GoEvisit uses artificial intelligence, machine learning and evidence based medicine to reduce consult times to under 10 minutes without any wait. You describe your symptoms in the app, then get a diagnosis and treatment plan from a doctor. GoEvisit has partnered with Alliance Pharmacy to offer prescription delivery to your home or office.
TELUS Health virtual care provides online access to family doctors, nurses and specialists via your mobile device, tablet or computer.
MD Connected offers virtual specialist appointments which include Dermatology, Pediatrics, Urology, Psychiatry and more. It also allows for virtual walk-ins to speak to a doctor within minutes for medical advice, prescriptions/refills, referrals, medical forms, mental health, travel consultations, or COVID-19 screenings.
MindBeacon offers mental health support for Ontario residents dealing with stress, anxiety, depression and more. Simply create and account and answer questions about how you are feeling and your situation. A therapist will create a plan for you and will work with you one-on-one.
Reason for Action: It was identified that TeamUHN requires a resource to support assessment of when virtual care is suitable for a patient. The Clinical Guiding Principles for Virtual Care were developed to meet this need.
Purpose: This document is a guide for TeamUHN, including care providers, administrative staff, researchers, and learners, to enhance the patient care experience through virtual care. It was developed and is maintained by UHN's Virtual Care Clinical Advisory Panel. Comments and suggestions are always welcomed (contact details below).
Consider clinical, psychosocial, socioeconomic, cultural and social identity needs and preferences when determining suitability for virtual care. As with any important decision, ensure that all available options are provided to and understood by patients, including research study participants, so that they may have the opportunity to consider their options and participate fully in shared decision-making.
Virtual care offers opportunity for innovation – allowing for alternate models of care, alleviating pressures to health care capacity, expansion of clinician scope, incorporating multidisciplinary care teams, and more.
Virtual Care at UHN is committed to working with patient partners, clinical teams, research teams, Social Medicine Program, and groups across UHN to creatively and effectively meet the evolving needs of our patients and TeamUHN.
Please contact Jennifer Catton (Director, Outpatient Strategy & Diagnostic Performance) at Jennifer.Catton@uhn.ca or provide feedback via this survey.
1 High risk prescribing: Prescribing of high-alert medications. High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error. Harm is defined as a temporary or permanent impairment in body functions or structures. Includes mental, physical, sensory functions and pain. Institute for Safe Medication Practices
Background: Telemedicine has emerged as a feasible adjunct to in-person care in multiple clinical contexts, and its role has expanded in the context of the COVID-19 pandemic. However, there exists a general paucity of information surrounding best practice recommendations for conducting specialty or disease-specific virtual care. The purpose of this study was to systematically review existing best practice guidelines for conducting telemedicine encounters.
Methods: A systematic review of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) of existing guidelines for the provision of virtual care was performed. Data were synthesized using the Synthesis Without Meta-Analysis (SWiM) guideline, and the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) tool was used to evaluate the quality of evidence.
Results: A total of 60 guidelines for virtual care encounters were included; 52% of these were published in the context of the COVID-19 pandemic. The majority (95%) of provider guidelines specified a type of virtual encounter to which their guidelines applied. Of included guidelines, 65% provided guidance regarding confidentiality/security, 58% discussed technology/setup, and 56% commented on patient consent. Thirty-one guidelines also provided guidance to patients or caregivers. Overall guideline quality was poor.
Discussion: General best practices for successful telemedicine encounters include ensuring confidentiality and consent, preparation before a visit, and clear patient communication. Future studies should aim to objectively assess the efficacy of existing clinician practices and guidelines on patient attitudes and outcomes to further optimize the provision of virtual care for specific patient populations.
Currently in British Columbia, Ontario and Alberta you can provide virtual care from your home or your office by phone or video. There are only two things you need to get started:
You should use email addresses for coordinating virtual care, whether in groups or individually. Depending on what tool you use, you’ll also have to email your patient with the virtual link/URL so they know how to access the video before each visit.
You might also want their phone number for communicating with your patient, for example if there’s any issues with the virtual care link, or if you’re going to provide care through WhatsApp, FaceTime, etc.
Having both an email and phone number helps coordinate the visit to ensure your patients know what to expect.
Primary CareIn order to offer virtual care you need your patient’s consent. At this time, verbal consent is enough, just make sure it gets documented in their chart. See below on how to properly document patient consent.
However, if you can, CMPA recommends having your patient sign a consent form. You can send them this example from CMPA and have them electronically sign it and send it back. Otherwise, a lot of virtual care tools have options to obtain consent electronically, so double check that they offer this before signing up.
In Ontario, the new COVID-19 codes are provided by OHIP (see below for more information on COVID-19 fee codes), which means you only need your patient’s consent and their email/phone number to get started. However, if you are providing normal Telehealth codes then you need to register with OTN in order to get paid for them. OTN is the government-funded non-profit that was created to expand the use of telemedicine across the province.
Since OHIP doesn’t insure Telehealth services (except for the current COVID-19 k-codes), when you submit claims to OHIP for virtual care they are actually paid by OTN, who reimburses OHIP for your services.
To register fill out the OHIP Virtual Care Physician & Dentist Registration Form and email it to serviceactivation@otn.ca or fax to 416-354-8280. Membership is free if you receive 50% or more of your earnings from OHIP.
Once registered, in order to be able to provide virtual care you are required to:
You and your patient must be present the whole time during the call in an approved OTN video solution (see ‘Virtual Care tools’ below for more details).
You and your patient must be present the whole time during the call in an approved OTN video solution (see ‘Virtual Care tools’ below for more details).
Select a billing code along with the applicable Virtual Care Program B-code (see below for more details)
Do not include fee codes for services excluded from the Virtual Care Program (see below for more details).
There are two types of video visits that you can use to speak with patients, a hosted video visit or direct-to-patient video visit.
A Hosted Video Visit is when you speak with a patient who is currently at a patient host site. A patient host site is an organization that provides patients with an on-site location with videoconferencing technology and, in some cases, clinical support services (nursing support, diagnostics through peripheral devices).
A direct-to-patient video visit is when you speak with a patient who is either at their home or any other location besides a patient host site. This includes situations where your patient schedules and manages the encounter independently using their own technology, or where an organization provides support resources (e.g. access to technology).
In order to be eligible for payment for hosted video and direct-to-patient telemedicine video visits, you need to register with OTN.
***Remember, this is only if you plan on providing virtual care that doesn’t include the OHIP k-codes. We recommend registering if you haven’t already so you can expand your virtual care options.
The CMPA has approved the following statement that they recommend you use to initiate a Virtual Care patient encounter:
“Just like online shopping or email, Virtual Care has some inherent privacy and security risks that your health information may be intercepted or unintentionally disclosed. We want to make sure you understand this before we proceed. In order to improve privacy and confidentiality, you should also take steps to participate in this virtual care encounter in a private setting and should not use an employer’s or someone else’s computer/device as they may be able to access your information.
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