHN).

Patients who return to the nearest emergency department because they're unable to get the followup care they need is not a new phenomenon.

But with the wider use of virtual care implemented during the COVID-19 pandemic, Somers said she was motivated to help.

She created a project that provides donated prepaid cellphones to those who are homeless, struggling with mental health or substance use, or socially isolated, in hopes of getting people followup care instead of going to the ER.

Since the project launched almost three years ago, early data shows the cellphones have helped some individuals avoid ER visits and receive the care they need.

"Providing a phone to these people [is a] very practical device for improving the continuity of their care, which reduces their ER visits," Dr. Howard Ovens, a staff emergency physician at Toronto's Mount Sinai Hospital and a member of the Canadian Association of Emergency Physicians (CAEP) public affairs committee, said of the project. 

The need to connect vulnerable patients with followup care outside of the ER existed long before the pandemic, Somers said.

Those who are experiencing homelessness "often live in conditions that adversely affect their overall short- and long-term health," according to the non-profit and non-partisan Canadian Observatory on Homelessness.

The organization also said that "being unhoused makes it difficult, and in some cases impossible, to access general health-care services" for several reasons, including not having a health card or access to a phone.

Of those visiting the emergency departments at the UHN, an average of one in 20 patients lacks an active phone number, according to the UHN Foundation.

"There's so many ways now that not having a phone disadvantages a person," Somers said.