Virtual care: when and why?
August 4, 2021
Use critical thinking to consider if virtual care is appropriate for your patient.
In the early stages of the COVID-19 pandemic, ACP developed interim guidelines to support pharmacy teams provide virtual care to meet the immediate needs of their patients. This allowed Albertans to receive pharmacy care at a time when many were unable to see their pharmacy teams in person. ACP recognizes that virtual care can be an important option for many individuals, including those who have mobility issues or who live in remote locations. That’s why ACP developed the guidelines for Providing virtual care to patients for longer term purposes, so that appropriate virtual care can continue as we learn more about its need and effectiveness. The need for consistent demonstration of fundamental professional behaviours is critical, where pharmacist assessments are thorough and critical thinking is applied to decisions that support effective patient experiences and the appropriate use of drugs.
ACP’s Standards of Practice for Pharmacists and Pharmacy Technicians (SPPPT) have not changed to accommodate virtual care. The standards are exactly as they were written before the pandemic began. Pharmacists and pharmacy technicians must review the guidelines in context with the SPPPT. Virtual care must be provided in a way that meets or exceeds the requirements of all applicable legislation, standards, and guidelines for in-person care. The guidelines were created as an interpretation of existing standards to support pharmacy professionals when providing virtual care.
Pharmacists and pharmacy technicians must use their professional judgement to determine if it’s appropriate to provide virtual care to their patients. To help make that determination, here are some questions and answers, drawn directly from the guidelines.
What does “virtual care” mean?
Virtual care is any professional interaction between a regulated member and a patient that occurs remotely using an enabling technology.
What does “enabling technology” mean?
Enabling technology is something that permits the communication of health information between individuals in different locations.
Telephones have been used in pharmacy for many years. Are telephone conversations with patients considered virtual care?
When the telephone is used routinely for ancillary communication with patients, it is not considered virtual care. However, for complex clinical patient interactions, a telephone conversation would be considered virtual care.
What are some examples of enabling technology?
- applications on smart devices or computers,
- video conferencing,
- secure email, or
- telephone (where complex clinical patient interactions occur).
Can virtual care be used at any time if the patient prefers it?
Virtual care should only be used when the regulated member has determined that providing virtual care is in the best interest of the patient and that the benefits to the patient outweigh any potential risks. When used, the SPPPT must be complied with.
Once I have complied with the guidelines, when can I start providing virtual care to a patient?
Regulated members must ensure they establish and maintain a professional relationship with each patient for whom they provide virtual care. Establishing a professional relationship means the regulated member must interact directly with the patient, their agent, or their caregiver.
Before providing virtual care, a regulated member must identify themselves to the patient and verify the identity of the patient (see 11(a) and 11(b) of the guidelines for Providing virtual care to patients).
Regulated members must also confirm informed consent from the patient prior to providing virtual care (see 12, 13, and 14 of the guidelines).
Can I prescribe while providing virtual care?
An in-person encounter is required by SPPPT 12.2 (renewing a prescription when you do not have the original prescription), 13.2 (prescribing in an emergency), and 14.2 (prescribing at initial access or to manage ongoing therapy). Virtual care may be used to extend or adapt a prescription other than those previously mentioned, as long as the pharmacist is able to
- complete a thorough clinical assessment of the patient,
- access all information required to make a clinical assessment,
- identify and take appropriate action for any drug therapy problems,
- conduct follow up on the care they have provided, and
- meet any other requirements of the SPPPT.
When doing so, the pharmacist must be alert to indicators that the patient should be assessed in person by the pharmacist or another health professional.
What if I determine virtual care is not appropriate or the patient can’t be seen in person?
If a pharmacist determines virtual care is not appropriate or is unable to perform an in-person assessment when required, the pharmacist must consider other options, including transferring the patient’s care to another pharmacy or collaborating with or referring to another healthcare provider.