During this rotation, residents will:
1. Develop methods and styles of communication necessary to run an efficient synchronous virtual medicine encounter (audio or video calls).
This may differ significantly from communication skills used in traditional clinical settings.
Learners will need to be able to elucidate signs and symptoms without traditional use of a physical exam.
Learners will need to explain concepts and instructions to patients over a virtual medium.
These skills will be directly and indirectly evaluated by the supervisor.
2. Develop organization and communication skills necessary to efficiently deliver asynchronous virtual medicine care (etc. bidirectional messaging, written text, leaving voicemails, helping patients and families troubleshoot technology).
These tasks will be completed as part of the regular clinic workflow and assessed directly/indirectly by the supervisor.
3. Practice patient safety by determining patient suitability for virtual care.
Learners will assist their supervisor in triaging consults for virtual care clinics.
In select clinical circumstances learners will be evaluated for proficiently recognizing when a virtual patient requires an in-person ambulatory visit or emergency department care. Learners will be expected to assist in arranging safe care for the patient and following up to ensure that care was received.
4. Become familiar with virtual medicine technology* and use of the Ontario Telemedicine Network and/or DoveTale virtual visits including privacy legislation and standards.
The resident will receive orientation to this technology at the beginning of their rotation including privacy settings and standards.
The resident will gain skills in initiating a consultation, leading a consultation, documenting patient encounters and trouble -shooting problems through OTN and/or DoveTale virtual visits
This skill will be evaluated by the supervisor during daily practice
5. Acquire skills that can be used to effectively to run a virtual medicine clinic in future practice.
This skill will be obtained through observation of patient flow and integration of virtual medicine into daily practice, observing different use of virtual mediums by staff physicians, and developing a familiarity with obtaining patient consent and other ethical considerations for virtual care.
Obtain and document consent and limitations for the virtual care encounter
Review the medical legal information regarding virtual care (OMA web site)
Advocate for improved and wider access to virtual care to improve the patient experience
*currently only OTN Hub (videoconferencing) and telephone encounters are approved for clinical purposes by HHS. Alternative platforms (Skype, Zoom.us, FaceTime, WebEx…) are under review for approval – Virtual Care working groups and IT are currently working on the Privacy and Information Security parameters to ensure patient rights are protected while mitigating risk to organization and staff. Review current policies. OTN licenses may be available for residents, but at this time, residents can only participate or run sessions established under a supervising Faculty’s billing code. This should provide opportunity for observation and assessment. (May 2020)