Growth of virtual health care and telemedicine a positive pandemic result
Public health recommendations amid the COVID-19 pandemic to ‘stay home’ are valid and necessary, but what should patients be doing when they get sick?
Recently I had a family member in Ontario call me in B.C. seeking medical advice because they felt socially obligated to avoid health facilities. It was great to see Canadians doing their part to practice physical distancing recommendations. I felt it was prudent for them to be seen non-urgently but found myself unsure where to recommend they go. After doing some research, within an hour of our conversation they were remotely assessed by a local family physician and on their way to a pharmacy to pick up prescribed medication. Telemedicine programs have demonstrated promising data related to cost savings and improvements in patient outcomes and access to care. A 2019 review study published in the American Family Physician found the suggestion that patients may be more satisfied with telemedicine than face-toface encounters and that access to care was improved by using the technology. The management and diagnosis of patients across a number of presenting complaints was similar in virtual compared with in-person visits.
While telemedicine programs have taken off in the U.S., the uptake in Canada has been slow for a number of administrative reasons. Provincial licensing variation, privacy concerns, adequate telemedicine training, and the inability to physically examine patients using the technology, are all limitations that have made regulatory bodies reluctant to its use outside of circumstances that necessitate it.
In February of 2020, the Virtual Care Task Force — a collaboration of the Canadian Medical Association, and the regulatory bodies of family doctors and specialists — released its recommendations for expanding the implementation of virtual care in Canada.
The timing of these recommendations is ironic. In March of the same year, the COVID-19 pandemic has required governments to expedite decision-making and to implement unprecedented legislation. Telemedicine has been no exception — The College of Physicians in Ontario, B.C., Alberta, and most other provinces have responded with new guidelines around telemedicine, and provincial governments have responded with the addition of new fee codes physicians can use to see patients virtually while maintaining maximal physical distancing measures.
Canada’s public health departments have been clear with their valid and necessary message to all — stay home if you’re sick. Recommendations and communication around isolation, return-to-work, and the self-assessment of possible COVID -19 symptoms have all been widely disseminated and are updated on a daily basis. Canadians are encouraged to use online selfassessment tools and to follow the advice from the assessment or from subsequent telephone conversation with a health practitioner before visiting a health facility.
My experience with my family member last week reminded me that patients already have a difficult time navigating the healthcare system, and it becomes increasingly complicated during a time of such extraordinary uncertainty. I think there are a number of simple things that we can all do to help avoid overwhelming our system while keeping ourselves and each other safe.
1. Continue to practice physical distancing and follow the daily advice of your provincial Chief Medical Officer of Health.
2. If you are experiencing respiratory symptoms or think you may have been exposed to COVID-19, complete the appropriate self assessment tool and follow its recommendations. covid-19.ontario.ca/ self-assessment/
3. If you have a family doctor, become familiar with their current telemedicine options — continuity of care is best. You might not need to see them today, but knowing how to access them when you need it is important.
4. If you do not have a family doctor, try to become familiar with telemedicine options — the websites of walk-in clinics often have this information.
5. If you are experiencing an acute health problem you believe needs to be physically examined by a physician, don’t be scared to reach out. COVID-19 may be putting the health of many Canadians at risk but it does not mean that during we won’t sustain bone fractures, lacerations or have more serious events like heart attacks and strokes.
Front-line health-care workers continue to come into work so that Canadians can stay home and stay safe. Let’s let the health-care workers be the heroes — if you think you might be ill don’t feel guilty about doing something about it. Telemedicine and our emergency telephone-lines are still an important resource we can all use while maintaining proper physical distancing.