Virtual care was, until recently, only used sparingly in extreme remote situations. The world changed with the outbreak of COVID-19, and healthcare needed to adapt. Virtual care quickly became an expected option of access to healthcare. A survey released by Canada Health Infoway and the Canadian Medical Association (CMA) in August 2021 stated 94 per cent of physicians were currently using virtual care and more than 70 per cent felt that virtual care improved their ability to meet patients’ needs of quality and efficient care.
As we emerge from the worst of COVID-19 and many physicians resume in-person patient visits, what role virtual care should play going forward? And how can we strike the balance between virtual and in-person care?
What are the benefits of virtual care?
Many daily activities are conducted online, from shopping to banking, entertainment and even dating. It is no surprise that physicians and patients alike are looking to the benefits of providing healthcare virtually. According to the Canadian Institute for Health Information (CIHI), virtual care is any interaction that occurs remotely between a patient and or/members of their circle of care. This includes emails, telephone calls, video chats or even texting. Here’re the two main benefits of virtual care:
1. More convenient and efficient patient care
Virtual care allows a physician to see patients quickly and efficiently. Practices may struggle with crowded wait rooms, appointments that stretch beyond their appointment time, and lost time as clinic rooms need to be cleaned and reset.
A connected online platform allows physicians to access lab reports, test results, patient records and even to consult with other health professionals in a timely fashion. This convenience may decrease heavy workloads and improve physicians’ mental health.
2. Greater flexibility
Virtual care can create more flexibility for both the physician and the patient. Physicians report that virtual care allows more flexibility to work from more places. This is helping improve their work-life balance.
Virtual care has made it possible for patients to receive care more timely and efficiently. An online meeting requires no cleaning and enables the physician to see consecutive patients quickly. Instead of an overwhelmingly busy day made busier by wasted chunks of time, a physician can smoothly address a patient’s needs from a virtual clinic, regardless of where the patient is.
What are the challenges of virtual care?
There is a time and a place where real, in-person patient contact is necessary. Virtual care presents its own set of unique challenges.
1. Limits to what can be assessed
If you have ever squinted at your computer screen trying to decide if a rash looks red or just the lighting, you know virtual physical assessments can be challenging.
Virtual care limits what a physician can assess and narrows the scope of assessment. Some conditions require a physical exam, and taking vitals depends on the patient’s ability to use available devices.
2. Under-use of in-person visits
There is no appropriate substitute for in-person care when it’s needed. If virtual care is the only method a patient uses, the standard of care may fail to be met. Physicians and patients alike may run the risk of relying too much on virtual visits.
What are the best practices in virtual care?
Virtual care can work beautifully but will not work for every practitioner, every patient or every situation. As of 2020, The College of Physicians and Surgeons of British Columbia says telemedicine may be used for:
- Routine check-ups
- Follow-up appointments
- Specialty consultations where physical assessment is not needed
Practitioners must also consider the patients’:
- Internet access
- Access to a private setting
- Comfort with using the virtual care technology
- Understanding of the limitations of virtual care
- Consent to receiving care in this method
The bottom line is that as a physician, you know you can’t compromise the standard of care. If virtual care can’t meet the patient’s needs, the patient must be seen in person.
Top tips for finding the balance between in-person and virtual visits
1. Educate yourself
The CMA offers a Virtual Care Playbook that offers strategies for providing safe, effective and efficient care. You can find details on:
- How to schedule a virtual visit
- Technology needs for setting up a virtual care workstation
- Obtaining consent and consent forms
- The ins and outs of charting
Although virtual care is still a new tool, physicians can use these resources to make it a smoother transition.
2. Be safe
Incorporating virtual care includes knowing the kinds of problems that can be safely assessed and treated. The CMA says virtual care can be used to assess and treat:
- Mental Health issues
- Skin problems
- Urinary, sinus and minor skin infections
- Conditions monitored by home devices or lab tests
- Sexual healthcare
- Travel medicine
- Reviews of lab, imaging and specialist reports
The CMA does not believe new or severe emergency symptoms can be safely assessed or treated virtually. These include:
- Chest pain
- Shortness of breath
- Loss of neurological function
- Neurological symptoms
- Ear pain
- Abdominal/gastrointestinal symptoms
- Musculoskeletal injuries
Virtual care offers a unique opportunity for physicians to meet the needs of patients while providing professionals with more flexibility and access to resources.
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*Crystal Jo is a Registered Nurse and a professional freelance writer who specializes in medical information.
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