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Navigating the future of safe, equitable virtual care:

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4 common themes tied to the expansion and enhancement of services across the country

By Alya Niang

In response to the pandemic, health systems across Canada quickly pivoted their delivery of care and launched or expanded virtual care options. Since then, health systems are recognizing how virtual care can address the diverse needs of patients and health care providers to deliver safe, timely and equitable care.

In 2020–2021, the Government of Canada provided funding to the provinces and territories to enhance technology and infrastructure that would facilitate the delivery of virtual care, to evaluate the impacts of virtual care or to establish policy supports for virtual care. As a result, provinces and territories implemented a wide range of initiatives.

To share the successes and challenges of these initiatives and to inform future virtual care policy and delivery, the Canadian Institute for Health Information (CIHI) conducted interviews across the country.

Despite the diversity in priorities throughout the provinces and territories, four common themes tied to the expansion and enhancement of virtual care services were uncovered:

Equity – It remains a key virtual care priority. In some provinces and territories, the strategies focused on ensuring that individuals with different socio-economic means were not disadvantaged. In others, the focus was more structural in nature, for example, ensuring internet access for rural and remote communities, which was a key equity issue for most jurisdictions.

In response to the many people facing barriers to using virtual services such as access to technology and connectivity and digital health literacy, jurisdictions are addressing these issues by:

  • Providing locations, such as community health centres, where patients can access the technology to engage in virtual care;
  • Developing device-lending programs where patients can obtain the necessary technology for virtual care programming with minimal out-of-pocket costs;
  • Providing education and support to both patients and providers on using available virtual care technologies;
  • Ensuring that digital access options are accompanied by non-digital options, to meet patients’ needs and circumstances; and
  • Providing translation services, and having technology platforms and information materials available in different languages so that patients can access virtual care in their primary language.

Data standards and connected care– High-quality virtual care rests on a foundation of seamless data-sharing to support quality and continuity of care; however, connected care—systems that communicate with each other—is a long-standing system challenge.

Most provinces and territories still have a way to go to achieve standardized data collection, and some are still identifying and defining their specific data needs. In some jurisdictions, certain regions, sectors or providers may still collect data using manual or paper methods or processes, hindering progress. Supporting the transition from paper records to digital systems is viewed as an integral part of health systems’ digital evolution.

Most jurisdictions are focused on connected care within their own province or territory and recognize that a future priority must be expanded to include all of Canada. This is particularly relevant for jurisdictions where there is frequent patient travel for medical care outside their provincial/territorial borders, and where virtual services could reduce the need for travel.

Health human resources – The pandemic both exacerbated existing and introduced new challenges with health human resources (HHR). As these challenges impacted the ability to plan, implement and support new virtual care initiatives, jurisdictions have highlighted the importance of having sufficient staff to deliver front-line services and to support policy, governance and strategic work. It is also important to emphasize that the increased uptake of virtual care may have contributed to a challenging HHR environment as health care personnel across sectors were faced with the additional burden of adapting quickly to provide virtual services, such as creating new protocols, changing patient pathways or launching new tools that may not have been well-integrated into existing workflows.

To address HHR challenges, provinces and territories are seeking to provide change management supports, further develop virtual care offerings, expand scopes of practice, and leverage skills and expertise of nurse practitioners and other health professionals to support the delivery of care. Virtual care offers new ways to optimize HHR and can allow a redistribution of available resources by reducing the constraints imposed by provider location. Most jurisdictions are trying to find the optimal balance of in-person and virtual care delivery to meet the needs and preferences of providers, patients and the overall system.

Patient and provider engagement – Including both patients and providers in virtual care development and implementation is a foundation of high-quality, evolving health systems. Most jurisdictions see the importance of including both patient and provider engagement when developing, implementing and evaluating the virtual care policies, strategies and projects they focused on during the pandemic. For example, several jurisdictions launched patient and provider forums and advisory groups to inform their virtual care initiatives. Others conducted surveys and evaluations with providers to support change management initiatives and to improve tool design to meet patient and provider needs.

Moving forward together

As provinces and territories consider how virtual care can become an integrated part of their

health services beyond the pandemic, data will play a large role. Standardizing

virtual care data, measuring the delivery and impact of virtual care services, and continuing to share information and learn from each other will remain key to improving Canadians’ experience with virtual care.

“Virtual care has greatly increased in most health sectors across Canada throughout the pandemic,” says Kelly Hogan, Manager, Virtual Care Initiative, CIHI. “Patients and providers both reported high levels of satisfaction in using it when in-person contact had to be minimized. Now we can look to the future and continue to integrate virtual and in-person care in even better and sustainable ways to meet the needs of Canadians and providers across the country.”

Please visit www.cihi.ca/en/virtual-care-in-canada for additional information on virtual care services across Canada.

Alya Niang is a Communications Specialist at the Canadian Institute for Health Information.

 

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