Providing patient care in the COVID era

In the past four months, the move to virtual care has been accelerated due to the global pandemic. Our physicians have made the transition to virtual care, overcoming obstacles and discovering benefits along the way. 

Virtual care tools like OTN and REACTS have been around for several years but their value has truly been put to the test. Often thought of as an “alternative” way to practice medicine, the use of these tools has become essential in providing timely patient care in our new socially distanced world. 

We spoke with a primary care provider and an internist to learn about their experiences providing virtual care during the pandemic.  Below you’ll find a summary of the benefits and challenges.

The Benefits

The pivot to virtual care has seen several benefits, the most obvious being how quickly physicians were about to move into the virtual space once the stay at home order was put in place. 

“We went from one hundred percent of our care happening in-person to ninety percent being done virtually in just a couple of weeks,” said Dr. Michael Green, Department Head of Queen’s Department of Family Medicine. “As primary care providers, we did not have an option to decrease care availability. With the use of the OTN platform and telephone visits, we were able to maintain the number of our overall patient visits. I am really proud of how quickly we were able to adapt to the changing climate.” 

The Department of Family Medicine also found that they were able to use video calls to complete a proper teaching visit, allowing residents to be on the call and interact with the patient and then consult with their attending physician.  

Virtual care, either through a video visit or phone call, has not only provided patients with prompt clinical care but also eliminated the need to take time off work, pay for parking or find childcare, which saves both time and money.
 
“After patients have been taught how to use the virtual care modalities, they enjoy the fact that they don’t have to leave their home and family members can be present for the visit,” said Dr. Lisa Nguyen, Assistant Professor, Department of Medicine, Division of General Internal Medicine. 

The Challenges 

When looking at video visits, connectivity and bandwidth seem to be the biggest obstacles. Between the physician and the patient, there are several things that could interfere with a video consultation or affect the quality of the video. Other factors such as data usage and a patient’s access to technology (i.e. smart phone, tablet, computer) also play a major role opportunity for a video visit and its effectiveness. 

“It is a little tougher with the elderly population, particularly if they are not tech savvy or already have sensory impairments (e.g. hard of hearing and visual impairment),” said Nguyen. 

The use of telephone visits has greatly increased, unfortunately, the disadvantage to this consultation style is that a lot of communication is non-verbal and that cannot be expressed or seen over the phone.  

“Most of my older patients prefer telephone calls but then it is much harder to do any physical assessment,” said Nguyen.   

Virtual care is here to stay

When the threat of COVID-19 is reduced and the world gets back to a new normal, Dr. Green’s hope is that his team continues to incorporate virtual care into their practice. “We can’t do everything over the phone or on a video call, that’s just a fact. However, I can see us moving to more of a 50/50 split between in person and virtual care visits as it benefits the patients to have that option available to them.” 

Share your experiences

We’d like to hear about your experiences providing virtual care. This system of care delivery is here to stay and SEAMO would like to learn what is working well and areas for improvement.  Send us an email to seamo.communication@queensu.ca or tweet us @SEAMOKingston.  

Our Digital Health Support Team is here to assist.  The easiest way to reach them is through email at seamo.digitalhealth@queensu.ca.