Revolutionizing Healthcare: The Push for Virtual Care

The healthcare system is undergoing a transformative journey, marked by an increasing reliance on virtual care, remote monitoring, and a better understanding of social determinants of health (SDH) post pandemic. This posting will explore a comprehensive overview of key concepts and learnings, with an emphasis on the potential of virtual care to alleviate patient volumes in hospitals and enhance access to healthcare.

Virtual and Remote Care

The excitement surrounding virtual care is well-founded, driven by its potential to revolutionize patient outcomes, satisfaction rates, and alleviate the burden on hospitals by reducing stays (Farias et al., 2019; Kraai et al., 2011). Government recognition of these benefits, particularly in a post-pandemic context, underlines the significance of embracing virtual care as a mainstream healthcare approach.   During the pandemic, many health care visits became virtual, the literature has validated that these visits were met with patient satisfaction and positive outcomes (Mohammed et al, 2021).  Not only does virtual care and remote monitoring provide an increase to health care access for patients, but it has also shown to decrease the need for acute care and lessen the burden of hospital capacity (Taylor et al 2021). Virtual surgical care programs have shown to optimize patient outcomes and decrease length of hospital stay (Health Canada, 2022).  Remote and virtual care has continued to grow to increase access patients and increase the measurements of monitoring.  Patients can be monitored simply via survey completion and as invasive as home vital signs and digital interviews.  The Toronto Grace Hospital (2023) has expanded their remote monitoring to include a badge that a patient can wear that will be able to detect falls, wandering for confused patients and more. Additionally, these programs offer a simple to use medication dispensary for patients who need assistance with medications.

Virtual care isn't without its challenges, especially in ensuring impartial access. Indigenous populations along with other vulnerable populations face barriers such as language, cultural sensitivity, and digital literacy (Fitzpatrick, et al 2023). Other concerns including rural areas with lack of digital technology, patient confidentiality, quality of care with limited physical exposure, resistance to change, patient engagement and funding Hardcastle & Ogbobu, 2020; Jorgensen et al., 2023; Srinivasan et al., 2020; Ontario, 2022).  To truly realize the potential of virtual care, it is important to address these challenges systematically, ensuring inclusivity and accessibility for all.

What is Health

To understand the magnitude of what virtual care is, the perception of health needs to be transparent. Saylor (2003) used the circle of health to express the balance in between renewal and recovery, and activity and performance. Throughout the years, the definition of health has been amended to fully appreciate the over all wellbeing of a person (Leonardi, 2018). It was addressed that complete well being may not be attainable, no matter the circumstance.  Achieving a definition that is both scientifically accurate and applicable within diverse clinical contexts requires a thorough consideration of factors such as cultural biases and clinical context (Leonardi, 2018). Moving beyond the absence of diseases, conceptualizing health as a capability, acknowledging its ongoing and dynamic nature, ensuring it is achievable for everyone, and incorporating both malaise and well-being for a holistic understanding are all recommended features to the definition of health. Coping and managing well-being and malaise, goes beyond traditional reductionism without falling into ideals, making health a realistic goal for everyone. It recognizes the relevance of this definition, especially for individuals facing chronic diseases, offering inclusivity, and mitigating the risk of medicalization associated with overly positive wellness concepts. Despite the challenges in measuring capabilities, the use of self-reported evaluations is deemed a logical and meaningful approach. This understanding of health encourages the exploration of multiple definitions tailored to specific knowledge and operational goals, reflecting the adaptive landscape of health.

Determinants of Health

Understanding the determinants of health is fundamental when considering virtual care. This exploration acknowledges the multifaceted influences, ranging from income and social status to lifestyle choices. Dr. Andermann’s (2019) approach on treating the patient over the admitting diagnosis addresses the barriers of discrimination and lack of knowledge of resources by looking to address the underlying issues. This could include dietary consumption of diabetic or congestive hear failure patients.  Throughout the decades there has been an increased awareness of non-medical SDH that influence medical outcomes. Initially, SDH was looked at through a an individual, health services and societal level (Andersen & Newman, 1973) now many variables are needed to be considered including living conditions, finances, dietary choices, and hygiene (Braveman and Gottlieb, 2014). To tie this back in with virtual and remote care, these vulnerable populations will need to continue to be identified as target populations to improve access to care.  

Digital Literacy

The success of virtual care is correlated with digital literacy and education. As per the Socioecological Model (McLeroy, Steckler & Bibeau, 1988) there are several layers that come to play in assisting the patient with digital literacy. Within the individual level, patient engagement and willingness to learn are assessed, while at the interpersonal level, family and friends are brought to the forefront to support the patient. Individuals aged 75 or older have been identified as facing challenges in adopting new digital solutions (Jorgensen et al., 2023). To address these barriers, remote and virtual care should be intuitive and user-friendly, with provided tutorials. The Government of Canada (2021) reported that 63% of seniors were non- or basic users of the internet. To underscore the importance of literacy, the Public Health Agency of Canada stated that 88% of seniors are not health literate (Baillie, 2023).

Institutional and Public Policy

When examining the outer layers of the socioecological model, institutional and public policy act as significant partners to ensure the continuity of remote care in communities. Virtual and remote care must undergo continuous validation through standardized reports to Ontario Health to receive proper funding. Key performance indicators include average length of stay, patient satisfaction, risk reduction, and readmission rate (Caregility, 2022). Institutions collaborate with their public counterparts to share, trend, and emphasize this information.

Considerations for the Future

While virtual care has proven its worth, addressing funding issues and establishing standardized reporting mechanisms are pivotal for its sustained success. The emphasis lies in ensuring equitable outcomes and bridging disparities, particularly in the context of vulnerable populations like Indigenous and homeless populations. The future of healthcare demands a continued focus on the determinants of health, creating a more inclusive and accessible healthcare ecosystem.

Leadership Approach

When completing a professional reflective audit, it was clear how imperative it is to lead in change management. To establish a program like virtual care, educational and operation resources must be shared within the teams. Clear communication on rationale and expectations will be important to ensure quality patient care.

Working in healthcare management shows that being responsible, working together, and being able to adjust are super important for leaders. Healthcare is always changing, so it's crucial to follow rules and guidelines from licenses and unions. This helps us understand the constantly changing environment in healthcare. Being good at handling changes and working well with others are important skills for making patient outcomes better.

The exploration of healthcare dimensions in this journey underscores the pivotal role of virtual care in shaping the future of healthcare. As we navigate through challenges and innovations, the layers of health dimensions, the importance of inclusivity, and a holistic approach become the guiding principles for ensuring the well-being of individuals and communities. The call to action is clear: a significant push for virtual care is mandatory for the future of healthcare.