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Welcome to episode 27 of the Technology in Human Services podcast. In this episode, I’m chatting with a few folks from the Somerset West Community Health Centre in Ottawa about their experiences with digital equity and virtual care. On the line with me are Sue Merrill, Manager of Quality Improvement, Planning and Evaluation, Lisa Vadeboncoeur, Digital Equity and Virtual Progamming Project Assistant, Magda Osman, Community Health Promoter.
I connected with Sue late in the Fall of 2020 after I saw their request for proposals for a Digital Equity and Virtual Programming Capacity Building Project. Digital equity is something that has come to everyone’s attention during the pandemic as a huge issue and challenge in newcomer communities. It was exciting to see an organization formally tackling the issue in our sector and I wanted to learn more. Fast forward to June 2021 and we have all learned a lot. It seemed like a good time to find out Somerset West Community Health Centre’s experience with their project, and what we can all learn from them.
As you’ll hear, they’re still learning, but what they have implemented with a little bit of funding is valuable for us all. I hope you enjoy the conversation.
You can learn more about their project in the Settlement Sector & Technology Task Group AMSSA Lecture webinar recording.
Machine-Generated Transcript
What follows is an AI-generated transcript of our conversation using Otter.ai. The transcript has not been edited. It may contain errors and odd sentence breaks and is not a substitute for listening to the audio.
Marco Campana 0:00
Welcome to Episode 27 of the technology and Human Services podcast. In this episode, I’m chatting with a few folks from the Somerset West Community Health Center in Ottawa, about their experiences with digital equity in virtual care. on the line with me, we’re Sue Merrill, manager of quality improvement planning and evaluation, Lisa van debunker, digital equity and virtual programming project assistant, and Magda Osman community health promoter. I connected with Sue late in the fall of 2020, after I saw their request for proposals for a digital equity and virtual programming capacity building project. Digital equity is something that has come to everyone’s attention during the pandemic as a huge issue and challenge in many communities, including newcomer communities, it was exciting to see an organization formally tackling the issue in our sector. And I wanted to learn more. Fast forward to June 2021. And we have all learned a lot, it seemed like a good time to find out Somerset West Community Health Center’s experience with their project. And while we can all learn from them, as you’ll hear, they’re still learning. But what would they have implemented with a little bit of funding is valuable for us all. I hope you enjoy the conversation.
Marco Campana 1:03
Welcome, Sue. And Lisa to the technology and Human Services podcast, I’ll let you both introduce yourselves, the organization you’re with and the work that you’re doing, and then we’ll kind of dive in.
Sue Merrill 1:13
I’m Sue Merrill. I’m the manager of quality improvement planning and evaluation at Somerset West Community Health Center.
Lisa Vadeboncoeur 1:22
I’m Lisa Vadeboncoeur, and I’m the project assistance for the digital equity project that we are currently running. Great, thank you both for joining me. And this all sort of came about because of an RFP that I came across, I think, on charity village probably almost a year ago, where you were really looking to it and this was, you know, after we’ve all pivoted, we’re all working digitally working remotely. And you put out an RFP for a digital equity and virtual program, capacity building project, which really caught my eye because as we were doing some work, even before the the settlement sector technology task group,
Marco Campana 2:01
the idea of digital equity and digital inclusion and the digital divide had really started to come to the fore in our sector. And I think in a way that perhaps it hadn’t in the past, we were all kind of aware of it. But I think with with the complete pivot remotely, it was something that all of a sudden, we were all faced with both within our organizations as well as in communities. And so I’d really love to maybe you can give us kind of an overview of where that came from and how it started and, and why.
Sue Merrill 2:30
Sure. So when like everyone else, when COVID hit, and we had to pivot non essential in person services to something virtual, we just did what everyone else did, we tried our best and some stuff kind of picked it up really quick, Trevor had a gift for it, other people had no clue. And so we just we, we started with what I call our first phase, which was just jumping in and doing the best we could with what we had, which wasn’t a lot, no dedicated staffing, no funding, no specialists. And we just gathered the people who seem to be good at it in a kind of cross team community of practice to share tips. And we volunteered to put down in writing little cheat sheets for those staff who were struggling and trying to like, just help each other, build our capacity from whoever knew the most already and spread that out. But it was clear that there was a lot more that needed to be done, especially when it came to supporting clients. And we knew right away that there was one thing to get our our services pivoted and get the staff trained to do it virtually. But there were a whole bunch of clients who wouldn’t be able to participate because they didn’t have the device or the knowledge or whatnot. So we knew we had some donations early on of devices. And we thought, Okay, great, we’ll get these out. And that’ll solve all our problems. And we learned really quickly that having devices did not solve our problems. It just showed us how much work it would take to bring real equity around technology that it wasn’t just about a device, it wasn’t just about a how to sheet, it wasn’t just about helping a client learn to use zoom, it was a really complex piece of work. And because we are focused on removing barriers to people who are vulnerable, we do it in all kinds of other ways. This became very quickly a priority for us to figure it out how to how to build equity. With this new technology when none of us, none of us were experts, we really hadn’t thought about it before. So that led us to this idea. We had a small grant that we had we could use for whatever we wanted from TELUS and we thought this would be a great way to learn more. It wasn’t enough to buy devices at that point or not more than a few devices. So we thought we would use it instead. to hire someone to really help us get our act together and build our own internal capacity, learn more and to really map out what the barriers were around equity for for different client groups because no one was the same. Some people needed a phone some people had a phone but that was too small. If you’re a Chinese senior, you’re needs are very different than someone who’s living in a rooming house. So we use the the RFP in this project to really map out the different barriers, the different needs and the different types of pathways that would help different client groups get closer to an equitable digital participation. And at the same time, we recognize that our staff, many of our staff represent the clients we serve. They’re working from home, some of them had the same barriers, I had some of the same barriers, I didn’t know how to use a lot of the technology I, we didn’t have the best broadband at home. So we also had to work at internally, building our skills and figuring out our own technological challenges. So that was phase two. And through that whole time, we knew we needed more devices. But we also knew that we needed staff support to really work that whole complex process. So we wrote some, we wrote a series of different proposals, and we were lucky to get to funded, which allowed us to hire what I call a digital equity and virtual programming team, project manager and client support folks, three people who really have spearheaded this thing. And that’s when we saw some really big changes and really big impacts because they can support the staff, they can match and do much more detailed needs assessments, they can do the procuring and the researching and the trial and error and problem solve and monitor the use and provide support to the clients. So that’s where we’re at now.
