With a greater emphasis being placed on virtual care, there is a move now to look at other medical conditions that can be helped out by the virtual or video conferencing method.
The role of virtual care has been growing significantly in Northern Ontario, according to Dominic Giroux, the president and CEO of Health Sciences North in Sudbury, the largest hospital in Northern Ontario.
Giroux commented in a news interview in September that virtual care appointments and consultations had more than tripled during a recent five month period in 2020, when compared to the previous year.
A new review in the Canadian Medical Association Journal (CMAJ) is examining the idea of more virtual care, especially for Alzheimer disease and other related dementia conditions.
"People with Alzheimer disease and related dementias may face unique challenges in securing access to necessary health care, such as difficulties recognizing their need for medical care, communicating health concerns and navigating complex health systems," said the article.
The review was authored by Dr. Paula J. Gosse, Dr. Charles D. Kassardjian, Dr. Mario Masellis and Dr.Sara B. Mitchell, all members of the Faculty of Medicine at the University of Toronto and the Hurvitz Brain Sciences Research Program.
The article also said that virtual care is increasingly being used as a method to overcome the physical barriers to health care and improves accessibility in rural and remote parts of Canada, which would apply to Northern Ontario.
"These challenges may be compounded during the COVID-19 pandemic, as people who normally rely on in-person support to complete daily tasks, such as transportation to and attendance at medical appointments, may be disproportionately affected by the need for physical distancing," said the article.
The article also examined and considered the uses of telephone and the use of video-teleconferencing (VTC).
The article said the telephone interview process had useful characteristics, but also noted that the VTC option was the closest to in-person assessments for such things as establishing a new diagnosis of Alzheimer disease or a related dementia.
The authors also noted there are challenges for VTC virtual care. This would make accurate assessments difficult for patients with severe hearing, visual or cognitive impairments. There are also problems that arise with slow or less reliable internet connections.
The review also examined the concept of virtual care from the patients’ point of view and found there was acceptance and satisfaction for VTC consultations, especially among older adults.
"Modality preferences among patients range from a preference for VTC over in-person encounters, to no apparent preference. Identified advantages of virtual care include convenience from resources and time saved, and improved access to specialist care," said the study.
In conclusion the article said virtual care is here to stay, it is rapidly evolving and should continue to expand as technology responds to health care demands.
However, there are still unresolved questions according to the authors.
- Is virtual care appropriate across the spectrum of cognitive and sensory impairment, including for those with more severe deficits?
- Can virtual care improve clinical outcomes in patients with Alzheimer disease and related dementias and other neurodegenerative diseases?
- Is the direct-to-home approach to virtual care feasible, acceptable, and effective for people with Alzheimer disease and related dementias?
- Is virtual care equally accessible to all people with Alzheimer disease and related dementias? If not, what measures can be taken to ensure equitable access?
The result according to the article is there are still limits on virtual care with "most experts" suggesting that virtual visits be used to supplement in-person encounters, instead of replacing them.
Len Gillis is a Local Journalism Initiative reporter at Sudbury.com, covering health care in Northern Ontario. The Local Journalism Initiative is funded by the federal government.
