An Overview of Direct-to-Patient Virtual Visits in Canada

Gray, Casey; Mason, J. Wright; Loshak, Hannah

doi:10.51731/cjht.2021.80

Cited by 9 publications

(17 citation statements)

References 11 publications

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“…The proliferation of private services could also explain the association between insurance status and the use of secure messaging. In response to COVID-19, temporary billing codes were established by all provinces and territories, with the exception of Nunavut [ 24 ]. Most provinces provide billing codes to cover synchronous visits through telephone and video, but coverage for secure messaging is sparse [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…In response to COVID-19, temporary billing codes were established by all provinces and territories, with the exception of Nunavut [ 24 ]. Most provinces provide billing codes to cover synchronous visits through telephone and video, but coverage for secure messaging is sparse [ 24 ]. The use of secure messaging services might therefore be limited by private health insurance coverage, as our study suggests.…”

Section: Discussionmentioning

confidence: 99%

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Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

Yu¹,

Hagens²

2022

JMIR Aging

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Background The COVID-19 pandemic has limited the provision of in-person care and accelerated the need for virtual care. Older adults (65+ years) were 1 of the highest user groups of in-person health care services prior to the pandemic. Social distancing guidelines and high rates of mortality from coronavirus infections among older adults made receiving in-person health care services challenging for older adults. The provision of virtual care technologies can help to ensure continuity of care and provide essential health care services during the pandemic to those at high risk of contracting the COVID-19 coronavirus, including older adults. It is also essential to understand and address potential socioeconomic, demographic, and health disparities in the demand for and use of virtual care technologies among older adults. Objective The objective of this study is to investigate socioeconomic disparities in the demand for and use of virtual visits during the COVID-19 pandemic among older adults in Canada. Methods A cross-sectional web survey was conducted with 12,052 Canadians over the age of 16 years, selected from Leger’s Léger Opinion panel from July 14 to August 6, 2021. Associations between socioeconomic factors and the demand for and use of virtual visits were tested using χ2 tests and logistic regression models for telephone visits, video visits, and secure messaging. Weighting was applied using the 2016 census reference variables to render a representative sample of the Canadian population. Results A total of 2303 older adults were surveyed. Older adults expressed the highest demand for and use of telephone visits, following by video visits and secure messaging. eHealth literacy was positively associated with the use of all 3 virtual care modalities. Higher income was negatively associated with the use of video visits (odds ratio [OR] 0.65, 95% CI 0.428-0.974, P=.03). Having no private insurance coverage was negatively associated with use of secure messaging (OR 0.73, 95% CI 0.539-0.983, P=.04), but living in a rural community (OR 0.172, 95% CI 1.12-2.645, P=.01) and being born outside of Canada (OR 0.150, 95% CI 1.041-2.173, P=.03) were positively associated with the use of secure messaging. Higher education (OR 0.078, 95% CI 0.633-0.97, P=.02) and being non-White (OR=0.054, 95% CI 0.312-0.92, P=.02) were negatively associated with the use of the telephone. Conclusions This study found that compared to video visits and secure messaging, the demand for and use of telephone visits were more prevalent among older adults during the pandemic. The gaps between the demand for and use of video and secure messaging services remain substantial. Our results highlight socioeconomic disparities among older adults that could potentially explain this trend. Lower income and a lower education level may act as barriers for older adults in acquiring the skills and technologies necessary to use more complex solutions, such as video and secure messaging. In addition, higher eHealth literacy was found to be critical for older adults to successfully navigate all types of virtual visit technologies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

Yu¹,

Hagens²

2022

JMIR Aging

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“…Horizon scanning in the virtual care space has highlighted the importance (and current limitations) of operational considerations of these technologies such as remuneration practices, inter-jurisdictional licensure, equitable and affordable access to care, data privacy and security, and appropriate patient selection. 13,15,17 The continued scanning for emerging technologies in the digital health and virtual care space will enable us to prepare and assess the potential impact on the healthcare system, as well as monitor the evidence base for HTAs when adoption decisions are imminent.…”

Section: Emerging Virtual Care Technologiesmentioning

confidence: 99%

Virtual care and health technology assessment considerations

Cooper-Jones

Mason

Kamel

et al. 2022

Healthc Manage Forum

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The COVID-19 pandemic resulted in a rapid adoption of virtual care. Virtual care existed before the pandemic for specific conditions and circumstances. Health Technology Assessment (HTA) of virtual care evaluated clinical and cost-effectiveness to inform decisions about the optimal use prior to the pandemic but the necessary implementation of virtual care during the pandemic meant HTA was not feasible prior to adoption. The questions for HTA no longer focused on clinical or cost-effectiveness and focused on implementation considerations. Health technology assessment post-adoption of virtual care included questions such as the appropriate medical conditions for virtual care, training, billing, patient and clinician perspectives and experiences, and equity of access. Moving forward, it is important for HTA organizations to identify new and emerging virtual care technologies, explore early and other types of evidence, assess the potential impact on the healthcare system, and explore the operational considerations.

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“…CADTH has published many reports on various topics within virtual care, including virtual care evaluation approaches, 10 enablers for virtual visits, 20 effectiveness of and guidelines for telehealth-delivered supervised consumption services, 21 virtual care for patients with schizophrenia/psychosis, 22 perspectives and experiences of virtual care, 23 virtual waiting rooms, 24 and remote presence versus videoconference. 25 CADTH's evidence bundle on Digital Health contains additional reports on telehealth and telemedicine.…”

Section: Conclusion and Implications For Decision Or Policy-makingmentioning

confidence: 99%

Virtual Care Use in Primary Care or Specialty Care Settings

Nayakarathna¹,

Neilson²,

MacDougall³

et al. 2022

cjht

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Five evidence-based guidelines met the eligibility criteria for this report. Of the 5 guidelines, 2 provided recommendations on rheumatology practice, 1 on stroke, 1 on oncology, and 1 on digital innovations for all areas of health; none of them focused on primary care specifically. Three were developed in the context of COVID-19. While all 5 guidelines were informed by a systematic literature search, some specific recommendations were based on expert consensus, given the absence of literature on the respective topics. The quality of evidence and strength of recommendations, where available, were generally assessed to be low across the guidelines. The evidence-based guidelines provided recommendations across various aspects of virtual care delivery including population considerations, patient conditions, and the types of care that can be offered virtually. They also provided recommendations on when to offer or discontinue virtual care, on patient privacy, and on staff training. One guideline provided a recommendation on fees and reimbursement. Multiple evidence-based guidelines stated that virtual care should complement rather than replace in-person care, and that virtual care should only be implemented when adequate resources and personnel are available and patient privacy can be secured.

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An Overview of Direct-to-Patient Virtual Visits in Canada

Cited by 9 publications

References 11 publications

Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

Socioeconomic Disparities in the Demand for and Use of Virtual Visits Among Senior Adults During the COVID-19 Pandemic: Cross-sectional Study

Virtual care and health technology assessment considerations

Virtual Care Use in Primary Care or Specialty Care Settings

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