Marco Campana 6:36
So I mean, it sounds like there’s, there’s there’s so much to unpack below the surface of what went into it, but but even just the investment, so a team of three people to help support both staff as well as clients. We’re hearing a lot from from other organizations that they’ve either had to repurpose staff, or get a short term amount of money, whether it’s from a foundation or even from, from a main funder to create digital navigators to create other kinds of roles. And, and so I wonder if we can step back a little bit to look at when you brought in the consultants, what that what that process was like, and what it what it did for you, because I know that a lot of organizations are even a year into this are still trying to figure out how to get it right. You know, what, what are the what’s the right way to build a foundation, we’re all just kind of doing, and we want to be able to evaluate it, we want to be able to figure out moving forward, this isn’t going away, you know, we eventually we won’t be fully digital, and some already aren’t, but will be hybrid, we’ll be using technology more and more. So I’m curious about the value of having somebody come in and work through a process with you and your staff, and what that looks like,
Sue Merrill 7:36
the very first step, when we hired the consultant, what the first thing that that meant was, I could oversee the direction, which was around equity and quality service, which I know about. But I didn’t have the expertise to lead a project about this, I was one of the people who needed training. So that already helped me right away, because then I could focus on what I’m good at the strategy and getting people engaged across the organization, looking for funds, looking at partnerships, that’s my role. And the consultant became a subject matter expert who could really drill down meet with the teams figure out what they needed, make suggestions that they might not have thought of come up with some responses. They also, you know, through talking to the teams realize that a lot of people were ready for a little more training on engagement that like using the tool is one thing, but using the tool effectively. So having a screen of people who don’t talk and nobody says anything. You know, we wanted to get to that place. Now. We’ve got people on But now what do we do with them? So so she did a we called them?
Marco Campana 8:41
I think you told me they were the digital cafes.
Sue Merrill 8:43
Yeah, digital cafes. So we wanted staff to have like an informal interactive approach to training not like we know, there’s a million Google like there’s a million YouTube videos where people if they were really wanting to, but it’s always the early adopters who do that stuff that we’re working with the people who aren’t going to do that I’m not going to Google a tutorial, and we’ll go through it. So we did it. So as interactive groups where we could practice stuff, and she could show us how things work, she talked about things like turning off the camera because it leads to zoom fatigue, and that that’s okay gave some good strategies for how to engage people using the like buttons and the emotional because the research has shown that if you don’t engage them quickly, they tune out or they multitask. So lots of good tips and tricks that was really one of the first cafes we did. And then through all that we also did a design lab on how to really like come up, we came up with sort of profiles of clients and the type of barriers they would face and made it real and then really talk through what would be the steps overcome those barriers to the digital divide and the inequity. And that helped us really understand the complexity more and point to solutions. So that by the time we got money for devices, we could jump to the what I call the phase three, which was building the capacity of clients to be able to access a device that worked for them to have Access the service that they wanted to access.
Unknown Speaker 10:03
So in many ways, you’re playing an entirely new role as an organization as a technology mediator, facilitator and supporter, which is a huge learning curve. And so it sounds like it was helpful to go through that process, but also then to get some funding to create this team. So maybe we can speak a little bit to the client side of what that experience was like, because again, you serve such a diversity of people, and some more vulnerable than others, some more digitally literate than others, etc. So what that what that role that was kind of looked like and what it’s been, what it’s been like, since you’ve been able to implement it, and in particular with the team, Magda, do you feel comfortable just even giving some examples of the kinds of supports or different things the difference it made for clients off the cuff? Well, yeah, absolutely. Hey, hi, everyone. Welcome. Thank you for joining us.
