Virtual Care

This is a remarkably well done standard of practice that will obviously evolve rapidly over time and with improvements and evolution of various technologies including web-enabled telemetry devices such as stethoscopes, blood pressure and glucose monitors and pulse oximetry as well as thermometers, etc. I see this standard of practice eventually dovetailing into a standard of practice involving the use of AI assistance in the evaluation of patients as well as the documentation of the patient interaction. Another addition to the standard of practice that may soon become necessary is the inclusion of AI API's on practice websites (ie. "chatbots") that dispense medical advice to patients through a "chat format". While such chatbots are surprisingly effective and dispense surprisingly good advice, they can very easily and unexpectedly dispense absolutely incorrect advice. Any and all such potentialities should be limited to having the chatbot, for example, limit the nature of advice given (which may be seen as a type of "virtual care") to how to contact the Physician for an appointment or after hours emergency care. The CPSA will soon be required to have a standard of practice on the training and ongoing evaluation of AI API's on Physician websites, as this technology will no doubt continue to evolve rapidly over time. The CPSA, as if it doesn't already have enough to do, needs to rapidly evolve its standards of practice on the use of AI both in office and on Physician websites.

Thank you for your work on this.
How will 3 a,b,c be enforced? I think it is important to think about this before the standard is passed, rules only as goos as their enforcement. For example, you may consider choosing disciplines for which you are aware there is a clear shortage. Otherwise, people may claim patients can not access, for example, obesity care, and so rather than supporting access to more equitable care in the province the province pays for care provided by people who are not local and do not intend to be with any degree of regularity. This is a nice segway to #6 - which is essential and so a timeline for access may be necessary, with exemptions only for known severe shortages.

Lastly, you could consider the importancce of virtual care from an environmental standpoint - as much care as reasonably possible should happen this way to address both equity and sustainability. Travel to appts accounts for a significant portion of healthcare's carbon footprint in AB. This sustainability lens needs to be in the fabric of the CPSA's standards (AI - huge consumer of resources - just reading comment below :)).

Thank you

This represents an improvement from the previous standard in accounting for access to care for patients from rural and remote areas. It continues to present virtual care as substandard care when it may not be. There are many situations that make care inaccessible to patients in person even in urban areas including physical disability, poverty (lack of access to transport or inability to leave work obligations), and psychiatric disability (such as agoraphobia and PTSD). We should allow patients to make an informed choice to seek virtual care over in person by explaining the limitations of virtual care. In addition, we should consider the possibility that some factors, such as disability and caregiving responsibilities, which make it difficult for patients to seek in person care, make it difficult for physicians to provide in-person care. Those physicians may also have a valuable contribution to care provision in this province.

I am encouraged to see the loosening of some of the wording to accommodate reasonability and appropriateness which will make the standard more reflective of what actually happens in real life practice.

One area that the AMA informatics committee physicians raised concerns about was the need to be aware of other jurisdictions' regulations when providing virtual care and the "must" language associated. This was felt to be extremely difficult in continuity of care situations, as you often just call the patient on their cell phone, and may not know where they are located for a quick call. Also, the relationship and continuity are felt to be more important than needing to sort out jurisdictional matters before providing care. It is recognized this may not be all in the CPSA purview, but if the CPSA could work to develop a common understanding about continuity of care situations virtually across the country, that would be immensely helpful.