Expanding virtual care could improve patient care and narrow gaps in access for Canada’s sprawling population, says Dr. Gigi Osler, President of the Canadian Medical Association (CMA).
Osler was in Yellowknife last week for the NWT Medical Association’s annual general meeting to collect insights from doctors in the territory on virtual care and cultural competency.
Seven in 10 Canadians open to virtual care
Virtual health care refers to the “virtual visits” that take place between patients and clinicians using video and audio communications technology.
They allow “virtual” meetings to occur in real time, from just about any location.
An August Ipsos poll revealed that 70 per cent of Canadians would use virtual appointments if given the opportunity.
The CMA is looking to bridge care gaps by introducing virtual care and technological innovation, said Osler.
“Technology is not as scary and expensive as you’d think,” she said, adding that many Canadians already securely conduct highly confidential business online, including banking.
Tech advancements could address increasingly scarce dollars for health care, she said. Canada’s seniors make up 20 per cent of the population, but that demographic demands more than 50 per cent of health care spending.
“When I look at those numbers I think we have got to start doing things differently,” said Osler.
Virtual care piloted in the east
At Western Hospital in Alberton, P.E.I. a private company is contracted as part of a pilot offering virtual services.
Technology exists that transmits images through medical equipment like stethoscopes, though it is not widely used yet. If implemented properly a doctor hundreds of miles from a patient could listen to the heartbeat of a patient and perform other diagnostic tests. The technology could also be used for seniors who want care centralized at home.
Local nurses have limited diagnostic technology and virtual care could help practitioners make decisions about whether to medevac or send a patient for further testing, said Osler.
To implement virtual care, provinces and territories would have to bridge internet access gaps for remote communities and economically disadvantaged Canadians.
“There are access issues even in big cities,” said Osler.
The greatest barrier is Canada’s licensing rules, she said. Medical practitioners take national exams but are limited to serving patients in their home provinces.
To offer telehealth and locum care, Canada would need to create a national license.
Workplace diversity and traditional healing
The CMA also visited the Arctic Indigenous Wellness Centre to understand how the territory is incorporating traditional healing into health care.
The organization, which represents 85,000 medical practitioners, has a vested interest in seeing “structural changes” around cultural competency and safety, she said.
Osler points to Whitehorse General Hospital, which has seen significant progress to incorporate cultural safety into delivery of care, taking it “further than any other mainstream hospital.”
Improving patient outcomes also hinges on boosting diversity in the physician workforce, said Osler.
Lacking diversity in the medical field has tangible effects on health outcomes for women, who are under-diagnosed and under-researched. Women presenting with cardiac arrest were studied over the course of 17 years in a 2018 American study. The study found that mortality was higher among female patients cared for by doctors who were men.
The same study found that mortality rates equalized for both men and women who were treated by women doctors. In addition to continued training, boosting diversity in the workforce is one of the most effective ways to improve patient outcomes and cultural competency.