Magda Osman 10:51
Thank you. So I am a health promoter at Somerset West. So I work with within community development. So a lot of the
Magda Osman 11:01
community members that received the the devices were mainly people in need of laptops. So we didn’t distribute any cell phones, flip phones, smartphones, or, or tablets. Because they were predominantly families. And it was a lot of people in one house, usually just one device. And that device was offered through the school. And then when lockdown wasn’t happening, I’m not 100% sure if they were required to return it or not. So there was just a lot of questions about what was happening with the devices from the schools. We were hearing incidences of like mothers who were doing schooling online, virtually through their cell phones, doing all their courseworks, you know, project work everything, writing essays, everything off their cell phones using Google Docs on their smartphones. And we can imagine how challenging would be to write an essay on a smartphone. And that’s the kind of context they were living in working in and then trying to navigate. And then we also heard, families tell us that it would having this device would drastically improve their quality of life. Because it would allow them to connect to more services that were taking place, virtually, it would give them a level of autonomy, where instead of having to depend on others, or calling other people to get those supports, having that device would give them back a sense of control and autonomy throughout their day to day life. And then also, it would kind of mitigate some of the risks that they were being exposed to without a device. So their services were that are offered completely virtually. And in order to sometimes access it, they’d have to come into the office to connect with a staff or things like that, but if they’re able to do things virtually, they’re not having to take public transportation or things like that, they can have that virtual connection. So we did see a lot of positive impacts there. And I do know there were some other people who needed cell phones from my team. I I’m not connected to the, to those individuals, but I do know, it was distributed. And it was a really big issue that people didn’t even have cell phones to connect with people and they they couldn’t connect with neighbors they weren’t able to access Food Bank because everything you have to call in advance now. They getting access to the most basic needs was a huge barrier without that device. And the way we even found out that that was a barrier was when the income tax clinic happened. And to I see you nodding so I heard this secondhand Sue, if you have more context, please jump in. But people were like sharing their neighbor’s phones or friend’s phones. And they we book an appointment with them to try and call them back. But if they weren’t with their friend at that exact time, we couldn’t get ahold of that person anymore. So like
Marco Campana 14:19
old school party lines, one phone line for the entire building done a thing, right?
Sue Merrill 14:24
Wow. Yeah, we had it. Sorry. Go ahead. Sorry. No, please jump in. I was gonna say we’ve heard a lot of that like I don’t think we realized how many people relied on neighbors for phone communication. But back before I think it was still a barrier like you said, but it was hidden because people would just do things in person. But once you remove the option to do it in person, they are suddenly completely cut off. And so we were amazed at how many like we have we have primary healthcare as well as social services and all the all the docs are making their appointments by phone now, and so couldn’t even reach people to make their appointment. So there was a For the Ottawa, new comer Health Center, and that’s what she said she was totally relying on her neighbors to make her doctor’s appointments and to find her. And so with the lockdown, she couldn’t access any of those. So the phone was like this enormous freedom. And then she, like you said mega, then she tapped into all kinds of other things. She could join other groups. She could call her, her neighbors, she could have social things, she started learning sup to you some apps, so she wasn’t so isolated. But it started off as like, how do you how does she even reach her doctor, we also had an example of someone who, again, they were getting specialized COVID testing through us, but they didn’t have access to a phone. So we didn’t know how we would reach them. And so we gave them a phone while lent them a phone. And sure enough, they tested positive. So we were able to reach them, get them into voluntary isolation, connect them to all the wraparound supports, but like just letting people know they tested positive would have been impossible. It’s amazing. And I mean, it’s, I think it would be, it’s probably shocking to a lot of people to hear that the phone, having a phone, forget the internet, but having just a phone, and a phone line was a barrier,
Marco Campana 16:07
I think we have a sense that everyone at least has a phone. So you can at least make calls and things like that. But even the cost of a phone, whether it’s a landline, or a cell phone, even a basic cell phone is out of some people’s reach. So that I mean, that’s not something we heard a lot of because in the task group, for example, we heard a lot of stories of they don’t have internet, but they have a phone. So at least we’re talking to them on the phone for hours at a time to help them feel less isolated to give them that kind of service. But and Maggie, I see you shaking your head. So in this case, it was actually people who didn’t even have the device. You know, forget the device, they didn’t have a phone line, not even a landline, for example, to be able to do this so that the vote the incredible vulnerability in those situations, and your ability to identify that is it when we think about technology, we’re all kind of thinking high up. But this is like basic, basic foundational stuff that people don’t even have in the community. That’s, that’s amazing. That’s fascinating. That’s why I’m sorry, No, go ahead.
Magda Osman 17:02
I was gonna say even before the lockdown, a lot of community members would come into the community hosts, or community spaces and request to use their cell phone. And it was always an issue for us to get in contact with a lot of our clients, because their phones would be disconnected on and off numbers would constantly be changing, things like that. And like we would have several other relatives listed things. So there were work around, or you could just knock on their door. But then when the lockdown happened, I remember we all went into panic mode because we’re like, how are we going to get a hold of people knew their situation, kids. Already, we’re having trouble with completing homework, if it was being sent through Google Docs, with their schools, and this is before lockdown. Because they would have to come into the community house to do that, or print off their homework or access internet. So we already knew it was going to be an issue. And we went into like crisis mode advocacy right away. Because we knew people were going to fall through the cracks because this equity, digital equity was an ongoing issue.
Marco Campana 18:12
It was already an issue Preet predating COVID, obvious I’m wondering Magda as well, you talked about giving devices to people. But what about connectivity? So for example, in some cases, just the phone is enough, and they have the phone, but then internet an internet connection? Was that something that you were also able to offer them or, or help facilitate in some way?
Magda Osman 18:32
So do you want to answer that a bit more?
