OntarioMD and the Ontario Medical Association are committed to helping raise awareness to physicians and their practices about tools that they might consider in supporting their patient community during the COVID-19 pandemic. While OntarioMD has not evaluated these tools and does not endorse one tool over another, we believe there is value in curating a list of tools to which OntarioMD has visibility based on our relationships and/or engagements with various provincial and national stakeholders. We encourage all practices to contact vendors directly for product-specific questions.
During this time of COVID-19, you will likely need to think about three things using virtual tools:
Care for patients with suspected COVID-19:
Care for regular patients:
There are many virtual tools that can be used to help you provide the best care in a rapidly changing outbreak environment.
On March 14, 2020, the MOH and OMA agreed on temporary telephone and video fee codes for family physicians and specialists to reduce the risk of COVID-19 spread by keeping people at home and out of doctors’ offices. Please visit the OMA virtual care page for more information on the temporary K codes: K080 (virtual minor assessment or equivalent), K081 (virtual intermediate assessment or equivalent), K082 (mental health and counselling or equivalent) and K083 (specialist), the Ontario Virtual Care Program codes and Frequently Asked Questions.
Any direct-to-patient telephone, telemedicine and video calling platforms can now be used as the work is remunerated with the new fee codes, rather than the platform you choose. This allows rapid and wide scaling of care that works best in your area. When choosing, consider how easy the technology is for you to use, how easy it is for patients to use, how the technology can help you keep patient information private and secure, and that you must record the work in your medical record. Additional technical guidance may be provided by the Ministry to inform technology selection and this page will be updated to point to the information. Consider the right type of contact, for the right patient, at the right time, for the right problem. Video conferencing and phone calls are payable under the fee codes above, but email and texts to patients may also be useful for care, even if not discretely funded.
Unless you are using virtual care technologies where consent from the patient is handled at sign-up, you should ask patients for their consent.
Information vetted by OMA and OntarioMD legal teams and the CMPA has been created to make this easier. OMA Legal has prepared a short paragraph statement and information to provide to patients to initiate a Virtual Care patient encounter which has also been vetted by the CMPA. Click the blue button immediately below to view the statement.
More information to help support the consent process is available on the OMA’s virtual care page. We also suggest posting the following information to your website, in your office, or making it available to patients and adapting it for when you explain it to them. Click the blue button immediately below to view this information:
You should also record that verbal express consent was obtained when using a product that does not have explicit health care consent.
OHIP has issued two recent InfoBulletins pertaining to virtual care. InfoBulletin 4745 details changes to the Schedule of Benefits for Physician Services (Schedule) in response to COVID-19 influenza pandemic effective March 14, 2020. InfoBulletin 4746 covers billing for virtual physician services and technical guidance.
Ontario Health (Digital Services) has created instructions for physicians on how to get ONE ID credentials to use provincial digital health systems such as the OTN virtual care tools. Physicians can visit the CPSO website to get ONE ID credentials or check to see if you already have them.
Ontario Health (Quality) has created a guidebook with OTN on best practices for bringing virtual care into your clinic. You might find it helpful. It can be found here.
There are also tools that can be leveraged for your practice to enhance the flow of patients, enable their care at home, or the ability for you to communicate with them. Some are offered by EMR vendors and some are stand alone. All below have stated they are PHIPA compliant, and consent for use is collected by the tool on patient sign-up.
EMRs have other workflow assistance built into their core functionality that can assist with working virtually. Here is a sample of what they may offer: