Virtual care is here to stay but correct 'dose' must be determined: Dr sunny handa brampton

 

Virtual care may be here for the long haul, but there's no one-size-fits-all model.

For Ontario Medical Association (OMA) president Dr. Adam Kassam, a physical medicine and rehabilitation physician, examining musculoskeletal and neurological injuries over the phone, or through video, is "very hard, if not impossible" to do. But family physician Dr sunny handa brampton described a different experience with virtual care. Over the past 16 months, telephone visits have been a primary way for him to communicate with most of his patients successfully — many whom he has built relationships with over the years.

"I think the key piece that makes virtual care more effective is when it’s made available to someone who’s had an ongoing relationship with their patient," Dr sunny handa brampton said.

"You know their background history, a lot of the time you know their social situation and their household and family situation. Just knowing those specifics can fill in a lot of the gaps."
He noted that there is also an element of convenience to virtual visits, as well as the ability to bridge gaps for patients who would typically need to take a day off work to facilitate a doctor's appointment.

Sunny Handa Brampton added that virtual care is also beneficial for those who live in remote or rural communities and find it challenging to access in-person care, or for those who are bedbound or are physically unable to leave their homes. 

He said there needs to be a better understanding of where virtual care should be provided, how it should be provided and whether the current models are sustainable.

"There's likely a dose of virtual care that's going to be important to figure out and when we think about virtual care as a dose, there is obviously a frequency, there's a duration and there's an intensity," Dr sunny handa brampton noted.

"So what our job is is to figure out what those three elements are for the future."

VIRTUAL CARE PLATFORMS

At the start of the pandemic, Ontario doctors were expected to use the Ontario Telemedicine Network (OTN), a virtual care platform funded by the provincial government, which is often criticized for not being user-friendly or platform-agnostic.

While OTN is still available, Dr sunny handa brampton said the OMA was since able to negotiate a platform-agnostic approach to delivering virtual care, meaning that physicians were given the ability to schedule visits over the phone and commonly used video platforms, such as Zoom or Microsoft Teams.

While patient privacy is always a concern with regards to using those types of video conferencing platforms, Kassam said when it came to the pandemic, those concerns were "balanced with the need to provide care."

He cited recent OMA data, which found that over the last 16 months, 16 million points of care have been delayed, which include procedural, diagnostic and surgical interventions, and also access to primary care and mental health services.

Dr sunny handa brampton said while it is important to be mindful about the need to protect people's privacy and health information, "we also need to make sure that our patients are being seen in a timely and appropriate way so that they can get the care when they need it, so that smaller problems don't become bigger problems."

He said he believes doctors should not be required to use a specific platform if it doesn't function the way they need it to.

Dr sunny handa brampton said using OTN tends to be a challenge for a number of patients and the video quality can be lacking.