Is Virtual Care the New Norm?
Increased Use of Virtual Care
When the COVID-19 pandemic struck Canada, healthcare delivery changed almost overnight. The demand for and provision of virtual care services – connecting with a healthcare provider by email, phone or video call – surged because virtual care was viewed as an effective means to minimize in-person visitation and reduce the spread of the virus. Pre-COVID-19, more than 80 per cent of care was being delivered in-person. In April that number drastically reduced to about 40 per cent (Canada Health Infoway 2020a). In other words, 60 per cent of visits are now being conducted virtually.
It is interesting to note that a variety of virtual care options are being used by Canadians who have COVID-related health concerns. For example, through April approximately 23 per cent of those seeking COVID-related care visited their family physician virtually, 19 per cent accessed the system through 811 or a telehealth line, and 17 per cent reached out to a private sector virtual care provider (Canada Health Infoway 2020a).
This increase in virtual care activity was also evident on the e-prescribing side. Canada Health Infoway’s PrescribeIT® service – which allows prescribers to electronically transfer a prescription from their electronic medical record (EMR) system to their patient’s pharmacy – saw a 24 per cent increase in transaction volumes and a 38 per cent increase in e-renewal requests (Bruce 2020). Again, a paperless, fax-less option that negates the need to drop off a prescription at the pharmacy is not only convenient, it is an important contributor to flattening the curve.
A Rapid Virtual Response
Providers and jurisdictions quickly ramped up their virtual care services to ensure continued delivery of quality care. Infoway supported digital health leaders across the country as they coordinated activity, identified priorities and accelerated their ability to respond.
To help accelerate the shift to virtual care, Infoway reallocated existing funds to create a Rapid Adoption of Virtual Care Fund (Canada Health Infoway 2020b). In consultation with the jurisdictions, we identified three priority areas for investment that would have the biggest impact in the shortest amount of time:
- Increasing capacity of 811/tele-triaging services,
- accelerating the implementation of virtual care solutions (including e-visits and home monitoring), and
- offering online mental health services.
This rapid response was possible because we were able to leverage the digital health investments we have made over the past two decades. We now have a solid digital health infrastructure to support data access, including lab results, wide implementation of EMRs in primary care, patient portals for many Canadians and the foundations to provide care virtually.
To exemplify our progress, 86 per cent of primary care physicians in Canada are now using EMRs – giving them access to their patients’ medication profiles, lab results, immunization records and the basic information they need to provide good care (Canadian Institute for Health Information 2020). Access to such essential information, from anywhere, has been critical during the COVID-19 pandemic and has allowed clinicians to continue to ‘see’ and treat their patients. Clinicians with integrated systems – which allow them to access data from a variety of sources, deliver care virtually and incorporate advanced functionality like PrescribeIT® – are even better able to provide quality and comprehensive care to their patients. And they can do so in a manner that keeps patients safe, especially those who are most vulnerable.
Is Virtual Care the New Norm?
The evidence is clear: virtual care is an effective means of care delivery. And just like some situations demand face-to-face meetings while for others an email or phone call will do, virtual visits are just one of the available delivery model options – not the only one. However, today virtual care is the safest way to deliver primary care; it increases access to care and is convenient.
The question is: what will happen in a post-COVID-19 world? Anecdotal information from clinicians and patients alike suggest that there is no going back. Virtual care has reached a tipping point in Canada and a ‘virtual first’ approach may well be the order of the day.
This is good news for those of us who have been preparing for this day for decades. A new day in healthcare is here. We are ready.
About the Author(s)
Michael Green is the President and CEO of Canada Health Infoway, a federally-funded not-for-profit organization. Michael has long been a visionary for the way digital health solutions can make public health systems more sustainable and improve the patient experience.
Bruce, J. 2020. PrescribeIT® [internal document]. Canada Health Infoway. Author.
Canada Health Infoway. 2020a. Covid-19 Tracking Survey Results. Retrieved May 11, 2020. <https://www.infoway-inforoute.ca/en/component/edocman/resources/reports/benefits-evaluation/3815-covid-19-tracking-survey-results>.
Canada Health Infoway. 2020b. Rapid Response to COVID-19. Retrieved May 6, 2020. <https://infoway-inforoute.ca/en/solutions/rapid-response-to-covid-19>.
Canadian Institute for Health Information. 2020. How Canada Compares: Results from the Commonwealth Fund’s 2019 International Health Policy Survey of Primary Care Physicians. Retrieved May 6, 2020. <https://www.cihi.ca/sites/default/files/document/cmwf-2019-accessible-report-en-web.pdf>.
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