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Virtual Care at IWK Health

What is virtual care?

Virtual care refers to the many ways we can provide health care and services using different types of technology, such as video calls, telephone, texting, and/or e-mail.

Many people find that appointments by telephone or video can be as effective as in-person appointments.  Virtual care appointments offer added convenience for many patients and clients – for example minimizing time away from school/work.

Together with your care team or health care provider, you can talk about whether a virtual appointment is a good option for you. When you think about your health concern, consider whether meeting by video appointment or over the phone might be a good option.      

If you have met the health care provider before, you can expect that meeting by video or the telephone is going to feel a bit different.  That’s ok. Share what feels different or maybe feels awkward, and together we can figure it out. 

 

Privacy and security

Video appointments

All virtual video appointments at IWK Health are done using a secure, web-based video conferencing program that meets the requirements of the Patient Health Information Act (PHIA). That means meetings are confidential and we take steps to increase security, including using the most up-to-date version of the program. Your team will use a private “room” for the appointment and the video conference link is not shared with anyone else. Due to privacy legislation, appointments are not recorded. 

For the most secure connection, we encourage you to connect to virtual appointments using the latest version of the video appointment app on your desktop, laptop, tablet or mobile device.  If you don’t have access to the internet or need support to have the equipment necessary to be able to join an appointment by video, let your health care provider know. They will help explore options or together you can discuss what will work best.


Which medical problems are suitable for virtual video visits?

Virtual visits can be helpful for discussing: 

  • mental health problems
  • many skin problems (take photos to send before the meeting; they are clearer than video)
  • urinary, sinus and minor skin infections
  • sore throats, if your doctor can arrange a throat swab to test for strep
  • eye redness without pain or change in vision
  • sexual health, including screening and treatment of sexually transmitted infections, and hormonal contraception
  • travel-related health care
  • conditions monitored with home devices and/or lab tests (e.g., blood pressure, cholesterol, thyroid and some parts of diabetes care)
  • review of lab tests, imaging (e.g., x-rays and ultrasounds), and specialist reports

Some medical problems not currently recommended for virtual visits include:

  • new symptoms such as chest pain, shortness of breath, loss of vision, loss of hearing, sudden weakness or numbness (you would need to go to a hospital emergency department)
  • ear pain (your doctor would need to look inside your ear, which cannot be done via video)
  • cough (your doctor would need to listen to your chest with a stethoscope)
  • abdominal or digestive problems (your doctor would need to feel your belly)
  • muscle and joint injuries (your doctor would need to feel the affected area for tenderness, warmth, etc.).

You should see a doctor in person for the above problems the first time. However, your follow-up visits may be suitable for virtual care.

 

Tips to get the most out of your virtual appointment:

  • When possible, find a quiet, private place where you can speak openly.
    • You may want to talk with your family or housemates about ways to minimize disruptions and distractions. For example, avoid loud music or TV in the setting.  
    • If you are in a place where people might be able to overhear and you have information you want to be kept confidential consider moving to a space where you can close the door, or won’t be overheard.
  • Plan ahead.
    • If you have other children in the home, think about what can entertain them during the session. 
    • You may want to prepare questions ahead of time.  Feel free to have your questions in front of you. You can take notes too.
  • Being in one location can help you focus on the discussion (for example you may want to avoid walking or driving a vehicle during your appointment).
  • Setting up your computer or device
    • Being able to see each other clearly on a virtual video visit makes it easier to communicate with each other. Having a webcam or camera on your device, and a microphone or headset are ideal.
    • Some people have found that using a headset keeps their conversation more private and helps them to hear more clearly.
    • Raising your device to eye level can make a big difference, or position your laptop so we can see your face clearly is helpful
    • Avoid sitting in a location with bright windows behind you.  It’s better to have the light in front of you.
    • Ensure your camera and speakers aren't blocked.
    • Be sure to shut down any programs or apps that can distract or be seen during the video visit.
    • Ensure your device is fully charged.
    • If you have a limited data plan with your device, please be aware video visits use data. Talk with your health care provider or team about options.
    • Try to use your own device whenever possible so that others cannot access or interrupt your appointment.
  • Chose a seating arrangement that works for you and provides good screen visibility. Larger rooms tend to work best with younger patients so they can move around, explore, and complete any activities.
  • Consider whether or not you want someone with you or if you would prefer to attend the appointment on your own for privacy.

 

Need help?

If you are scheduled for a virtual video appointment, there will be a contact name and number  provided to help if you are having technology issues and to make sure you are set up for success. Refer to your appointment email for the best contact information.  If you can’t find this information, please call the IWK Switchboard at 902-470-8888 and they can put you through to your care team. 

Patient resources available at: Virtual Care Home | Nova Scotia Health Authority (nshealth.ca)

 

Frequently Asked Questions

Why use video and not the telephone for a virtual appointment?

