Providing Care

Virtual care can reduce barriers for individuals who have to travel to see their OAT prescriber (e.g., those living in rural and remote locations) and can promote continuity of care. 

For Physicians

• • OAT may only be prescribed when you have a pre-existing longitudinal relationship with the person you are prescribing OAT for, or you have completed and documented a full assessment (virtual or in-person) and can provide ongoing follow-up care

  • Physicians providing virtual care must be aware of and meet the CPSBC's Standard on Virtual Care. 

For Nurse Practitioners and CP-OUD Registered Nurses and Registered Psychiatric Nurses

• • Must act in the client’s best interest & follow BCCNM standards on Virtual Care

    • • When providing virtual care, CP-OUD RNs/RPNs can only prescribe to known clients or clients that have been assessed in person by another health care provider.

  • Ensure privacy, communication, documentation, and technology meet legal, professional, and record-keeping requirements

Clinical judgment should be used when determining whether a virtual UDT is appropriate and necessary. Clinicians should prioritize patient safety and avoidance of unreasonable barriers to care. Urine drug tests should not be used punitively or when results will not impact the clinical treatment plan. 

When UDT is clinically indicated, prescribers can:

• • Request the patient present to a local lab to provide a urine sample

  • Use collateral sources (e.g., Meditech, Cerner, or CareConnect) to see if a patient has recently completed a UDT ordered by another prescriber

  • Discuss whether the client can access a local clinic that has staff available to conduct a UDT, and the prescriber can coordinate with the clinic and follow-up with the patient around results

  • Coordinate with supported housing or shelter staff to conduct a UDT (where relevant)

    • • Prescribers may explore whether on-site staff are able to conduct a UDT and facilitate virtual connection with the prescriber (you). The ability to support this varies by shelter/housing site and depends on local policies, staff training, and capacity. Prescribers should assess feasibility on a case-by-case basis and collaborate with shelter staff only where appropriate, agreed upon, and clinically indicated. Key considerations for prescribers exploring this option are: 

        • • Patient consent: Confirm the patient’s consent for shelter staff involvement.

          • Shelter capacity: Clarify directly with the shelter whether UDT collection and virtual care support are within staff scope and supported by existing protocols.

          • Clinical appropriateness: Use clinical judgment to determine whether shelter-supported UDTs are appropriate and likely to inform care, in keeping with non-punitive UDT principles.

          • Clear follow-up: Document how the UDT was conducted and ensure a clear plan for reviewing results with the patient.