Sue Merrill 18:35
Yeah, part of what made this project so complex was trying to figure all that out. And it turns out, it’s actually really hard to get internet for people because there’s to connect them to a provider, there’s contracts, they have to have a modem or router, they don’t know how long they’re gonna have that deal. Even if you can get a good deal, they’re nervous that they’ll go over. So even though it doesn’t feel like the best long term strategy, what we ended up doing was using a variety of either data plans or and this is where at least I might be able to answer this I can’t there’s like firestick, there’s a mobile hotspot, I don’t know, we came up with different ways of getting people so that they could use the device without having to install something in their in their apartment or their home,
Marco Campana 19:16
right or have a long term contract that they have a year from now, there may not be able to sustain for example, right.
Sue Merrill 19:22
And I think this is where, you know, I’ll be taking part and hopefully our center and other people will be trying to take part in some of these more collective impact and advocacy initiatives. Because really, really, you know, we know that from an equity point of view. Free quality broadband should be a fundamental human right now, like we cannot function without it. So we’re it’s like we’re taking buckets of water to people instead of giving them plumbing. You know, it’s I feel like that’s what we’re doing. And we’re doing it because that’s the only option we have in the short term, but it’s not a sustainable practice to be buying data plans and devices for every single person like You know, that’s that’s not the way to solve this problem. Well, no one I mean, we can respond in the in the crisis.
Marco Campana 20:07
And that works for people who you’re serving, but there’s plenty of people who don’t take good services anywhere necessarily. So how do they access? So if it’s not fundamental, if it’s not a human, right, and and everyone has access, then it’s still, it’s still an inclusion issue, right? Because if I’m getting services from an organization that has digitally become literate, and has a program that lends you the devices and bandwidth, and I mean, the learning curve is so steep for the organization itself, and it takes away from your, in theory, from your basic kind of reason for the services that you’re offering. And even though you’ve been able to kind of deal with it, and in fact, thrive in this, it’s a it’s a massive shift in the way that you you do your work. Whereas if it was something more fundamental and baseline for everyone, then you could work with people around digital literacy, but not necessarily on digital access, for example, right.
Sue Merrill 20:55
actly Exactly. Which would be more our wheelhouse, I think, you know, because we do that kind of work. And it’s, uh, you know, I, as someone who writes a lot of our funding proposals and tries to find resources for all our gaps and services of the emerging needs. This is a this is a challenge for me, because every time you go, there’s a limit to how much we can ask for we just went through it with a big ask for the City of Ottawa. And do I asked for digital navigator? Or do I ask for a mental health counselor, what a choice to have to make the choice I have to make, and I can only ask for this amount of money. So in the end, you know, I didn’t actually include much around digital equity. And because I do see, it’s important, but I do feel like it’s going to be maybe one of the long games where we’re going to have to keep building our internal we’re gonna have to, I think staff will probably often have to piggyback it on their rules, or we’ll do like we did in this situation where we say we hired a digital equity team. But basically, Lisa is really great at this stuff. She was already working part time for us, we we just switched her role we redeployed her, but it’s still part time, and it’s not ongoing. So that’s not a great thing. We had someone else who works four days a week running a program for Chinese seniors who’s very tech savvy. So they spend one day a week now doing digital navigation for those clients. But that’s only because they were part time,
Marco Campana 22:16
when also because they had the previous technology. It’s the serendipity week, again, we hear this a lot in settlement organizations, there was an admin person who happened to be techno literate, and like teaching other people technology. So we shifted her role. And then there are organizations where they didn’t have that capacity. And so they’re still struggling with clients and with staff to deal with all of this. So that whole inconsistency across it’s based on Well, you happen to have someone who can do it on the side of their desk. And now we can formally recognize that, but that’s not sustainable at all isn’t. And then the competition for dollars if like, if you’re going to a core funder, well, eventually everyone is going to have a digital component to their job. But that requires itself baselining and training and getting people comfortable. Because not everyone certainly is comfortable with technology. But in the interim di D, what choice do you ask for a mental health professional or a digital professional and like that, that’s a terrible choice to have to be forced to make? Yeah, for sure. I
Sue Merrill 23:09
think if we all had, you know, in the olden days, when there was a bit more admin staff, there was a bit more infrastructure support, we could probably absorb that a lot better. But we’ve all been cut down to the bone, right? So there’s very little non direct service budget, right. So that’s like why I even took this on, because I’m one of the few managers who doesn’t have a whole huge amount of program and response. So I can look at the cross team responses. But it’s, it wasn’t part of this job prior to COVID. But I think it will be an ongoing part of this job now is to kind of keep digital equity on the on the map. And luckily Somerset West is unique in a lot of ways, and that we have a cross team equity committee. So what I’ve been doing is bringing this work to the equity committee just because we look at all kinds of other things, we work from an anti oppression framework. And this is one of many systemic barriers that that impact our clients. And so just like we do in all kinds of ways, we might give a bus tickets for a transportation barrier or hire a cultural interpreter or people with lived experience for other access. Now, we need to build in digital equity. So we need to find ways as a center to address it. But we also need to be supporting a different approach as a society so that we could do less of that and more of just the drink service, which is what we’re here for.