  • Simulates in-person conversations and observations
  • Allows for eye contact and body language assessment
  • Facilitates deeper understanding of the patient’s home or work environment
  • Facilitates a visual exam
  • Allows for clinical observations such as movement, facial expressions, and sounds
  • Addition of visual information can help build, maintain, and/or strengthen therapeutic relationship
  • Allows family members and/or caregivers to be involved in the visit from different locations
  • Allows multiple members of the care team to join a visit from different places
  • Can be suitable for sensitive topics
  • Increases access for remote, rural, or homebound patients
  • Can be effective when patient is on remote patient monitoring, such as blood pressure monitoring, blood glucose, weight, and patient reported symptoms for a discussion with the patient

What are the benefits of virtual care for patients?

  • Easier to obtain care 
  • Reduces need for travel and related expenses 
  • Quicker to access some services
  • Health care from the comfort of your home or chosen space
  • You can continue seeing your health care provider when you cannot get to the clinic
  • Many patients and providers report virtual care improves their relationship.
  • Support persons can be with you at home and join your virtual visit
  • Less time away from work and/or school

What are the risks?

  • As with in-person visits, we do our best to make sure that information you give to us during virtual visits is private and secure.
  • However, there is a risk that others in your space may see/hear your health information when you use video or audio communications tools.
  • Using a personal computer or tablet is more secure than using a public computer, like at the library or coffee shop. Your Internet access at home (when password protected) will be more secure than an open guest Wi-Fi connection.
  • To protect your privacy, do not share your log in information or the link provided to you  with anyone.

Why use video and not the telephone for a virtual appointment?

  • Simulates in-person conversations and observations
  • Allows for eye contact and body language assessment
  • Facilitates deeper understanding of the patient’s home or work environment
  • Facilitates a visual exam
  • Allows for clinical observations such as movement, facial expressions, and sounds
  • Addition of visual information can help build, maintain, and/or strengthen therapeutic relationship
  • Allows family members and/or caregivers to be involved in the visit from different locations
  • Allows multiple members of the care team to join a visit from different places
  • Can be suitable for sensitive topics
  • Increases access for remote, rural, or homebound patients
  • Can be effective when patient is on remote patient monitoring, such as blood pressure monitoring, blood glucose, weight, and patient reported symptoms for a discussion with the patient

Can new prescriptions/refills be provided during virtual care visits?

Yes!

In Nova Scotia, health care providers may send prescriptions for medications electronically (by computer) to the Drug Information System (DIS). Or they may phone or fax them to your pharmacy. 

Prescriptions in Nova Scotia can be fulfilled by any pharmacy in the province. If your prescription was sent electronically, call or visit a pharmacy. Tell them your prescription is available in the Drug Information System (DIS).

For other provinces, check with the pharmacy on how the prescription should be sent to the pharmacy.   

What if I need interpretation during my appointment?

All patients have a right to access a trained health interpreter. If you need a speech or sign language interpreter, you have the right to one during virtual visits.

Patients cannot book their own interpreter. Before your virtual visit, you must inform your health care provider or clinic you need an interpreter as soon as possible. They will arrange the interpreter for you. 

How do I choose a space that works well for a video visit?

Choose a place for the video visit that is private, free of distraction, and comfortable. Try to:

  • sit in a comfortable seat
  • use good lighting, preferably in front of you rather than behind (so that the health care provider can see you)
  • be where other people can’t see or hear you, and you can speak openly
  • reduce any surrounding noise as much as possible or consider wearing headphones

Is it possible to include multiple members of my care team on a virtual appointment?

Yes – you and your team will decide who should join for your appointment based on what’s important to talk about that day.

Is it possible to have people who support me on a virtual visit with me?

Yes. You are welcome to have your person(s) with you during the visit. Please share with your health care provider whom is attending the appointment with you when it starts. 

Who decides if an appointment will be delivered virtually or in person?

It’s a joint decision.  You have expertise on knowing what works well for you and your family.  Your health care provider has expertise on what kinds of appointments work well for different health concerns.  For some health concerns, virtual appointments aren’t a good fit.  In other situations, a client or family may prefer to come to an appointment in-person. Together you’ll talk through the options and make a decision. If you decide to go to an appointment one way one time it’s a new conversation for your next appointment. You can always change your mind. 

How can I find out if virtual care is an option for me?

Your health care provider or team will talk with you about the different options you have for your appointment. 

What if my technology fails in the middle of the appointment? Is there a telephone number to call? What is the process?

It can sometimes happen that the video conference program stops or gets interrupted.  Prior to or at the beginning of your virtual visit, your health care provider will ask for your phone number and the address where you are  located for the appointment.  They will reach out to you by phone to keep the appointment going, or you can retry the video link sent to you in your appointment email.