178 7.5 Digital Healthcare

Virtual care is defined as “any interaction between patients and/or members of their circle of care, occurring remotely, using any forms of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of patient care”^[1]. With the onset of the COVID-19 Pandemic, the launching of new and/or expanded virtual care offerings has rapidly expanded, and virtual care is now an essential part of a sustainable model in the Canadian health care system.

For LTC, virtual care was extremely valuable and assisted vulnerable residents to retain the capacity to have ongoing appointments with healthcare providers, while avoiding risky and often expensive visits to consultant offices or the emergency room. Virtual care providers have had to pivot and adapt to changing rules and guidelines. Modifications have been made in both how services are funded, and in how providers are licensed to provide care across the country^[2].

Healthcare providers should reflect on and follow best practices, which include:

• Ensuring virtual care is suitable for the patient given the reason for consult, the patient’s condition and the restrictions of technology
• Ensure they have liability protection and confirm that the patient’s whereabouts will not impact their safety
• Be aware of the governing/legislated standards and guidelines concerning virtual care
• Track out-of-province virtual care appointments and rationalizations for providing such care when necessary
• Inform themselves of the local resources where the patient is located to ensure continuity of care
• Maintain comprehensive and up-to-date documentation for all virtual care encounters in the same manner in-person appointments would be documented

“Whether a nurse sees a client in person or through telepractice, and whether they deliver care through a private company or provincially funded program, they generally remain professionally and legally accountable for the services provided through this interaction.”^[3].

• Important legal considerations to consider include:
• Jurisdictional issues
• Health records
• Conflict of Interest
• Privacy^[4]

Limitations to virtual care:

• No direct observation of the client
• Communication

Risk mitigation with virtual care practice:

• Be knowledgeable of and practice within your scope
• Identify when telepractice is not appropriate
• Avoid conflicts of interest
• Obey professional standards
• Operate telepractice technology safely and in compliance with privacy legislation
• Cultivate and uphold effective communication skills
• Ensure comprehensive, complete documentation