Virtual care is booming amid COVID-19

Posted on April 30, 2020 in Health Delivery System

Source: — Authors: – Diseases-andConditions/Coronavirus
April 30, 2020.   Nicholas Sokic

‘The days of brick and mortar physical medicine are going to be less and less important,’ says Hamilton, Ont. doctor.

Like any function of society still able to continue under lockdown, doctor’s appointments have moved online. Canada has had some form of virtual care for a while now, but the use of phone and video to deliver medical care and advice has skyrocketed out of necessity.

Of course, digital healthcare had been on the rise for a while. Infoway’s 2019 survey showed that “50 per cent of Canadians now report they can access at least one digital health service online, such as viewing their health information, making an appointment, or consulting with a health care provider.”

In late March, as COVID-19 cases ramped up,  Telehealth Ontario became overwhelmed with the volume of calls, prompting an addition of 1,300 phone lines and 130 nurses to accommodate the demand. Still, that hasn’t been enough. With the stress to the system brought on by the pandemic, the average COVID-related call takes one day, while non-COVID calls average 2.5 days. The province is now telling people to call their primary physician if they have one.

In the U.S., Google has started to highlight virtual care in its search and maps functions given queries like “immediate care.”

Dr. Richard Tytus, based in Hamilton, Ontario, has been using virtual care for the past four years. He estimates that pre-pandemic use was about 20 to 30 per cent, and now he’s at 80 or 90 per cent.

Virtual care is especially crucial for long-term care homes, whose population is most at risk from the virus. Tytus looks after a number of retirement homes in Hamilton, Caledonia and Ingersoll which utilize a virtual program for their patients.

“So if someone needs a doc, I can see them within an hour,” says Tytus. “The staff brings the patient into the room and I can examine them, listen to their heartbeat and their lungs. They don’t have to leave the retirement home.”

Tytus is also the chief executive officer of WeCareMD, a board of Hamilton doctors utilizing virtual care through a video-based computer program. Their website claims that they have saved seniors in retirement homes over 750 trips to a doctor since 2017.

However, he says he has still seen “two or three” patients in person because they didn’t have the necessary internet reception.

Brian Antman, a chartered accountant, had a double knee replacement surgery on January 30. At first, the physiotherapy had been in person. Thanks to COVID-19, it’s been moved to Zoom. Twice a week, he puts his phone in a stationary position in the hallway so that his doctor can see him, and performs the necessary sets and exercises with the resistance band he purchased.

When I spoke to him, he had just finished a follow-up appointment with his surgeon. The previous one, which was in-person before the quarantine, had involved four hours of waiting.

“Today, it was scheduled for 11, he phoned me at 11 and it was over in ten minutes,” says Antman. “It was seamless, it was on time, concise.”

Tytus also mentions the examination kit and app, Tyto Care, (no relation) first developed in Israel and currently available in the U.S. Your doctor communicates with you through video and can direct you on how to place the stethoscope, for example, and from there you can receive a diagnosis and prescription all from home.

“Of course, there’s a specific set of procedures you can’t do virtually. You can’t do vaccines, you can’t do blood tests,” says Tytus.

Virtual care has also become a part of the way some pharmacists do business.

Lisa Bak’s pharmacy in Toronto is one of many that utilize aspects of virtual care. Specifically, video appointments with the patient in the clinic and the doctor serving several from a remote location. This being in addition to normal pharmacy duties like filling out prescriptions. The patient is alone with the doctor unless Bak is needed for certain tests, including ones for UTIs, pregnancy and strep throat. The program also has a digital otoscope and stethoscope, which Bak uses and then transmits the data to the doctor.

“[Use has] definitely increased in the last month or so,” says Bak. “Sometimes people aren’t too keen when I tell them about it, but once they do it they find it efficient. Kind of novel and unique. Mainly because it’s pretty quick.”

Outside of the lens of the pandemic, Canada has been outpaced by other countries in the use of virtual care. Canada was an early pioneer of telehealth through the late Dr. Maxwell House of Memorial University of Newfoundland in the 1970s, who used telephone calls for remote consultations.

According to the 2019 Canadian Physicians Survey, fewer than one in 10 family physicians allow patients to book appointments electronically, less than a quarter make themselves available by email, and just four per cent provide video visits.

In April of last year, 14 per cent of the 23 million general practice appointments in England were conducted over the phone, and 0.5 per cent by video conference.

Of course, any new technology brings with it some associated risks. In 2019, healthcare accounted for 35 per cent of cyber attacks.

The way we’ve been practicing medicine for the last 100 years is changing. The days of brick and mortar physical medicine are going to be less and less important

In terms, of cybersecurity,” says Derek Dow, an underwriter at the life sciences division of Beazley Canada, “It is important to ensure that the proper measures to reduce vulnerabilities are in place including employee education and training, enabling multi-factor authentication, customer education, as well as having a contingency plan, and the proper insurance coverage in case a breach occurs.”

Both Bak and Tytus seem confident that the spike in virtual care is here to stay, pandemic or otherwise.

“The way we’ve been practicing medicine for the last 100 years is changing,” says Tytus. “The days of brick and mortar physical medicine are going to be less and less important.”

Virtual care is booming amid COVID-19

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