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Lessons on virtual care from the COVID-19 pandemic

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On August 24, the Canadian Medical Protective Association (CMPA) hosted its first “virtual” Education Session titled Virtual Care in Canada: Lessons from the COVID-19 Pandemic.

The session focused on providing Canadian physicians with essential information on virtual care. “The COVID-19 pandemic abruptly changed the healthcare landscape, and unexpectedly drove physicians and patients to widely adopt virtual care to a much greater degree than ever before,” says Dr. Lisa Calder, incoming CEO at the CMPA. “We know physicians are looking for guidance on how to manage this new practice landscape.”

In fact, since March of this year, the CMPA has received an unprecedented number of calls relating to virtual care. As use of virtual care continues to surge, it is crucial that physicians know how to leverage the opportunities of virtual care and ensure a safe virtual care experience for patients.

“Virtual care is here to stay. Our next challenge is to safely integrate virtual with in-person care,” says Dr. Guylaine Lefebvre, Managing Director of Safe Medical Care at the CMPA and Moderator of the session. “The CMPA will continue to guide Canadian physicians as this hybrid model of medicine expands and evolves, and help them navigate issues of consent, privacy, and standards of care so that they can continue to provide the best care possible to patients across the country.”

The session, which featured digital health professionals, medical regulators, physicians, and medical-legal experts, provided advice on key issues in virtual care, including:

  • Standard of care – Regulatory bodies have long established that the standard of care does not change when using virtual care. However, the standard of care is evaluated in the context where care is provided. Should a patient require a more in-depth examination for diagnosis than can be provided virtually, generally the physician will be required to arrange this prior to providing treatment.
  • Suitability – Physicians should assess the facts and circumstances and determine if a virtual visit is a suitable alternative to an in-person appointment. Sometimes virtual will be the best option and sometimes in-person will be required. More specifically, physicians will want to use their professional judgment in assessing their ability to use virtual care, with regard to guidance from Colleges on how to provide care in the current context, and be mindful of the limitations of virtual care.
  • Privacy – Virtual care can create additional privacy issues to which the physician must be attuned. The CMPA encourages physicians to follow privacy best practices. A physician’s duty of confidentiality and privacy obligations continue during the COVID-19 outbreak. Patients should also be encouraged to take steps to participate in virtual care encounters in a private setting and using a personal device/computer and secured internet connection.
  • Consent – Physicians should obtain consent from their patient to use virtual care. Such consent should be obtained following an informed consent discussion regarding the increased privacy risks associated with electronic communications as well as the limitations of the virtual context and documented in the patient chart.
  • The future of virtual care – It is safe to say that virtual care has rapidly become commonplace in the delivery of healthcare out of necessity. As physicians transition out of the pandemic and face-to-face appointments are possible, it is expected that virtual care will integrate into more of a hybrid model, driven by patient demand and convenience. Issues of consent, privacy, and standard of care will continue to prevail as some of the most important medical-legal considerations of the new model of medicine emerge from the pandemic.

Physicians with questions or concerns about virtual care are encouraged to contact the CMPA (1-800-267-6522, www.cmpa-acpm.ca) for compassionate and informed advice.

Watch the CMPA education session

The CMPA Education Session can be viewed in full at www.cmpa-acpm.ca after September 8, 2020.

This article was provided by the Canadian Medical Protective Association.

 

 

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