Is virtual healthcare the new normal?

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

The current pandemic is deeply affecting many aspects of society. Accelerated usage of virtual healthcare is a good example. While frontline healthcare workers serve patients needing essential in-person care, some doctors and patients are meeting up over the phone or on video calls.

Virtual healthcare is well known to those living in remote communities. During the pandemic, it has become an option for everyone.

A debate has ensued about whether such care is good or bad. Proponents of either side are lining up evidence to prove the case. How can you argue with the fact that curable cancers in children have been missed in the absence of face-to-face consultations? How many lives have been saved by “seeing” the doctor virtually, when the alternative is no treatment at all?

The question should be, when is it okay to utilize virtual healthcare, and when not? And how should people approach the option?

Governments and regulators have been beefing up policies and billing structures for online medical consultations and treatments. In Canada’s public system, a plethora of new billing codes have been registered since the start of COVID-19. There hasn’t been as much attention given to educating the public about virtual care.

Until recently, there wasn’t much interest among healthcare consumers either. A survey of 4,530 American adults conducted by Deloitte in 2018 showed that 77% had never tried a virtual visit.

But as the ancient proverb notes, “Necessity is the mother of invention.” As COVID limited traditional doctor visits, the benefits of virtual care became apparent. Improved access and convenience, reduced travel, eliminated parking headaches. No transmission of infection.

A study published in the Canadian Medical Association Journal reported on virtual care use in the province of Ontario before and during the COVID-19 pandemic. The proportion of Ontarians who had a virtual visit increased from 1.3% in 2019 to 29.2% in 2020, with older people being the highest users. Data from the Massachusetts General Hospital psychiatry department switched from under 5% virtual visits in March 2019 to over 97% in March 2020.

Technology advances are also contributing to the trend. Diseases that may have required an in-person diagnosis in the past can now be detected using digital imagery tools, mobile health applications, and wearable medical devices.

Powerful medical groups are busy determining the support of clinicians’ need for effective integration of virtual visits in the practice of medicine.

Less evident are the support programs needed by consumers. How does a person know when is the right time to pick up the phone and when to make an in-person appointment?

In general, in-person care is always advisable for diagnostic and therapeutic procedures requiring physical contact (e.g., Pap smears and biopsies). The same for prenatal and newborn care. People dealing with multiple health issues or who struggle to communicate virtually should also present in person.

But virtual visits will likely be a significant part of the healthcare experience henceforth. So it is advisable to get good at making the most of them. Just because you are not leaving home doesn’t mean you don’t need to prepare. Preparation is more important than ever.

Make sure you know how to use whatever equipment is required – from the telephone to computers, mobile apps to specialized software. Be in a quiet space, with sufficient light to read and write, and so the provider can see and hear you well. Have patience and fortitude in case technology fails and to avoid misunderstandings.

If you haven’t seen your doctor in person since the start of the pandemic, make an in-person appointment.