Virtual care and COVID-19: A survey study of adoption, satisfaction and continuing education preferences of healthcare providers in Newfoundland and Labrador, Canada

Abstract

IntroductionVirtual care has expanded during COVID-19 and enabled continued access to healthcare services. For many healthcare providers, the adoption of virtual care has been a new experience in the provision of healthcare services. The purpose of this survey study was to explore healthcare providers' experiences with virtual care during COVID-19.MethodsA web-based survey-questionnaire was developed by applying Rogers' theory of diffusion of innovation and distributed to healthcare providers (physicians, nurses and allied health professionals) in Newfoundland and Labrador, Canada to explore virtual care experiences, satisfaction and continuing professional development (CPD) needs. Analyses included descriptive statistics and thematic analysis of survey responses.ResultsFifty-one percent of respondents (n = 432) indicated they were currently offering virtual care and a majority (68.9%) reported it has improved their work experience. Telephone appointments were preferred over videoconferencing by respondents, with key challenges including the inability to conduct a physical exam, patients' cell phone services being unreliable and patients knowing how to use videoconferencing. Majority of respondents (57.5%) reported quality of care by telephone was lower than in-person, whereas quality of care by videoconferencing was equivalent to in-person. Main benefits of virtual care included increased patient access, ability to work from home, and reduction in no-show appointments. Key supports for adopting virtual care included in-house organizational supports (e.g., technical support staff), local colleague support, and technology training. Important topics for virtual care CPD included complying with regulatory standards/rules, understanding privacy or ethical boundaries, and developing competency and digital professionalism while engaging in virtual care.DiscussionBeyond the COVID-19 pandemic, virtual care will have a continuing role in enhancing continuity of care through access that is more convenient. Survey findings reveal a number of opportunities for supporting healthcare providers in use of virtual care, including CPD, guidelines and resources to support adaptation to virtual care provision (e.g., virtual examinations/assessments), as well as patient educational support.

An Approach to the Design and Development of an Accredited Continuing Professional Development e-Learning Module on Virtual Care

“…The Canadian Institute for Health Information (CIHI) reported that between March to September 2020, the percentage of patients availing of virtual care services increased from 6% to 56% [1]. Virtual care refers to the delivery of healthcare services digitally or at a distance using Information and Communications Technology [2,3,4]. During COVID-19 a variety of virtual care types were used with synchronous and asynchronous appointments being the most common [3,4].…”

“…Virtual care refers to the delivery of healthcare services digitally or at a distance using Information and Communications Technology [2,3,4]. During COVID-19 a variety of virtual care types were used with synchronous and asynchronous appointments being the most common [3,4]. Synchronous virtual care refers to communication between healthcare provider and patient that occurs in real time and can include use of telephone and/or videoconferencing.…”

“…Synchronous virtual care refers to communication between healthcare provider and patient that occurs in real time and can include use of telephone and/or videoconferencing. Asynchronous communication does not occur live and may include the use of e-mail messaging, messages left for patients in a portal site, and e-consultations [3,4,5]. Considering the goal of reducing COVID-19 exposure during the recent global pandemic, virtual care proved to be most effective in that it minimized exposure and risk to healthcare providers by reducing movement of people [2][3][4][5][6][7].…”

“…Asynchronous communication does not occur live and may include the use of e-mail messaging, messages left for patients in a portal site, and e-consultations [3,4,5]. Considering the goal of reducing COVID-19 exposure during the recent global pandemic, virtual care proved to be most effective in that it minimized exposure and risk to healthcare providers by reducing movement of people [2][3][4][5][6][7]. In addition, virtual care helped patients stay home who may have otherwise traveled to a healthcare site and incurred risk of unnecessary exposure [3,4,6,7].…”

“…Considering the goal of reducing COVID-19 exposure during the recent global pandemic, virtual care proved to be most effective in that it minimized exposure and risk to healthcare providers by reducing movement of people [2][3][4][5][6][7]. In addition, virtual care helped patients stay home who may have otherwise traveled to a healthcare site and incurred risk of unnecessary exposure [3,4,6,7]. Virtual care was also used for control and triage during COVID-19, remote monitoring of patients, treatment and management, and provision of online health services [3,4] [3,4,[12][13][14][15].…”