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Virtual urgent care is here to stay: driving toward safe, equitable, and sustainable integration within emergency medicine

  • CAEP Academic Symposium Paper
  • Published:
Canadian Journal of Emergency Medicine Aims and scope Submit manuscript

Abstract

Background

Virtual care in Canada rapidly expanded during the COVID-19 pandemic in a low-rules environment in response to pressing needs for ongoing access to care amid public health restrictions. Emergency medicine specialists now face the challenge of advising on which virtual urgent care services ought to remain as part of comprehensive emergency care. Consideration must be given to safe, quality, and appropriate care as well as issues of equitable access, public demand, and sustainability (financial and otherwise). The aim of this project was to summarize current literature and expert opinion and formulate recommendations on the path forward for virtual care in emergency medicine.

Methods

We formed a working group of emergency medicine physicians from across Canada working in a variety of practice settings. The virtual care working group conducted a scoping review of the literature and met monthly to discuss themes and develop recommendations. The final recommendations were circulated to stakeholders for input and subsequently presented at the 2023 Canadian Association of Emergency Physicians (CAEP) Academic Symposium for discussion, feedback, and refinement.

Results

The working group developed and reached unanimity on nine recommendations addressing the themes of system design, equity and accessibility, quality and patient safety, education and curriculum, financial models, and sustainability of virtual urgent care services in Canada.

Conclusion

Virtual urgent care has become an established service in the Canadian health care system. Emergency medicine specialists are uniquely suited to provide leadership and guidance on the optimal delivery of these services to enhance and complement emergency care in Canada.

Résumé

Contexte

Les soins virtuels au Canada ont rapidement pris de l’ampleur pendant la pandémie de COVID-19 dans un environnement où les règles sont peu strictes, en réponse aux besoins urgents d’accès continu aux soins dans un contexte de restrictions en santé publique. Les spécialistes de la médecine d’urgence sont maintenant confrontés au défi de conseiller sur les services de soins d’urgence virtuels qui devraient rester dans le cadre des soins d’urgence complets. Il faut tenir compte des soins sécuritaires, de qualité et appropriés, ainsi que des questions d’accès équitable, de la demande publique et de la durabilité (financière et autre). L’objectif de ce projet était de résumer la littérature actuelle et l’opinion d’experts et de formuler des recommandations sur la voie à suivre pour les soins virtuels en médecine d’urgence.

Méthodes

Nous avons formé un groupe de travail composé de médecins urgentistes de partout au Canada qui travaillent dans divers milieux de pratique. Le groupe de travail sur les soins virtuels a effectué un examen de la portée de la documentation et s’est réuni chaque mois pour discuter des thèmes et formuler des recommandations. Les recommandations finales ont été distribuées aux intervenants pour obtenir leurs commentaires, puis présentées au symposium universitaire 2023 de l’Association canadienne des médecins d’urgence (ACMU) pour discussion, rétroaction et perfectionnement.

Résultats

Le groupe de travail a élaboré et atteint l’unanimité sur neuf recommandations portant sur les thèmes de la conception du système, de l’équité et de l’accessibilité, de la qualité et de la sécurité des patients, de l’éducation et des programmes, des modèles financiers et de la viabilité des services virtuels de soins d’urgence au Canada.

Conclusion 

Les soins d’urgence virtuels sont devenus un service établi dans le système de santé canadien. Les spécialistes en médecine d’urgence sont particulièrement bien placés pour fournir un leadership et des conseils sur la prestation optimale de ces services afin d’améliorer et de compléter les soins d’urgence au Canada.

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Acknowledgements

The authors would like to thank the following partners who reviewed the working group recommendations and provided expert input: Dr. David Petrie (on behalf of EM:POWER), the Society of Rural Physicians of Canada, the CAEP Rural Remote and Small Urban Section, and the CAEP DigEM Committee.

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Authors and Affiliations

  1. Unity Health Toronto, Toronto, ON, Canada

    S. Mehta

  2. North York General Hospital, North York, ON, Canada

    S. Mehta

  3. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    S. Mehta, J. Hall & L. Chartier

  4. IWK Health, Halifax, NS, Canada

    K. Gardner

  5. Department of Emergency Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

    K. Gardner

  6. Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    J. Hall

  7. Sunnybrook Research Institute, Toronto, ON, Canada

    J. Hall

  8. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    J. Hall

  9. Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    D. Rosenfield

  10. Division of Paediatric Emergency Medicine, The Hospital for Sick Children (SickKids), Toronto, ON, Canada

    D. Rosenfield

  11. Department of Pediatrics and Emergency Medicine, University of Ottawa, Ottawa, ON, Canada

    S. Tse

  12. Children’s Hospital of Eastern Ontario, CHEO Research Institute, Ottawa, ON, Canada

    S. Tse

  13. Faculty of Medicine, Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada

    K. Ho & K. Grant

  14. Faculty of Medicine, Disciplines of Family Medicine and Emergency Medicine, Memorial University of Newfoundland, Newfoundland Regional Health Centre, Grand Falls-Windsor, NL, Canada

    D. J. Bradbury-Squires

  15. Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    E. Lang

  16. University Health Network, Toronto, ON, Canada

    L. Chartier

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  1. S. Mehta
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Corresponding author

Correspondence to K. Gardner.

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Conflict of interest

SM holds shares in Signal 1, an artificial intelligence company focused on providing health care solutions. The corresponding author states that there are no conflicts of interest on behalf of all other authors.

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Mehta, S., Gardner, K., Hall, J. et al. Virtual urgent care is here to stay: driving toward safe, equitable, and sustainable integration within emergency medicine. Can J Emerg Med 26, 305–311 (2024). https://doi.org/10.1007/s43678-024-00658-8

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  • DOI: https://doi.org/10.1007/s43678-024-00658-8

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