Marco Campana 24:32
Right? I wonder if you could speak a little bit though, to the internal capacity, because you did spend a bunch of time with the consultant in getting staff up to date. And I know that in some of our previous interactions, you sent me some schedules even of like, you know, with some of the Chinese seniors on zoom or on WeChat and different technologies, and what some of the successes have been around being able to pivot with those clients who you were either IE you were either either able to get up to digital literacy or they already had it and then perhaps even with just with the device or In the process of shifting your programming, how you’ve been able to continue to serve your populations?
Sue Merrill 25:06
Yeah, so one of the things we did in the phase one, the jumping in is, you know, we sent out a Google form to all the staff and just said, Can you fill this out? If you’re doing something virtual, because we didn’t even know how many people were doing it, we had no idea. And back then that was within the first couple of months of COVID, we found that there were 45 different activities being offered across the organization, which just blew my mind, I had no idea. They were like, you know, from Chinese line dancing on zoom to, you know, circle time, playgroups to like the Children’s Services had started a YouTube channel where they just put stories and music that people could access parents could access anytime, a real variety of neat things happening. So then we use that Google form to say, Well, what else would you need from the organization, and that’s the place to train us show us how to do this. And devices for clients. And so that’s when we did the RFP. And then through the RFP, I think we started to build this kind of community of practice, which I think has been one of the real silver linings of COVID. As an organization, we’re quite big, we’ve grown a lot. And it’s harder to keep being integrated across. We’re a one stop shop, a hub, which is a strength. But when you get too big, sometimes it becomes almost like every program can become its own little silo. Right? So I think what’s happened is this work crosses everybody. Everybody’s got a way they have to deliver whatever they did before even the docks, right. So I think what this did is it one, the consultant was able to bring us together and give real training and one on one coaching, recognizing that there was a digital divide even on our staff. And so for some, some staff, they just needed to have someone asked questions and point them in troubleshoot. I think that helped a lot that they had somebody they could go to, because before that nobody knew who would you go to. And then we had these regular meetings of people who were you could share tips and kind of identify issues and whatnot. So I think that just helped build our conversation and our knowledge base around it. We’ve been collecting a lot of tools that other groups have done, and Lisa and the consultant are, are putting this in a sort of iterative Handbook, which will have everything that staff will need. So we’re hoping that that will be the go to resource when the project’s over. If we don’t, if we’re not able to sustain hiring a specialist, whether it’s a consultant or staff that they’ll at least be a an online toolbox that really has all this. So I think in that way, we really have built our capacity. And I feel like I’ve learned a lot more to so I can kind of start building some structures. What I am worried about is the idea of the client support, I think that’s going to be an ongoing need this digital navigation as the term, I think we will need that it is a different skill set than frontline service delivery. And I don’t think it makes sense to have trained all our staff constantly to show people how to get on zoom, I think it’s almost like a, like you have an IT help desk. It’s almost like we need a client digital navigate hell. So that’s what I see is the ongoing need that I’m still not quite sure how we’re going to
Marco Campana 28:11
sustain. Yeah, no. And I think that’s a long term issue that I think all funders are kind of trying to deal with as well. So Lisa, you want to jump in Go ahead.
Lisa Volkow 28:18
I just just to add to that, I think, from what we’ve seen from clients is their family will often step in to help them which one of the, one of the teams, I was supposed to support the clients. There was 10 tablets. And we’ve, after they were delivered, that the tablets, the families were will help, will help they were mainly seniors, so we will help them. So in the end, they didn’t really need as much support as we had anticipated. So but these again, are it’s a learning experience of Oh, okay, well go within try and find the resource if you can, but if not, yes, then there might there would be a need.
Marco Campana 29:04
Yeah, and I mean, it sounds like you have to kind of plan for there to be a need and hope for the best. But if you don’t plan for that, and there is a need, if all of those 10 all needed your support, then you would have had to provide it in this case, it was useful because you had community members who could help or family members, but but you still have to at least anticipate, you know, the lowest level of of literacy in some ways, or else you won’t be able to serve them. Right.
Sue Merrill 29:26
And I think there is a role for volunteer engagement and this is just that again, in a crisis situation to it. There’s resources and time and, and work that go into finding recruiting, screening, onboarding of volunteers. And so that doesn’t happen. Like it isn’t a replacement. You know, it’s it’s a it’s a longer term strategy as well, but it, it has its own work associated with it. And I did find that challenging during the the COVID, especially during lock downs, you know, to try to find and sustain that kind of support. So that was why in the end by phase three, I was like, I need a team, I need that to be a job. This is a job. This isn’t like a nice to have this extra complement. You know, and I think there’ll be roles for volunteers. But again, I think if you’re Reliant for a service delivery, that’s not the role of a volunteer to be
Unknown Speaker 30:18
well, uniquely service provider. Well, you
Marco Campana 30:20
also need to you need consistency in that service. And you can’t, I mean, again, you either all of a sudden, you’ve got two volunteer coordinators, because you’re trying to turn people through because there’s always turnover, or you just have that money as as to hire a digital navigator or to for example, in it and sell priorities. You know,
Sue Merrill 30:37
there’s a lot of risk management around that too, because you’re helping, like, even if you get volunteers to set up the devices, well, like, what if there’s some kind of, you know, there’s all kinds of privacy and security issues that have to be managed? And I we don’t have the expertise to even manage? You know, it’s like, I joke about like, people would ask me, if I put controls on my teenagers, computers, it’s like my teen. And I would have to ask my teenager how to put the control on the computer, right? So we’re not even in a position to monitor a volunteer. So So again, we still need to leave, you still need subject matter experts, you still need people with technological know how and then maybe you could build your team to include some some key volunteers. So I do see that as a longer term strategy, erase.
