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Reason for Action: It was identified that TeamUHN requires a resource to support assessment of when virtual care is suitable for a patient. The
Clinical Guiding Principles for Virtual Care were developed to meet this need.
Purpose: This document is a guide for TeamUHN, including care providers, administrative staff, and learners, to enhance the patient care experience through virtual care. It was developed and is maintained by UHN's Virtual Care Clinical Advisory Panel. Comments and suggestions are always welcomed (contact details below).
Consider clinical, psychosocial, socioeconomic, cultural and social identity needs and preferences when determining suitability for virtual care. As with any important decision, ensure that all available options are provided to and understood by patients so that they may have the opportunity to consider their options and participate fully in shared decision-making.
Part 1: Clinical Considerations
Care providers should consult and practice within the virtual care standards or guidelines defined by regulatory bodies and/or associations of their profession.
Access barriers must be considered in clinical decision making regarding virtual high risk prescribing. High risk prescribing should be practiced in environments where the goals of therapy are clear and patients receive ongoing interprofessional care (e.g., Palliative Care, Chronic Pain Management and Addiction Medicine).
Part 2: Patient Preference, Access & Barriers
Patient preference regarding virtual or in-person care must be always be considered. If the patient and provider decide on virtual care, it is important to also establish the most effective modality (e.g., telephone or videoconference). The following principles are intended to support patient-centred care and UHN's primary value of "the needs of patients come first" (see
UHN's Patient Declaration of Values).
Access and Equity
A literature review on access and equity barriers to participating in virtual care amongst particular populations has been initiated (April 2021). This document will be updated to include findings of the literature review.
Please note, Virtual Care at UHN is working towards developing patient resources to build digital literacy skills and outline device requirements. Additional resources will be linked to this document as they become available.
Virtual Care at UHN is committed to working with patient partners, clinical teams, Social Medicine Program, and groups across UHN to creatively and effectively meet the evolving needs of our patients and TeamUHN.
We always welcome comments and suggestions to improve the Clinical Guiding Principles for Virtual Care.
Jennifer Catton, Director, Outpatient Strategy & Diagnostic Performance.
Examples of urgent virtual care programs with appropriate expertise and supporting resources.
1 High risk prescribing: Prescribing of high-alert medications. High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error. Harm is defined as a temporary or permanent impairment in body functions or structures. Includes mental, physical, sensory functions and pain. Institute for Safe Medication Practices (2018, 2005).