We have all been mandated to engage in social distancing and self isolation in order to prevent the further spread of Covid-19, and this includes physicians and other health care providers. The Chief Medical Officer of Health has ordered that all non-essential and elective services provided by regulated health professionals be reduced to minimal levels. This order is fully supported by the College of Physicians and Surgeons of Ontario (CPSO) evidenced by the fact that the CPSO has directed physicians to use their professional judgment to ensure that they abide by this order. This in turn has impacted the way in which health care services are provided to patients. The CPSO has instructed physicians to adopt virtual care into their practice, where appropriate, in order to continue to provide their patients with access to health care while avoiding potential exposure to Covid-19.
Providing health care services virtually allows physicians to continue to ensure that their patients’ health care needs are addressed during the wake of the pandemic. However, there are important considerations to keep in mind as administering virtual patient care may present some unique challenges.
When providing virtual care, physicians are required to continue to meet their legal and professional obligations as well as maintain the same standard of care that would apply to an in-person visit. From a privacy perspective, providing medical care virtually may pose some risk as there is an increased potential of a breach of privacy. There are different ways to engage in virtual consultations, some more secure than others. Using unencrypted methods of virtual care may result in health care services being delivered in a way that is non-compliant with the requirements under the Personal Health Information Protection Act (PHIPA). Failure to protect patient health information and comply with the requirements under PHIPA may result in a host of liability issues.
Physicians are required to safeguard the privacy and confidentiality of their patients’ personal health information at all times. Therefore, it is necessary to ensure that the technology used, as well as the physical setting in which the virtual patient consultation is being administered, is secure in order to comply with the physician’s legal and professional obligations regarding patient privacy. It is important for the physician to evaluate the suitability and safety of the physical setting in which the care is being delivered to patients, and to have a plan in place in order to manage an emergency or adverse incident occurring during the course of the virtual delivery of patient care.
Further, it is necessary to obtain consent from the patient to communicate virtually prior to engaging in remote delivery of health care services; the patient’s consent should then be documented in their file. The CPSO stresses the importance of obtaining consent from patients when using various modes of virtual care; however, given the current circumstances, such consent can be obtained immediately after the virtual visit has been initiated1.
Although providing health care services virtually is not necessarily ideal and may not always be practical, the current health crisis seems to dictate this method of providing care to patients, since it presents a means for physicians to continue to deliver health care to patients in an effective and timely way. For more information, please feel free to contact our Professionals Practice Group.
1 Covid-19: FAQS for Physicians (April 2020), online: College of Physicians and Surgeons of Ontario