9 DECEMBER 2023to use virtual care in the future, 59% are unlikely to use it in the context of virtual on-demand clinics without the ability to provide continuity or a physical assessment when needed. Physician remuneration had been a barrier until March 2020. Despite physician compensation modernization in Alberta for virtual care during the pandemic, some providers were concerned that certain diagnoses could be missed without a physical exam. Other physicians have remarked on the erosion of work-life boundaries and video fatigue. Furthermore, until now, healthcare providers have had next to no training in virtual care. On a positive note, however, the province-wide AHS electronic medical record system being deployed through 2024 will provide sharing of patient health information across different providers and geographic zones, even though communication with primary care remains one-directional information access only at this time. In 2021, the Alberta Virtual Care Working Group, a body with multiple stakeholders from Alberta Health, Alberta Health Services, Colleges of Pharmacy, Nursing, and Physicians, Federation of Regulated Health Professionals, Indigenous peoples, and patient representatives examined the state of maturity of virtual care in the province, proposing design principles for virtual care. Not surprisingly, with virtual care still in its infancy, when examining the technology, interoperability, leadership and governance, care models, and sustainability, we>90% of those surveyed in AHS Virtual Health reported very basic maturity. SO HOW WILL VIRTUAL CARE SUCCEED IN ALBERTA AND BEYOND? Virtual care must not operate in a silo. Providers and the system must not think of virtual care as something novel and exotic. Virtual care is simply healthcare and must be integrated into the continuum of patient care needs. Patients should not be arbitrarily separated into those that receive virtual care from one team of providers, and another team that provides in-person care.SO HOW WILL VIRTUAL CARE SUCCEED IN ALBERTA AND BEYOND? 1. Virtual care must not operate in a silo. Providers and the system must not think of virtual care as something novel and exotic. Virtual care is simply healthcare and must be integrated into the continuum of patient care needs. Patients should not be arbitrarily separated into those that receive virtual care from one team of providers, and another team that provides in-person care. Properly coordinating this care, allowing for patients to move dynamically and seamlessly between these two realms within the same circle of care is essential for the future; much like online banking is simply one form of banking in a larger host of financial services.2. The system and government must decide on how to allocate resources for all of healthcare. Is the virtualization of care simply for patient convenience, or does it actually improve access to care? Alberta, very much like the rest of Canada, is in a crisis with a shortage of family physicians. The data shows that despite the uptake of virtual care, overall clinical volumes have not increased. This is simply because virtual care does not shorten a clinical encounter. Often, more time is needed to ensure that critical details are not missed without a physical exam.3. There needs to be a robust evaluation strategy. While there is plenty of data examining clinical encounter volumes, the evidence to prove that virtual care is safe, or cost-effective is either varied or absent. Society, along with our healthcare system and elected officials, need to decide if we are after cost savings, improved access, or ideally both. This can only be accomplished with reliable data on patient outcomes, and tangible and intangible costs to the system as well as to society.Covid-19 has forever changed the way healthcare is provided. Virtual care is here to stay. For it to be sustained, we must align as providers, patients, and systems, to ensure that care is safe, equitable, clinically appropriate, and integrated with the rest of healthcare. ACCORDING TO A FEBRUARY 2021 SURVEY CONDUCTED BY ALBERTAPATIENTS.CA, WHILE 73% OF PATIENTS ARE LIKELY TO USE VIRTUAL CARE IN THE FUTURE, 59% ARE UNLIKELY TO USE IT IN THE CONTEXT OF VIRTUAL ON-DEMAND CLINICS WITHOUT THE ABILITY TO PROVIDE CONTINUITY OR A PHYSICAL ASSESSMENT WHEN NEEDED
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