Publications
Virtual Care
11 April 2023
Recent years have seen a transformation in health care thanks to virtual care. Virtual care connects health consumers with health care providers, through technology, allowing for the delivery of safe and efficient care when and where it is needed[1]. The promise of virtual care is that it can help consumers receive more appropriate and timely care.
The COVID-19 pandemic has accelerated the adoption of virtual care, making it an essential part of our health care system. In just a year or two, we have made a decade of progress. We cannot afford to go back to the pre-pandemic health care system. Instead, we must take advantage of the advancements made in virtual care to improve patient care and promote better health outcomes.
Benefits of virtual care
Virtual care offers several benefits to consumers and health care providers. These include:
- Reducing travel time and costs related to attending appointments.
- Minimising disruptions to daily routines, especially for those who face difficulties attending face-to-face appointments or have to travel long distances.
- Providing easier and more timely access to care, including the ability to receive care from the comfort of their own homes.
- Granting access to specialist services that might not be available in your area otherwise.
While we can see many of the benefits that virtual care provides, consumers see that it needs to complement traditional face-to-face care rather than replace it. Virtual visits offer convenience and improved access for consumers and carers by reducing the need to take time off work, secure child and elder care, and find transportation. Consumers tell us that they prefer seeing a new clinician face-to-face to establish rapport. Still, virtual care has become an essential component of our health care system and its use will continue to grow.
What does virtual care involve?
Virtual care connects consumers with their health care providers through various means such as phone calls, video calls, remote monitoring, or sending clinical information electronically to another person or site for evaluation or management. For example, consumers can track their health status using remote monitoring devices such as heart monitors and send this data electronically to their health care providers for review. This allows for real-time monitoring of patients’ health conditions, enabling timely intervention and appropriate delivery of care. With virtual care, consumers can receive medical attention remotely.
The importance of terminology
While virtual care, telemedicine, telehealth, and digital health are often used interchangeably, these terms are different. Virtual care and telemedicine refer to the use of technology to provide remote clinical services, while telehealth encompasses remote health care services, education, and administrative support[2]. Digital health involves using technology to manage health and wellness, including electronic health records, health apps, and wearable devices[3]. Despite the terminology differences, their underlying goal is to enhance access to health care services, improve patient outcomes, and lower costs.
Electronic patient portals can improve consumers’ involvement in their care. Consumers and family carers play a critical role in managing our health, especially when living with chronic conditions like diabetes, cancer, and in recovery rehabilitation. We want to schedule appointments ourselves, request blood tests and medication consistent with our treatment, review test results, and communicate with our care teams using secure messaging and telephone or video conferencing. This is the promise of the Digital Health Record (DHR) that we are focused on.
Evaluating Telehealth with an Equity Lens
Evaluating Telehealth through an equity lens is crucial because virtual care can also worsen existing health disparities[4]. Consumers’ access to technology, broadband, and digital literacy varies widely among consumer populations, leading to a reinforcement of existing inequities in health care access.
To ensure the permanent expansion of telehealth does not have unintended consequences, health care providers must take intentional action to minimise digital barriers associated with age, location, preferred language, and socioeconomic status. By doing so health care providers can improve access to quality care and promote health equity within our highest risk and most underserved communities. To achieve this, it is essential to work with a range of consumers to understand their needs and preferences for engaging with telehealth. We also need a plan for consumer education and upskilling so that consumers feel confident in participating in virtual care. Services need to seek consumer feedback from people who have used virtual care appointments to hear about their experiences. This is all part of bridging the digital divide and ensuring that all patients have equal access to virtual care.
Virtual care and the environment
Virtual care has been promoted for almost a decade to reduce carbon emissions by decreasing the need for travel. In the UK, travel accounts for 10% greenhouse gas emissions across the National Health Service (NHS), with an estimated 5% of all road travel in 2008 attributed to the NHS[5]. Although the size of greenhouse gas emissions from virtual care in other countries is uncertain, the UK can serve as a proxy given their shorter distances and higher use of public transport. It is unclear what the direct carbon footprint of telemedicine is and whether there are any rebound effects. We need to look at this issue further to understand the environmental impact of virtual care.
Conclusion
In conclusion, we want virtual care to become an indispensable part of the health system. Patient portals have a role in building agency and allowing consumers and carers to be more active in care.
Virtual care is here to stay, but what it will look like, who it will benefit, and who it will leave behind is to be settled. We do not want to worsen long-standing inequities, leaving many vulnerable people on the wrong side of the digital divide.
[1] What is virtual care? – Virtual care (nsw.gov.au)
[2] Haleem A, Javaid M, Singh RP & Suman R “Telemedicine for healthcare: Capabilities, features, barriers, and applications” (2022), Vol. 2, Sensors International, 100117
[3] See Note 2
[4] Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review
[5] Health care’s response to climate change: a carbon footprint assessment of the NHS in England