by Sadaf Ahsan
Telemedicine is like a long-distance relationship, clinical neurophysiologist Evan Lewis says.
“Nothing can replace being with your partner, physically, in the same room,” he says. “But if your partner goes off to Europe or somewhere to study, you’re going to use all the things possible to augment your relationship. Telehealth is a tool in our toolkit. It’s meant to complement our practice.”
Lewis runs an epilepsy clinic where patients can be seen on the same day as opposed to the typical six- to 18-month wait for a neurologist in Toronto. To him, telehealth is a no-brainer. But despite being around for well over two decades, it has generally been viewed as a last resort for patients and practitioners in Canada.
It’s much more routine in the U.S. and Europe. Prior to the pandemic, fewer than 0.15 percent of Canadian health-care visits occurred via digital services, probably because so many either did not know it was an option or simply did not trust it to be as effective as in-person treatment.
Since COVID-19, telehealth has become a primary option. It’s efficient and accessible, faster and cheaper than a brick-and-mortar clinic, and requires fewer resources. It’s also safer, keeping sick people out of waiting rooms.
Most importantly, telehealth reduces hospital readmissions by 15 percent and mortality rates by up to 35 percent. Consultations with doctors, arranged through virtual health-care companies, are covered by the B.C. Medical Services Plan and OHIP in Ontario.
“Telehealth is more important now than ever with doctors closing their clinics all over Canada,” says David Del Balso, Tia Health’s CEO. “Provinces across the country have been slowly rolling out virtual care—COVID has accelerated this—and many plan to continue offering coverage after the pandemic ends.”
Whereas telehealth used to be more common in rural areas and for Indigenous and mental-health services, it has now gained footing in just about every clinical department in most parts of Canada.
A typical appointment is similar to an in-person booking: you can schedule it online, often for the same day. You receive a notification once a doctor is available, and a patient chart for continuous care. A discussion and treatment plan follow. Follow-ups and referrals can be made, X-rays and blood tests can be assigned, and medications can be delivered.
With patients only going into a clinic when necessary, the process becomes more efficient offline as well, and health risks are also reduced for doctors, who can go in for urgent cases only.
Ontario’s virtual health-care services include: the nonprofit Ontario Telemedicine Network (OTN); Women’s College Hospital, on its way to becoming Canada’s first virtual hospital; a program at SickKids Hospital; and growing private services.
In B.C., the Provincial Health Services Authority has an Office of Virtual Health, which has a toolkit for clinicians to use. Meanwhile, WorkSafeBC and ICBC recently approved telehealth for anything that doesn’t require a physical examination or assessments, according to the Doctors of BC website. It states that new temporary fee codes were created for specialists, effective April 15, “as a response to the changing needs of the health care system during the COVID-19 pandemic”.
Telehealth is not a replacement for in-person treatment, but instances when a patient must be touched are rarer than you might expect. Seventy percent of medical conditions can be diagnosed without touching, according to Hamza. Most diagnoses are based on personal history, symptoms, and what a patient feels.
Many of the doctors behind these networks are hoping for sustainable public funding. Different telehealth services are covered in different provinces, often due to legislation that does not allow doctors to provide treatment to patients outside their offices or even their jurisdiction. In fact, many doctors are pushing for national licensure so they are able to provide virtual care to underserved communities across the country.
All health-care tech must be compliant with British Columbia’s Personal Information Protection Act to protect patient privacy.