Marco Campana 31:20
It does raise a really important question, though, that comes up a lot, which is in particularly because you’re in the health sector around privacy, security and confidentiality. I mean, in your case, in some cases, you’re managing personal health information. And there’s legislation about the privacy, the paida and fippa, for example, in settlement, people are still trying to figure that out. They just so many different kinds of devices, so many different kinds of technologies and channels and modalities, how have you been able to deal with that in in training staff and interacting with clients and ensuring that the tools and I remember in your RFP way back when there wasn’t a couple of technologies that we you were you were either already using or wanted to look into, which are specific to the health sector and have encryption and security baked baked into them? Is that something you’ve continued to explore?
Sue Merrill 32:04
Yeah, this is where another like when I think about the phases, the first phase, we did cheat sheets, we kind of asked what other people were doing. And basically what we decided was most of the platforms. For Non clinical, we cannot use zoom or any of these things for anything clinical or where private health information will be discussed, you have to use the OT n, which was very buggy at that time and not user friendly. But that was like a hard line we had to draw because of the privacy. But eventually, we migrated over to a new EMR that was electronic medical record, pa suites, which has a virtual component that’s much more user friendly. So once we had done that, which had nothing to do with COVID, we were just on track, then people that got a lot easier for the medical and clinical there were still there’s still a desire for a zoom version that is HIPAA compliant. And we’ve been in talks with zoom through some of our partners and networks. And it’s been very complicated to find out whether or not it really is football or not, is it USB? Like it’s very hard, and it’s very expensive. And we have not landed there yet. So where we have very limited tools for clinical work for non clinical work for group we’re doing what a lot. The first phase, a lot of what people did is we basically read a waiver, we said, virtual is not as secure as in person, we cannot guarantee that this will be jumping, we cannot guarantee you that, you know we can just give you and then people have to make informed consent to stay on.
Marco Campana 33:34
But that’s important. And being able to have that conversation and have the literacy internally to be able to talk to clients about that is that is essential, right,
Sue Merrill 33:41
very early on, we came up with a script that we would all share different people tweaked it. And then over time, we came up with a basic guideline for staff that said, This is what you have to do you have to read the statement out you have to and we we did subscribe to zoom Pro. And we we gave recommendations around using waiting rooms, and we had a couple of zoom bombings. And then we had like debriefs on what people could do. But still pretty much letting the staff other than the following the script not being able to do whatever. Now we’ve just heard from our sort of sector, that more stringent guidelines have come out around virtual and there will be expectations that we are now meeting a higher. So that’s actually the phase we’re in now, even even for the non clinical pieces. Yeah. Yeah, I think it’s mostly built for the clinical. It’s just that, again, we’re a health center. And you know, if we’re doing a wellness group with seniors, I think we’re getting to the place where we’re saying we really should be using. We have to balance the privacy for those groups with accessibility. So we’re
Marco Campana 34:42
huge, right? Yeah,
Sue Merrill 34:44
we have to we don’t want to create we know we can make it the most secure thing possible and no one would get on it and then that would be going against our equity lens. So we have to do this. So right now I would say there’s, we have somebody internally who’s working on our some of our policies. So we’re going Back to those policies and making sure there’s a section about virtual because we already have policies about privacy and security and informed consent. Now we have to make sure we add and then it maps to what the requirements are. So now we’re having to get a little more technical and a little more tight. And, and then we’ll have to do training with staff about that and make sure people know, okay, it was the Wild West at first, and this was good enough. And now this is the new normal and moving forward, we’re gonna have to do it like this. And so I think that’s really the phase. That’s one of the phases we’re in now and having to make some decisions organizationally about where’s the where’s the line between access and privacy? Yeah, I mean, that we feel comfortable. It’s all risk assessment, risk management,
Marco Campana 35:45
right. And again, I think a lot of organizations, it’s useful to hear that you’re going through that process, and that you’re, in fact, still kind of, and I think this is cyclical, too, because new technologies will present themselves new clients and the technologies they’re using will come into into our agencies, and we’ll be re reassessing risk constantly and changing it over time. So it’s like, it’s a new skill that is becoming part of your institutional kind of approach.
Sue Merrill 36:07
Exactly. And and that’s why I also think that there why you need somebody on your staff who can be really like be the advisor to this stuff. That’s been it’s been hard for us, we don’t have a go to we have a privacy officer, but they’re not. They don’t know about zoom. And so we so the the digital equity team has been playing that role for us, we we bring issues to them and say, Can you guys look into this, and then they talk to people, and they do some research? And they kind of, you know, come back with some recommendations. So and yeah, like you’re saying, like, the zoom came up with a new platform. So we’ve already ruled it out for clinical when they came back and said, Now we have something and we’re like, okay, let’s take a look. And then yeah, so I think it’s gonna be ongoing, you know? Yeah, I think it’ll be an ongoing.
Marco Campana 36:47
No, absolutely. And I mean, I think it’s great that you have the team and the subject matter experts, who have the time and space to kind of do that investigation as well. And I’m curious if you’re having conversations with other organizations, you mentioned, you’re getting some guidance from your regulatory or your, your association framework, is this something that you’re also having a conversation, you know, across with other organizations that sort of share your learning build a bigger community, for example?
