Going Virtual in a Time of Crisis - Virtual Care resources for Canadian Physicians

Greetings,

This post links to a brief article about virtual care, specifically about supporting Canadian physicians and other clinicians as we shift rapidly towards a "virtual first" model of care, in the midst of the COVID19 pandemic.

www.linkedin.com/pulse/going-virtual-time-crisis-care-resources-canadian-physicians-bhyat

We will attempt to keep the links below up to date, and welcome submissions/additions of really practical resources to help docs get up and running with virtual care tools.

Also please consider joining the Facebook group noted below, a Peer to Peer Virtual Care support group for physicians, recently started by family physician Dr. Cassie Millar and colleagues in Calgary

Please see the rapidly evolving list, below. We're still seeking to fill in content from multiple regions.

Kind regards,
Dr. R. Bhyat

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Facebook Virtual Care Peer 2 Peer Network
Discussion/Peer Support group on Virtual Care implementation for Canadian Physicians. Helpful peer network sharing tips/tricks from the trenches.

www.facebook.com/groups/224675608724335/?ref=share
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International articles

BMJ Article - Covid-19: a remote assessment in primary care

** A brilliant how-to overview of managing suspected COVID19 cases using Virtual Care. Includes an excellent step by step visual guide.

www.bmj.com/content/368/bmj.m1182

Canadian articles

JMIR - Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

This article by Appireddy et al, at Queen's University, describes a successful model for Specialist physicians delivering post-acute follow up care via virtual visit. Includes a very handy, adaptable virtual visit workflow diagram. Dr. Appireddy's work is part of a CIHR research initiative.

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Alberta

Alberta Medical Association

Great overview from the AMA with tips and reference to the super practical DTO toolkit.

www.albertadoctors.org/leaders-partners/ehealth/virtual-care

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British Columbia

Doctors of BC

The Doctors Technology Office branch of Doctors of BC has some very practical resources to get a clinic up and running with Virtual Care, fast. Their two documents, listed below and attached, lead the clinic through the process in a practical, step by step approach to implementation.

Quick Start Guide

www.doctorsofbc.ca/sites/default/files/dto_virtual_care_quick_start_guide.pdf

*** DTO Virtual Care Toolkit <— very Practical

www.doctorsofbc.ca/sites/default/files/dto_virtual_care_toolkit.pdf


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Manitoba

Doctors of Manitoba

The Virtual Care resources page contains many practical resources on how to get started with Virtual Care in your practice.

doctorsmanitoba.ca/covid/virtualcare/

Info page on Virtual Care during the COVID 19 crisis: doctorsmanitoba.ca/2020/03/covid-19-coronavirus-updates/

This page makes reference to the Provincial document “COVID 19 Guidance on Outpatient Care Delivery:

Includes info on MB-specific physician billing codes for virtual care and notes that in the Short Term, digital video conferencing solutions like Skype or Zoom are ok.

sharedhealthmb.ca/files/covid-19-guidance-for-outpatient-care-delivery.pdf
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Ontario

OMA

The OMA is playing a critical leadership role, working with the Ministry of Health and OntarioMD to rapidly expand virtual care provision options for Ontario physicians.

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OntarioMD

Amazing virtual care resource page here, newly redesigned: OntarioMD.news

The resource include a step by step overview of virtual care, and then links to the Ontario Health Quality document. Very useful.

Here is a direct link to very recent webinar recordings featuring primary care and specialist docs implementing virtual care:

www.ontariomd.ca/pages/watch-physicians-demonstrate-virtual-care-tools-and-submit-your-questions-during-ontariomd%E2%80%99s-webinars-on-march-20.aspx

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OCFP

This link provides a nice poster with messaging for patients / public relating to Virtual care/telemedicine:

www.ontariofamilyphysicians.ca/tools-resources/timely-trending/novel-coronavirus-2019-ncov/ocfp-coronavirus-infographic-4-final.pdf

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OTN

These links to their very useful resource and training pages includes practical examples and workflows that clinics could adapt, using any platform (not just OTN invite).

support.otn.ca/en/connect-help

training.otn.ca/course/view.php?id=10090

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Quebec

Useful document on virtual care for physicians during this pandemic, from CMQ, Téléconsultation en situation de pandémie:

www.cmq.org/page/fr/teleconsultation-en-situation-de-pandemie-rappel-des-obligations-des-medecins.aspx

McGill University Department of Family Medicine, Herzl Family Practice Centre

The Herzl Telemedicine Essentials Guide - a very practical, step by step guide covering the basics of video visits.

www.mcgill.ca/familymed/files/familymed/herzl-telehealth_the_essentials.ye_.pdf

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Saskatchewan

Government of SK

Basic info on Virtual Care for Providers
www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/information-for-health-care-providers#virtual-care

Yukon

The Yukon is providing Virtual Care to its citizens using the Doxy.me platform. Physicians should consult the Yukon Medical Association (www.yukondoctors.ca) while citizens can learn more at yukon.ca/covid-19 and here: yukon.ca/en/news/new-virtual-care-options-yukoners

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NATIONAL resources

National Specialist body - RCPSC

A very helpful page from the Royal College, presented by Province and Territory with links:

Telemedicine and virtual care guidelines (and other clinical resources for COVID-19)

www.royalcollege.ca/rcsite/documents/about/covid-19-resources-telemedicine-virtual-care-e

National regulatory - FMRAC

Their relatively recent telemedicine policy provides high level reassurance that telemedicine is ok. Each provincial/territorial college has their own variations on this policy. ON, AB, and BC are good examples.

fmrac.ca/fmrac-framework-on-telemedicine/

National Medical Protective advice - CMPA

Similarly, providing reassurance re: virtual care, as long as due diligence is maintained in professional practice.

www.cmpa-acpm.ca/en/covid19

www.cmpa-acpm.ca/en/advice-publications/browse-articles/2015/videoconferencing-consultation-when-is-it-the-right-choice

National Family Medicine body - CFPC

CFPC-Infoway EMR Best Advice Guide - Advanced and Meaningful Use of EMRs

patientsmedicalhome.ca/resources/best-advice-guides/best-advice-guide-advanced-and-meaningful-use-of-emrs/

Modules 2 and 6 both cover most aspects of Virtual Care in a simple, quick read format for family docs. This is not an implementation guide, however.

National Medical Association - CMA

Working together with the CFPC and RCPSC, the CMA recently released the excellent Virtual Care Task Force report. An interesting read providing a good current state overview, but not applicable for rapid implementation of virtual care in a crisis.

www.cma.ca/new-report-roadmap-improve-virtual-care-canada