Telemedicine: Accessing Specialist Care

by Dr. Dustin Jacobson

Gone are the days where patients had only one option for telemedicine services. Pre-Covid-19 patients were relying on telehealth and OTN visits; both options were infrequently used and often plagued with technical issues. Over the course of the last few months, the telemedicine landscape in Ontario has drastically transformed. Patients now have dozens of options to digitally link with their practitioners from home, and the government has allowed for appropriate reimbursement for practitioners. Individual family doctors and groups are embracing and flourishing in this field, and new companies backed by large healthcare conglomerates now see patients virtually while promising prompt and holistic care. Telemedicine services indisputably have an advantage in promoting access to care in these difficult times. Necessity is truly the mother of invention!

At the same time, however, the pandemic has negatively impacted individuals’ ability to access specialist care and there remain gaps for these services in the availability of telemedicine. Specialists often operate solely, making it all the more overwhelming to provide robust virtual care options. One company that is helping to fill this gap is LinkedHealth (www.linkedhealth.ca), a new Toronto-based company which bands together multiple specialists. The specialists all have the ability to see patients in person when required, either from the outset or after deemed necessary following a virtual appointment. Patients have been impressed with their efficiency (generally being seen in ~2 weeks from referral) and the quality of care provided.

While specialist care does often require more hands-on interventions, having the ability to ‘triage’ consults during this time for those patients who truly need immediate in-person assessment can be an important function of specialists’ virtual care. Imagine, as an Orthopaedic Surgeon, seeing a patient virtually within a couple weeks of referral and pursuing one of three care pathways as clinically appropriate: 

1. I need to see this person ‘now’ & will facilitate this

2. I can see this person ‘later’ & will arrange accordingly 

3. I don’t need to see this patient in person at all and a virtual visit will suffice

The current backlog of patients requiring specialist care, compounded by delays in care due to COVID-19, are well-known and the media is highlighting important cases on a daily basis. Virtual care is here to stay, and offering rapid virtual specialist consultations is a key component of a comprehensive virtual care model.