The rapid deployment of virtual care is often referenced as one of the small benefits of this pandemic.  The option to connect with our healthcare providers safely was important and, in some cases, critical. The fact that it happened so quickly after years of very slow progress also made us realize (with some optimism) that change can happen quickly when the pressure is on.

Statistics from January-August 2021 show that the most common way to connect was via phone calls (78%) with video and asynchronous messaging also being utilized (19% and 3% respectively).  Another survey showed that Canadians want to connect with their healthcare providers via telephone (69%), video (56%) and secure messaging (57%).  Comparing these statistics shows that there is already an unmet need between what is desired vs. what is being delivered. But is switching from an in-person appointment to an appointment on the phone or video the optimal use of virtual care? What other options and innovations could make patient experiences and outcomes better? How do we keep up the momentum? And how do ensure that what is being offered is safe and appropriate?

Consider this definition of virtual care:

“Any interaction between patients and/or members of their circle of care occurring remotely, using any form of communication or information technology with the aim of facilitating or maximizing the quality of patient care.”

It doesn’t limit virtual care to synchronous phone or video appointments, focuses on providing quality patient care, and leaves room for innovation.

Virtual care is healthcare - not a separate tool or system that isn’t integrated with the rest - and it will not be a single solution.  It isn’t appropriate for every interaction and we must consider all aspects of quality - including safety, acceptability and accessibility - when it is being deployed.

How do we create the conditions where an optimal virtual system can grow? We believe we need a strong foundation built on collaboration and the recognition that we need to work together through partnership and co-design. Collectively we will accomplish more than if each silo or group in the health system does their own thing. We also need some basic ground rules and a commitment to making progress towards our goal but also realizing that in a complex system like healthcare the goalposts will constantly be moving – it isn’t possible to define a perfect final destination, there will always be room to improve.

Over the last ~20 months we have been part of a working group focusing on virtual care in Alberta. This group came together with the understanding that there is an opportunity for virtual care to have a positive impact on healthcare but there are also risks and we need alignment and collaboration across the healthcare system to get the most out of the opportunity that is virtual care.  The group’s initial work has resulted in the Optimizing Virtual Care in Alberta report. The report lays the foundation for future work and includes agreed-upon design principles and recommendations for the next steps. 

There are lots of reasons to be optimistic and excited about the innovative technology that will have an impact on healthcare. We need to intentionally create the conditions that will enable innovation, but we also need to recognize, prioritize, and address the barriers that stand in the way.  We need to intentionally plan for and prioritize issues so people don’t get left behind and so the people who could benefit most can also utilize virtual care.

We are optimistic about the collaboration that occurred across the member organizations and believe in the principled approach. The working group didn’t set out to solve problems but found common ground on what we want as a foundation for virtual care in Alberta. We also believe this could be a model for other aspects of healthcare as well.

Please share your comments, feedback, and ideas with us. We are also planning a webinar on November 29 as part of Digital Health Week. The webinar will be a conversation with Dr. Ewan Affleck and an opportunity to dive deeper into the process and content of the Optimizing Virtual Care in Alberta Report.

Register for Creating the Conditions to Optimize Virtual Care: A conversation with Dr. Ewan Affleck

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