Sue Merrill 37:12
Yeah, we’d like to be able to do that, especially because we did get funded to to really ramp some stuff up, whereas we know, some smaller organizations did not. So it’s partly why, you know, we take part in this podcast or an interviews and try to, you know, share, we were on the live call things to you. And I think, you know, at some point, we’ll probably put it out there a bit more like for the coalition of community health and resource centers and share some of the tools, especially when we get the handbook done, because the handbook we were working on, we saw a wealth, a community health center, and golf had had done one, and we really liked it. But we wanted to make it more custom to what we’re doing and what we’re learning. So I think we’ll do the same thing, try to share it out. As opportunities arise, we don’t have a sort of concrete plan at this point. But that’s kind of like I guess, phase four, is once we come up with our policies and the handbook, and we’ve really like nailed, I think we want to do a little, you know, knowledge transfer an exchange with some of the partners in the sector. And see, I think the other thing that I’m just starting to do is the Social Planning Council of Ottawa has a sort of new kind of collective impact approach in partnership with the National Capital Freenet Association, and they’re really looking at how to build, like, as a sort of planning. So I’m gonna sit on their Advisory Committee for that. So I see a lot of that kind of work sitting there. You know, we’re like one example, we’re but we’re a service provider. We’re one one group, we’re not like taking this on for everybody. But I think that that table, hopefully, I’m hoping that they’ll be having, they’ll be bringing people together convening, and giving opportunities for this type of sharing and strategy development. I know the Alliance for healthy communities, like our sort of Association of Community Health Centers, they’re developing a digital equity strategy and what they call a playbook. That will include kind of like community based response, but also advocacy and system based response. And they’re looking at also like targeted advocacy at different levels of government for different types of the strategy. So that more big picture systems piece, they’re kind of steering. So I, you know, I see us as kind of feeding into each of those. Well, sure, with your practical experience pushing it up to, you know, to help them make policy around. Yeah. And then we can try out some of the tools that other groups have and see if it works for us, you know, and because that’s always what’s frustrating with this work, we know that everyone’s struggling with the same thing, and that probably something exists somewhere that we don’t invent, but then you have to find it, you have to compile it, you have to figure it out. So sometimes
Marco Campana 39:44
you have to take all of that time and it may not be the right tool and the answer you’ve spent I know Yeah. It’s it’s, it’s a huge issue for sure. Because there are so many tools, right. I know that an employment or youth employment project, I think they compiled a database of 300 interesting technology tools that People were using in the sector. And it’s impossible for someone who’s just getting started to look at that and say, Well, I don’t even know, like, how do you even assess them? You know, like unique pages and interviews and documentation before you can even decide that this is the right tool. And before you dive in and spend money and time and resources, and you know, very few organizations have that capacity in terms of not just competency, but the capacity in the space and time to be able to do that, right. It’s a huge undertaking. And then of course, it all changes, right, like zoom is a great example, how much it has changed from the beginning of last year when it was the thing, and then No, it’s not secure, and now it’s encrypted. And now it’s, you know, more secure. And I mean, it’s, it’s hard, you know, even within one tool, how much it can change over a small period of time. So it’s hard to keep track of right.
Sue Merrill 40:44
Yeah, and maybe you might be able to speak more about this too. But the other thing we had to learn is that there are tools that communities are comfortable with. So sometimes we have to learn those tools, like WeChat is a very commonly used tool and a lot of, say different cultural groups. I don’t know, I don’t want the Chinese community. I don’t know exactly who uses what, but I know that when we got our like our community of practice together, it’s really, really interesting. Because there was some people, they’re like, Oh, yeah, no, my committee wouldn’t use zoom, we use WeChat. And I was like, Oh, I don’t even know how WeChat works. So, so a lot of it was like, What is the staff know, what is comfortable with? And let’s go out or what’s the community know, uncomfortable with? And then you know, so trying to make people you fit to yours. So that was why we opted not to be like, top down at the beginning, people were saying, Well, what are we allowed to use? What are we supposed to use, and our group met, and we’re like, well, we can’t find any significant differences, actually, between any of these, but like, they’re all they all have their, their potential risks. So we decided to go with what you’re comfortable with what your clients are comfortable with just the script and you know, do do what you can do. And again, I don’t know if you know, once we do this next level of looking at things, if we’re going to need to say, Oh, geez, some of them really have dropped down, and we can’t condone that. But I think for a lot of our groups, we can still do that. Like there’s social groups there. They’re connecting groups, they’re not highly personal. And I also thought that when we move to a hybrid model, where we can start doing some things in person that will free us up also to maybe do anything that’s a bit touchy we can do in person, and anything that’s a bit more like the extra and social connection and less risky we can do. Virtually. So
Marco Campana 42:24
yeah, and I think you make a really important point, there’s, there’s a lot of struggle with getting new clients and the technology they’re using, or do we make them use something we’re using, right? where a lot of organizations, for example, you know, teaching clients how to use email, because they weren’t given permission to use WhatsApp, and WeChat and Facebook and things like that. So they spent a lot of time teaching them a technology that inevitably will be useful for them down the line when they’re seeking employment, and you know, all those kinds of things, you know, an email address is different in North America than it is in some other countries in terms of importance, but in the moment, what would what would they prefer these perhaps would have been the solution to meet the clients where they’re comfortable instead of taking them out of their comfort zone in particular during a pandemic? So so that, yeah, that that that pressure? I hear a lot of that from other organizations as well.
