Virtual care has become an accepted additional way to deliver care to patients efficiently and effectively. OntarioMD and the Ontario Medical Association are committed to helping raise awareness to physicians and their practices about tools to consider for virtual care delivery. While OntarioMD has not evaluated these tools and does not endorse one tool over another, we believe there is value in curating a list of tools to which OntarioMD has visibility based on our relationships and/or engagements with various provincial and national stakeholders. We encourage all practices to contact vendors directly for product-specific questions.
You will likely need to think about three things when using virtual tools:
Care for patients with suspected COVID-19:
Care for regular patients:
There are many virtual tools that can be used to help you provide the best care during outbreaks of infectious diseases or at any other time.
Any direct-to-patient telephone, telemedicine and video calling platforms can now be used as the work is remunerated with the new fee codes, rather than the platform you choose. This allows rapid and wide scaling of care that works best in your area. When choosing, consider how easy the technology is for you to use, how easy it is for patients to use, how the technology can help you keep patient information private and secure, and that you must record the work in your medical record. Additional technical guidance may be provided by the Ministry to inform technology selection and this page will be updated to point to the information. Consider the right type of contact, for the right patient, at the right time, for the right problem. Video conferencing and phone calls are payable under the new fee codes, but email and texts to patients may also be useful for care, even if not discretely funded.
Unless you are using virtual care technologies where consent from the patient is handled at sign-up, you should ask patients for their consent.
Information vetted by OMA and OntarioMD legal teams and the CMPA has been created to make this easier. OMA Legal has prepared a short paragraph statement and information to provide to patients to initiate a virtual care patient encounter which has also been vetted by the CMPA. Click the blue bar immediately below to view the statement.
More information to help support the consent process is available on the OMA’s virtual care page. We also suggest posting the following information to your website, in your office, or making it available to patients and adapting it for when you explain it to them. Click the blue bar immediately below to view this information:
You should also record that verbal express consent was obtained when using a product that does not have explicit health care consent.
OHIP has InfoBulletins pertaining to virtual care. Please visit the OMA Agreement on Temporary Virtual Care K-Codes page for more information. On October 9, 2020, the Ministry of Health and the OMA reached an agreement to temporarily fund payments that are equivalent to the rates in the Schedule of Benefits for Physician Services for eligible premiums when related to the provision of the temporary virtual care K-code services and introduced New Temporary Virtual Care K-Code K084A.
Ontario Health (Digital Services) has created instructions for physicians on how to get ONE ID credentials to use provincial digital health systems such as the OTN virtual care tools. Physicians can visit the CPSO website to get ONE ID credentials or check to see if you already have them.
The Information and Privacy Commissioner (IPC) of Ontario has developed a resource for Privacy and security considerations for virtual health care visits. This guide outlines the key requirements in PHIPA relevant to all custodians, including those who operate in a virtual health care context. The guide also provides some practical steps custodians should take to protect personal health information, particularly as they plan and deliver virtual health care.
Ontario Health (Quality) has created a guidebook with OTN on best practices for bringing virtual care into your clinic. You might find it helpful. It can be found here.
There are also other tools you can leverage for your practice to enhance the flow of patients, enable their care at home, or allow you to communicate with them. Some are offered by EMR vendors and some are stand alone. All the tools below have stated that they comply with Ontario’s Personal Health Information Protection Act (PHIPA), and consent for use is collected by the tool upon patient sign-up.
EMRs have other workflow assistance built into their core functionality that can assist with working virtually. Here is a sample of what they offer: