Not all virtual health care is created equal
As a primary care physician, I've seen more technological progress in health care in the past eight weeks than I have in the past eight years. Change typically happens slowly in health care and can be complicated by various factors and stakeholders. But due to COVID-19, the healthcare industry was forced to rapidly adapt, resulting in a large amount of change in a short amount of time.
Research from Canada Health Infoway reported about 40 per cent of routine (non-covid-19-related) health-care visits happened via telephone throughout April and May, with another 10 per cent via video. That's half of our routine healthcare visits happening virtually, which marks a substantial increase from the PRE-COVID-19 numbers. In a 2019 survey conducted by Infoway, in-person appointments made up 80 to 90 per cent of all healthcare visits.
While the expansion of virtualcare services over the past few months has been encouraging to see, it's important to note that not all virtual care is created equal.
As COVID-19 spread across Canada, we witnessed a clear increase in the virtual delivery of care, by many health care professionals and organizations (acute care, primary care, long-term care, mental health, etc.). Now, as we emerge from the pandemic, clinical leaders are encouraging the use of virtual services that support long-term relationships with patients, rather than services that can lead to a greater fragmentation of care.
In short, we must continue to advocate for high quality virtual care, rather than a high quantity of virtual care.
Virtual care enables the remote delivery of care via telephone, video call, email or secure messaging — but that's just one part of the virtual experience. Other digital health tools support the virtual visit, including an electronic medical record (EMR) to document the encounter and an integrated eprescribing service like Prescribeit, which enables your doctor to transmit a prescription electronically to your pharmacist.
Like so many aspects of our health-care system, prescribing medications was once firmly rooted in traditional methods: handwriting or printing prescriptions and handing them to patients, or faxing them to the pharmacy. At the onset of the COVID-19 crisis, clinics were suddenly confronted with the challenge of prescribing within a virtual model, and many doctors, myself included, recognized the value of an Emr-integrated virtual care tool like Prescribeit.
But these are the lessons we can take with us going forward, as we look to improve our virtual-care workflows. With a potential second wave of COVID-19 coming in the fall, clinics will refine and revise the virtual protocols they established during the pandemic. This new way of doing things will be very useful as we look to the future.
A number of high-performing health-care systems around the world have already integrated aspects of virtually delivered services into their models of care. However, in the best ones, virtual care typically augments existing patientphysician relationships, thereby enhancing continuity of care.
Once the current global pandemic subsides, we may still be in a hybrid clinical model consisting of in-person and virtual visits. The current scarcity of personal protective equipment (PPE) limits the in-person visits that a clinic can accommodate and, until PPE becomes much more readily available, the hybrid scenario is likely to persist.
There's still a lot of work to do to enable truly virtually delivered care. But I'm optimistic that, with the right leaders and advocacy, the positive advancements of the past few months in our health-care system will be maintained, and continuously improved upon.
We're at a critical period in 2020 where virtual health care has reached a tipping point. In the future, we may categorize health care in two ways: the pre-pandemic way of delivering care, and the postpandemic way.