Sue Merrill 43:10
Well, the other thing we learned, especially with some of the seniors, you know, when we first got this money, we thought we would, you know, we’ll we’ll get we’ll get devices into the hands of clients. And we’ll just get a zoom plan for two or three months just to see if it if they get it and they’re using it. And some of the seniors just said, Well, I’m not going to learn this new thing for two months. Like it’s not worth it.
Marco Campana 43:30
Right? Yeah. Fair enough.
Sue Merrill 43:31
First things that came back, like, expect me to do all that you might like, cut my plan or take this before like, Oh, Okay, nevermind, let’s, so the first thing that team came back to me and said, Okay, can we can we budget to get data until the summer? Like, let’s give them four days? And I was like, oh, okay, so that’s what we did. And then we bought fewer devices, but we tried to give more time for adoption. And so yeah, so I think we’re learning so many things as we go. Constantly. Yeah. So we had, we had, you know, seniors who weren’t using their device. And we finally were asking them what was happening and they were afraid of breaking it. And because it was a loaner program, they were, they were terrified that so they didn’t use it. They. So then we now we’ve ordered cases. And in fact, I just got one delivered lease, I gotta bring it in for Karen to test out. So we’re trying to like, like, meet all these different things that come up and say, that’s probably anticipate,
Marco Campana 44:30
how could you have anticipated something like that as a barrier until it became a barrier? And so it’s just so much in flux constantly. That’s, wow, what a great story is there? I’m aware of the time and you guys, you’ve all provided so much incredible feedback. Is there anything I haven’t asked about that? You want to make sure other people understand about the work that you’re doing to share some of what you’re learning and moving forward with that would be that you think would be useful that we haven’t touched on?
Lisa Volkow 44:56
I think one piece was about the trust. We build with the clients. I know, having a someone that’s helping technical technologically, often they want to work either directly with the program coordinators or the people. They’re close to that. I mean, that’s been my experience anyway, they, they feel. So really building the trust is very important, even when it comes to helping people with their devices, and that they still want to talk to someone they’re comfortable with.
Marco Campana 45:29
That’s it. That is a really good point. Yeah, trust and building rapport. Again, we’ve heard during the pandemic, in particular, with new clients, it’s really hard to build that initial kind of rapport and trust with someone who your own that you’ve never met, you know, face to face in person, just only virtually. So. Yeah, that raises a really important point Magda any any final thoughts or suggestions?
Magda Osman 45:50
Yeah, Lisa triggered my memory with the trust piece. Absolutely. So we were having clients that we couldn’t connect with. And it was really hard to connect with. And even when we would door knock, they wouldn’t open the door or answer or things like that. And then we would come around with the device, and then their whole mood changed, the whole relationship changed their trust change, because so many times like, clients have certain needs that we can’t fill or support. So we just listened. So they’re like, I’m not going to retell the same story again, or retail my needs to you, because you can’t support me effectively. So for us to actually meet that gap was was huge, even though it took a while if it really made a really big difference in that trust in that relationship building for sure.
Marco Campana 46:39
So being able to provide a device was kind of like the sandwich and that, that opened it up to to then being able to have those conversations to build more, more more like client supports and services with them.
Magda Osman 46:51
Absolutely. And I think it’s not only about that it built trust, but I think it took away a sense of hopelessness from people, that they were kind of just going to be left on their own, alienated and isolated during the pandemic, like this connection was provided to them, which lifted their spirits. And then they were more willing to engage with us in conversations, even when we would do our weekly check ins, or when we would go to drop off food or have other outreach or past talk about vaccination or other things. That door was really opened because of this device. That was really, really crucial for the quality of life.
Marco Campana 47:30
Thank you for sharing that. That’s that’s incredible, that the impact of a small a small piece of technology that can have on their lives, but then also on your ability to continue to provide services to them, and to help them in so many different ways. Well, thank you, all three of you, I really appreciate you taking the time, this has been an incredibly illuminating. So every time we talk, there’s something new, and I’m learning more and more. And I think I think this is a great conversation for folks in the sector to hear. So I appreciate you sharing it. And and yeah, once your your your, your your guidebook, and and other other materials are done, it would be great to sort of help push that out more broadly, even outside of the health sector. Because I think again, there’s there’s huge pieces like 80% of what you’re doing is common to any kind of social service organization. And maybe 20% is specific to the to the health but even that 20% around privacy and encryption and things like that. I think we all need to hear it. Because I speak to our organizations, I say let’s aspire to the highest levels of that, which is really in the health sector in particular and social work as well, that that speaks to those kind of regulatory frameworks. And I think what you’re doing is is very useful for everyone in the settlement sector in particular to hear about as well. So thank you all, I very much appreciate the time. It was great to chat with you. Thanks so much for listening. I hope you found this episode interesting and useful for you and your work. You can find more podcast episodes, wherever you listen to your podcasts are also on my site@markopolos.org I appreciate you listening and if you have any tips, suggestions, ideas or want to be interviewed or know someone who wants to be interviewed, please drop me a line through my website, or marco@markopolos.org Thanks again.
Transcribed by https://otter.ai