Many Canadians had likely never heard the term “virtual care” before the COVID-19 pandemic. Now it’s part of our lexicon, right up there with terms like “physical distancing” and “flattening the curve.” But when the pandemic is over and we stop talking about physical distancing and flattening the curve, will virtual care be here to stay?
Virtual care – connecting with a health care provider by email, phone or video call – has become a necessity during the pandemic because in-person appointments at clinics and doctors’ offices are not safe or feasible. Health care providers across the country have been offering virtual options for all but urgent or ongoing care, such as check-ups for expectant mothers.
Tracking by Canada Health Infoway (Infoway) shows that, by the end of April, the proportion of visits that happened virtually rather than in-person had increased to 60 per cent – a dramatic jump from less than 20 per cent prior to COVID-19. The most common way to connect with patients was by phone (40 per cent), followed by video visits (11 per cent) and email/online chats (5 per cent). For appointments specifically related to concerns about COVID-19, 23 per cent of Canadians contacted their family physician, 19 per cent accessed the system through 811 or a telehealth line, and 17 per cent reached out to a private sector virtual care provider.
Prior to the pandemic, even though many Canadians had likely never heard the term “virtual care,” their desire to connect with clinicians using modern digital technologies was already increasing. In a 2019 survey, 63 per cent said they would like to connect with their care providers by email, 58 per cent said they’d like to use SMS or an app, and 44 per cent said they’d like to use video calls.
Incidentally, in some clinical settings, patient satisfaction with virtual care is very high. Prior to the pandemic, for example, an e-visit pilot project delivered by the Ontario Telemedicine Network (now Ontario Health) found that 98 per cent of patients felt an e-visit was the same as or better than an in-person visit, 99 per cent said they’d use it again, and 92 per cent said it made accessing care more convenient. It’s important to note that in primary care and specialist settings, virtual visits tend to work best when they support established doctor-patient relationships.
With high levels of patient interest in, and satisfaction with virtual care (in certain clinical settings), why were virtual visits relatively uncommon prior to COVID-19? There are a number of reasons for the low level of virtual consultations, including challenges with appropriate tools and training for clinicians. However, physician remuneration was a very significant issue – most provinces and territories did not support payment for routine clinician use of virtual visits. When the pandemic struck, this critical issue was urgently addressed, out of necessity. Today, all provinces and territories have billing codes in place for virtual care.
The recent announcement that the federal government is investing $240.5 million to develop, expand and launch virtual care and mental health tools to support Canadians, is also a hopeful sign for the future of virtual care in Canada. We look forward to working with Health Canada and others to accelerate and support the roll-out of virtual care services across jurisdictions.
Why is it so critical to keep moving toward virtual health care delivery after the pandemic is over? In 2019, virtual care saved Canadians 11.5 million hours by not having to take time off work to attend in-person appointments. It also saved them more than $595 million in avoided travel costs. And it resulted in a reduction of 120,000 metric tonnes of CO2 emissions – which is better for everyone’s health. If we could sustain virtual visits at 50 per cent of primary care visits, we project annual savings of 103 million hours for Canadians, $770 million in travel costs, and 325,000 metric tonnes of CO2 emissions.
Virtual care will never replace in-person appointments, and that is not the goal. Highly effective virtual care is intended to be complementary to traditional in-person care.
And the evidence in favour of virtual care is clear. It’s a safe and effective means of care delivery. It can reduce pressures on our health system. Canadians want it and love it. It saves time and money and it’s good for the environment. So when the pandemic is over and we stop talking about physical distancing and flattening the curve, we must ensure that virtual care becomes a permanent part of our lexicon and of health care delivery in Canada.