Ensuring appropriate use of virtual care during the pandemic and beyond

The practice standard on Telemedicine was first published in 2013, written in the context of a health-care system that generally did not incorporate virtual care as a common option for patients. 

Fast forward now to March 2020 when the COVID-19 pandemic acted as a catalyst for a monumental shift from in-person to virtual care, fundamentally changing our perception of technology in the context of patient care. In response to the increased use of virtual care, the College made several point-in-time revisions to its Telemedicine practice standard to ensure there were no regulatory barriers in the way of clinically appropriate use of virtual care, and to clarify expectations of registrants who prescribe opioid and psychotropic medications.

Registrants have shown commendable adaptability in response to the changing practice environment and have embraced virtual care as a modality to expand access to services for patients during challenging times. Though there are many positive outcomes of the increased use of virtual care, the College has recently received expressions of concern that some registrants are limiting their practice to “virtual only” services, even when a patient’s condition may require an in-person assessment. While there is no doubt that the massive pivot to virtual care has demonstrated its value, virtual care must be maximized in a way that complements, rather than replaces, necessary in-person care.

In response to the issues brought forward, the College recognized the need to gather feedback from registrants, key partners and members of the public to determine if the practice standard, Telemedicine, is sufficient to ensure safe and appropriate medical care in our new COVID-19 impacted practice environment. This consultation began March 8, 2021 and will end on April 9, 2021. The response rate has been phenomenal—in fact, it was a College record. A total of 1,109 registrants and 283 members of the public have shared their feedback so far, along with several key health partners. 

The College thanks all those who took the time to participate in the survey. Insight into the experiences of registrants and patients, and recommendations from experts in the field, are critical to ensuring that the standard remains current and easy to operationalize in practice. The College will be reviewing each submission, and the results will be used to guide an updated practice standard which can continue to ensure virtual care is used appropriately and effectively.