Growth of vir­tual health care and telemedici­ne a pos­i­tive pan­demic re­sult

The Standard (St. Catharines) - - Opin­ion - DR. MICHAEL MUL­TAN Dr. Michael Mul­tan is a sec­ond year Anatom­i­cal Pathol­ogy Res­i­dent at the Univer­sity of Bri­tish Columbia

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.on­ 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.

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