Prior to the COVID-19 pandemic, the majority of medical consultations in Canada happened in person. In Ontario, for example, 98.4% of all visits from March to July 2020 occurred in-person. When the country went into lockdown, however, 95% of those moved to phone and/or video.
At the time, the healthcare community needed to continue to care for patients while minimizing in-person volume and travel. The obvious solution was virtual care, and clinicians focused on getting Canadians comfortable with using it.
The conversation among health leaders is shifting to future modes of care, combining the strengths of both in-person and virtual care.
As Dr. Dominik Nowak, TELUS Chief Medical Advisor explains, “Virtual care is normalized, and what we need to do now is be intentional and creative about what's next.”
Here are four transformations we're anticipating thanks to virtual care:
1. Enhancing relationship-centred care
Human-to-human interactions, and the trust established through them, are core components of positive healthcare experiences.
“People with a family doctor or trusted primary care professional in the health system often get more preventive care,” explains Dr. Nowak. “They need hospital care less often. They live longer and cost the health system less. Healthcare based in a primary care relationship makes our health system more sustainable.”
And virtual care is valuable for cultivating strong patient-clinician relationships. For example, in a 2021 study led by researchers from the Centre for Addiction and Mental Health, youth reported virtual mental health services as a convenient, accessible, flexible, and psychologically safe alternative to in-person care.
By incorporating virtual care, health professionals have more flexibility to consider barriers people face when attempting to access care. This flexibility is good for building consistent relationships with a care team and enhancing the relationship-centred care approach as a whole.
2. More support for health professionals
It only takes a glance at the news or a visit to an emergency room to see the strain on the medical system. Many health professionals are overextended and in need of support. Dr. Novak believes virtual care is poised to be a force that delivers it.
A key element of change, he explains, is improving how healthcare professionals connect with each other. One of the most helpful ways he uses technology in his own practice is to connect with a network of specialists. Through a digital tool, he can send questions to a specialist about a clinical scenario and receive answers in hours or days.
He calls this “the 'hallway consult' of the future.” It introduces a great deal of efficiency, often eliminating the necessity of a referral and potentially shortening the time from consultation to treatment by months.
3. Strengthening connection and collaboration
A disconnected health system can lead to gaps, inefficiencies, and friction for health professionals and patients. In Canada, approximately six million people have no family doctor, while many have reported waiting hours for emergency care.
Anyone working in the medical system knows how long it takes to transfer medical records, administer forms, and gather information on patients’ health concerns. Digital tools like TELUS EMR Virtual Visit and virtual care through the Collaborative Health Record can streamline record-keeping and give doctors and patients back their time. They allow physicians to see, treat, and monitor patients remotely through their electronic medical record (EMR).
This is especially the case when health professionals are able to include patients (and their loved ones) as active participants on the care team.
4. The evolution of the traditional consultation
The consultation is another legacy feature of the medical system that may adapt with the progress of virtual care.
“There’s a way we do things as a health system that we've maintained,” says Dr. Nowak. “We took that regular ‘start-and-stop’ visit that a person would have with their health professional and turned it into a virtual visit.”
But that format was born out of a physical limitation that is no longer present. We can now consider the most optimal way to care for each person using the tools at hand and their unique needs — with a more continuous model of practice. Evolving consultation practices may be particularly relevant for chronic disease management. Many people who need the health system have mobility restrictions, energy restrictions or compromised immunity, making it challenging for them to attend in-person appointments — yet monitoring their conditions requires regular touch points.
“The missing dimension of standard healthcare is health through time,” Dr. Nowak reflects. “That's going to be the future of virtual care.”
A future yet to be written
Virtual care is a powerful tool that enables continuity of care through an unprecedented pandemic. That alone is cause for celebration, but the technology ultimately achieved more than that.
It’s a key element of Nowak’s vision for a truly integrated, collaborative healthcare system.
“I imagine all of these components of care — from family practices to emergency rooms — as stars in the sky,” he says. “Between the stars, you may see some constellations that link them together. In this state of health-system pressure, what we really need to do is build more of those constellations and even build a supportive galaxy connecting all the stars. That’s where digital health comes in.”
Within a medical system gripped by deep structural challenges, virtual care is opening the door to solutions.