What is Virtual Care?

The uptake of virtual care is on the rise with the help of advanced digital health solutions. This modernization of our healthcare system has led to the emergence of new terminologies. Here we provide a brief overview of definitions and examples related to virtual care to help pharmacists navigate through the common terminologies used in digital health.

May Zheng

June 24, 2020

Over the last few years, virtual care services have been proliferating in Canada. We are now on the verge of a digital transformation in healthcare. The Ontario Telemedicine Network reports a growth of 36% in virtual clinical events last year. However, despite this marked acceleration in virtual care, our overall adoption rate remains sluggish compared to other countries like England and the USA: 

Undoubtedly, COVID-19 has further accelerated the uptake of virtual care, especially amongst our physician colleagues. Similarly, the Ontario Pharmacists Association is recommending video consultation platforms such as OTN and MedMe Health

But, what exactly do terms like virtual care, telemedicine, and digital health mean? How are they relevant to pharmacy and why should we care? 


Defining Virtual Care

Interestingly, provinces have different interpretations of virtual care as there is currently no standard definition. For example, Alberta defines virtual care as “telemedicine mainly delivered via videoconference technology”. In contrast, other provinces have a broader definition that includes telehealth services (eg. video consults for clinical and non-clinical activities, image sharing, telephone/email, teletriage, and telemonitoring).

  

The formal definition of virtual care provided by WIHV is:

“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.”

 

In other words, “virtual care” is a broad term that encompasses all methods used to remotely communicate and interact with patients. It does not, however, refer to specific technologies used, participants involved, or pieces of information exchanged. 


Infographic 1 - Defining virtual care

Digital health, Telehealth, Telemedicine, Virtual care — What’s the difference?

While “virtual care” is often used interchangeably with other terms, there are intimate differences.


Infographic 2 - What is the difference?

Telepharmacy vs. Internet Pharmacy?

 

It’s a common misconception to equate “telepharmacy” with “internet pharmacies” such as PocketPills, Felixforyou, and Well.ca

The main distinction is that telepharmacies have a physical location staffed with at least one  regulated technician, but the pharmacist remotely supervises the site’s day-to-day operations from a host pharmacy. Patients are able to establish and continuously build a relationship with the pharmacist via videoconferencing technology. In contrast, for internet pharmacies, the patient’s experience and care journey is entirely online.

Infographic 3 - Internet Pharmacy vs Telepharmacy

Over the years, many safety concerns have been raised regarding Internet pharmacies. Some of the most concerning risks include:

  • Privacy and security risks (e.g. uploading personal information online, errors in delivery process resulting in breach of patient confidentiality)
  • Integrity of shipped medications (e.g. improper storage conditions during delivery, expired products)
  • Absence of a readily available pharmacist to address therapeutic concerns  
  • Fraudulent/illegal practices (e.g. difficult to confirm practitioner’s identity and validity of license)
  • Sub-par quality of drug information 
  • Negligible patient-pharmacist relationship resulting in a lack of patient-centered care 

While Internet pharmacies utilize an impersonal call-center model, telepharmacies allow the pharmacist to provide patient consultations in real-time. This preserves the role of pharmacists, continuity of care, and the sense of community and personal touch akin to visiting a local pharmacy.

Future of Virtual Care in Pharmacy

Since COVID-19, we’ve seen large pharmacy chains partner with telemedicine companies. Shoppers Drug Mart teamed up with Maple and Rexall joined with Tia Health to launch virtual care platforms for physician consultations. 


If community pharmacies are facilitating access to virtual physician visits, why are pharmacists not delivering their clinical services virtually?


At this time, OPA has only endorsed the use of OTN and MedMe Health, a pharmacy-specific platform, to provide patient care via video consults. Research has shown positive patient experiences with virtual medication reviews conducted by pharmacists. Moreover, OTN and Ontario Health support videoconferencing over telephone use in healthcare delivery because it allows for:

  • eye contact and assessment of body language, which are especially important when discussing sensitive topics 
  • family members/caregivers to participate during the virtual visit
  • greater insight on the patient’s home environment


Canadian healthcare is constantly and rapidly evolving in these uncertain times. Increased demand has urged the growth of virtual care. It’s crucial to ensure that we embrace change and do not get left behind. Pharmacy needs to adapt to healthcare trends in the best interests of our patients and for the advancement of our profession. 


How have you been leveraging virtual care at your pharmacy? We would love to hear about your experiences with virtual care!

Suggested Readings 

References:

  1. Virtual Care in Canada CMA Discussion Paper: https://www.cma.ca/sites/default/files/pdf/News/Virtual_Care_discussionpaper_v2EN.pdf
  2. CMAJ Telemedicine on the rise but lagging in Canada: https://www.cmaj.ca/content/190/38/E1149
  3. OTN Virtual Care in Action: https://otn.ca/virtual-care-in-action-archives/
  4. OTN Virtual is Vital : https://otn.ca/providers/ohts/otn-insights-virtual-vital/
  5. Pharmacy Informatics Global Glossary: http://elearnhcp.ca/mod/glossary/view.php?id=3342&mode&hook=ALL&sortkey&sortorder&fullsearch=0&page=3
  6. Canada Health Infoway-What is Digital Health: https://www.infoway-inforoute.ca/en/what-we-do/benefits-of-digital-health/what-is-digital-health#:~:text=Digital%20health%20refers%20to%20the,through%20innovative%20digital%20health%20solutions.
  7. ATA Paper on Telemedicine, Telehealth, and Health Information Technology: https://www.who.int/goe/policies/countries/usa_support_tele.pdf?ua=1#:~:text=Telemedicine%20is%20the%20use%20of,telemedicine%20is%20the%20term%20Telehealth.
  8. CSHP Telepharmacy Guidelines 2018: https://cshp.ca/sites/default/files/files/publications/Official%20Publications/Telepharmacy%20Guidelines_2018.pdf
  9. Understanding the Use of and Compensation for Virtual-care Services in Primary Care: https://www.mcmasterforum.org/docs/default-source/product-documents/rapid-responses/understanding-the-use-of-and-compensation-for-virtual-care-services-in-primary-care.pdf?sfvrsn=2
  10. The Difference Between Telepharmacy and Internet Pharmacy: https://blog.telepharm.com/the-difference-between-telepharmacy-and-internet-pharmacy
  11. SDM Maple FAQ and Minor Ailments: https://www1.shoppersdrugmart.ca/en/health-and-pharmacy/health/maple-faq-and-minor-ailments/811501
  12. Tia Health and Rexall: https://tiahealth.com/rexall.html

Graphics: Michelle Yee & May Zheng
Editors: Rui Su, Yifan Zhou & Michelle Yee

Disclaimer: The contents of this blog is to be used for informational purposes only and is not intended to replace clinical guidelines or the advice of a health professional. Patients should contact a health professional for appropriate advice.
© 2020 MedMe Health Ltd. All rights reserved.

WRITTEN BY:

May Zheng

May Zheng is a 4th-year PharmD student from the University of Toronto.

MedMe is a thought leader and software provider in pharmacy care

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