President, Canadian Arthritis Patient Alliance
In March 2020, our lives changed with the declaration of a global pandemic and there was an immediate transition to accessing health care virtually. The anxiety and fear that immunocompromised patients experienced every time we ventured out in public was enormous.
My experience with virtual care in New Brunswick was minimal — only the occasional email with my rheumatologist’s administrative assistant. I had tried several times to have a prescription renewed virtually by my primary care physician, but I was always instructed to come into the office.
Health care shifts rapidly
Shortly after the pandemic was declared, the Canadian Arthritis Patient Alliance (CAPA) was contacted by the Ontario Rheumatology Association (ORA) regarding issues they were having with getting the billing codes from the Ministry of Health.
CAPA supported the ORA with a letter to the Premier, Minister of Health and Ministry bureaucrats to provide lived perspectives about how virtual care was necessary during this time (and after the pandemic where it made sense). Very quickly, both Federal and Provincial governments were implementing policies to help facilitate access to virtual care. For example, the Federal government changed regulations so patients living with chronic pain on opioids could renew their prescription virtually.
My real-world experience
My first virtual appointment was to renew a prescription. Not having to drive forty-five minutes and wait in an office with other potentially contagious patients lessened my fear and anxiety considerably.
A few months later, I had my first virtual rheumatology appointment. The experience felt less formal and stressful than going into the office. There was no travel and parking to find at a busy regional hospital and it certainly saved time and money which is important for people living with disabilities.
My rheumatoid arthritis (RA) had been stable, so the virtual appointment was a success. Part of the reason for my positive outcome is my doctor’s excellent administrative assistant who set up a pre-appointment telephone call to discuss issues and concerns.
When my rheumatologist returns from her one-year maternity leave in January 2022, my preference is to have an in-office appointment — whether my RA is still stable or not. She is the specialist, and at that time it will have been two years since my last office visit. Her opinion on how my disease has progressed is necessary for my peace of mind.
CAPA best practices for virtual care
CAPA has been involved with the Canadian Rheumatology Association in the development of best-practice statements for virtual care. We have also posted a virtual care checklist on our website. The more guidance we have can help ensure that health outcomes are not negatively impacted.
Virtual appointments won’t work for everyone all the time or be the saviour some believe for an ailing health care system. It is my hope, going forward post-pandemic, that there will be a mix of virtual and in-office appointments. This could potentially help those patients who are having a disease flare be seen faster and for those who are stable, access care more efficiently.
Patients need to educate themselves and advocate for the most appropriate type of appointment that meets their individual needs and preferences.