Virtual visits for COVID-19 patients

AHS’ COVID-19 Scientific Advisory Group (SAG) recently investigated the latest evidence from around the world pertaining to a key question:

What is the impact of virtual visits (e.g. videoconferencing, telephone, texting, email) compared with in-person visits on outcomes, quality and patient / provider satisfaction?

During the COVID-19 pandemic, virtual health consultations have been encouraged (where clinically appropriate) in lieu of in-person visits, in an effort to minimize virus transmission. In-person ambulatory visits have been limited to acute and emergent matters. Since mid-March 2020, several solutions, such as Skype and Zoom, have been explored so patients can remain in their homes during the virtual visit.

As a plan is being developed to resume non-urgent ambulatory visits, all providers are considering how they may continue to use virtual health as a tool to support patients moving forward. This review was meant to inform clinicians about the evidence around virtual care and fits with various reviews of virtual health that are ongoing, including CPSA. The following SAG guidance was provided:

Pragmatic Considerations

• Virtual health visits offer a pragmatic alternative to in-person consultations. Many jurisdictions in Canada, including AHS, are currently on a path to increase the use of virtual visits. Physicians will need to consider what conditions and elements of care are appropriate to be performed virtually.
• Existing evidence supports the use of virtual visits when IT platforms can appropriately address technological and capacity barriers for end-users (patients & providers). Across broad patient & provider populations, there is high satisfaction and acceptability with use of a variety of virtual modalities (video, telephone, email, text).
• Metrics related to virtual health, such as types, volumes, and outcomes of virtual health encounters should be captured in a database to inform decision making in Alberta’s health system. This would enable an opportunity to gain insights and a better understanding about the long-term impact of virtual health on patients and the health system perspective more broadly.
• An expanded review of the evidence is required to gain a better understanding of the application and outcomes of virtual visits in various models of care (e.g., patient’s medical home, team-based care, shared care models) and cost (patient, provider, remuneration, funding models). Existing literature did not address these aspects of virtual care which are important to support decision making within Alberta as we expand use.

To see the complete list of Rapid Response Reports, please check the COVID-19 Scientific Advisory Group website. New reports and updates appear here on a daily basis.