Virtual Care

Helping physicians minimize the risk of exposure to COVID-19

September 16, 2020

Updates to this webpage will be made as new information becomes available.

Providing Virtual Care can be as simple as a phone call but can also include secure messaging and video visits.

During times of medical emergency, whether caring for an individual patient or a large scale public health crisis, physicians should always give priority to providing patient care to the best of their ability. In rapidly changing and challenging situations, such as with the outbreak of the COVID-19 pandemic, physicians' office practices and delivery of care may be significantly impacted. Physicians should continue to act in the best interests of their patients and may need to adapt and be resourceful. Check out the Virtual Care Tools section below for further details on regulated and unregulated tools.

Virtual Care is one important way physicians can continue to care for their patients while ensuring the patient's safety as well as that of the physician and their staff. While privacy and security of patient information remains a high priority, in urgent situations choose tools that work well for you and your patient. Delivering care is the utmost priority.

On this page

Webinars

AMA partners and stakeholders should feel free to use the presentation material as they see fit for their own members. The AMA would ask that, where applicable, partners recognize the AMA via a short credit/author note. Thank you!

Please visit Webinars & Online Learning for recordings of all past AMA webinars and details on upcoming webinars.

April 3, 2020 Webinar:

Virtual Care codes and March 31 changes to the SOMB

The AMA hosted a webinar focused on Virtual Care codes and the March 31, 2020 Schedule of Medical Benefits changes.

View presentation slides.The information herein is what was known on the date of the seminar. Any intervening changes in the SOMB are not reflected in the slide deck. For full information please ensure to check the AMA Fee Navigator® and direct any questions to Health Economics.


March 27, 2020 Webinars:

Getting started with Virtual Care and help with privacy, tools and billing

The AMA hosted two webinars for Alberta physicians, focusing on how to start using Virtual Care for patient care while minimizing risk of exposure to patients, staff and physicians during the COVID-19 pandemic. Topics covered included getting started with Virtual Care, privacy, tools and billing. The two sessions were merged into one recording. View presentation slides

Privacy

With the introduction of any new technology into a clinic setting, it’s necessary to update the clinic Privacy Impact Assessment. However, in times of emergency it is necessary to approach compliance obligations in a way that does not increase the risk of exposure to COVID-19.  

In the urgent and changing situation that physicians and patients are currently operating, physicians should focus on adopting Virtual Care solutions that are safe for their patients, while continuing to be aware of and mitigate the risks of exchanging detailed patient information on unsecure platforms.

On March 19, 2020, the Information and Privacy Commissioner issued a notice regarding the submission of a privacy impact assessment (PIA) during a public health emergency. The notice said that the Commissioner has no authority in the Health Information Act (HIA) to relax custodians’ requirements to submit a PIA.

Recognizing the need to quickly implement virtual care solutions during this pandemic, as an interim measure only, custodians can notify the Commissioner by email to meet the PIA requirement.

It is recommended that physicians work with their Virtual Care solution provider to answer the following questions in their email to the Commissioner.

The Essentials to Getting Started with Virtual Care

  • Obtain patient email addresses and/or mobile numbers
    • Email addresses can be used for communicating new Virtual Care services to groups of patients, and depending on the Virtual Care tool can be used for sending the virtual visit link/URL to a patient.
    • Mobile numbers are useful for communicating with a patient if there are any issues with the virtual visit, or to ensure they are ready for their visit. 
  • Inform patients 
    • Patients should be aware of what Virtual Care services are being provided and how they will be communicated (via clinic or provider email address, text message, invite via application, etc.).
  • Confirm patient identity
    • If a patient is previously known to the physician or staff, identity verification may be as simple as recognizing each other's voice.
    • If not, ensure a process is in place to verify identity of the patient or their agent. This can be done by asking for full name, date of birth and one other key piece of information such as postal code.
  • Obtain patient consent
    • Verbal consent documented in the patient’s chart is fine as a minimum. CMPA recommends the use of a signed informed consent form: View Word version or PDF version
    • CPSA has provided guidance on obtaining and documenting consent in the following COVID-19 Virtual Care Statement.
  • Update patient chart
    • Ensure all conversations electronic or otherwise are documented in the patient chart. Do not rely upon the Virtual Care tool to document patient care episodes.
  • View checklist version of the above content

Virtual Care Tools

The CPSA COVID-19 Virtual Care Statement states that “The CPSA recognizes that in the extraordinary circumstances posed by the pandemic where patient safety may be compromised by a delay in deployment of Virtual Care technologies, that short term use of unregulated Virtual Care technology can be justified.”

To support the CPSA message the AMA is providing members with key information below on both regulated (PIA accepted by OIPC) and unregulated options. It’s important to note that many unregulated options may meet privacy and security requirements. This will be determined once a PIA is completed and submitted by a custodian in Alberta.

EMR Integrated Tools

The following tools are offer integration with community EMRs and are known to be compliant with Alberta’s privacy and security requirements.

  • Brightsquid Secure-mail is now available free for secure communication with any patient, physician, or clinic.
  • Microquest's dr2dr Secure Messaging continues to be free of charge. Healthquest Intake Forms are available to all clients for six months at no charge, and includes a COVID-19 assessment tool for patients. Visit Microquest.ca for more information.
  • QHR (Accuro EMR) is able to provide access to Medeo Virtual Care, which includes secure patient messaging and video patient visits, for six months at no charge for Alberta physicians. To sign up, visit https://medeohealth.com/sign-up/ 
  • TELUS Health has details and regular updates on TELUS Health Virtual Care offerings - many offered for free during the pandemic, related tip sheets, COVID-19 related templates, and critical contact information. They have also created province specific guidance on their EMR product capabilities in Get More From Your EMR.

View additional details on EMR integrated solutions

AHS Tools

  • Zoom.us is currently in use by AHS in various locations.

Unintegrated Tools

There are many other virtual care tools available to Alberta physicians. While they are not integrated with community EMRs, many do meet privacy and security requirements and may work with your clinic workflow.

We have consolidated a list in our toolkit of various offerings with some functional, and privacy and security compliance details. This list will be updated as new information becomes available. We do not have a formal accreditation or validation process, so we highly recommend that physicians perform a thorough review of the solution prior to selection.

We recommend the use of regulated tools. However, for use in urgent situations, unregulated tools can be considered when “safer” options may not be available. They may not necessarily meet privacy and security requirements such as data stored within Canada, encryption, etc.

Billing Codes

Alberta Health has made temporary amendments to the Schedule of Medical Benefits to further support virtual care.

The following is an overview of codes that are now available to support virtual communications between physicians and patients. It’s critical to refer to AMA Fee Navigator® for more detailed information to ensure full understanding of the requirements for claiming the new codes.

Virtual Care Codes (without limitations)

03.01AD
$20.00

Advice to Patient or their Agent via Telephone, Email and Videoconference including Virtual Care during a Viral Epidemic. Maximum 1 per patient per physician per day.

Have questions about using the 03.01AD code? See our billing tip: 03.01AD for COVID-19 for helpful information and answers to common questions.

03.03CV

Assessment provided by General Practitioners (GP) and Specialists via telephone or secure videoconference; 10+ minutes physician: patient direct time.

Rates will be equal to an in-person limited assessment (HSC 03.03A) and vary by skill.

03.03FV

Follow up assessments (visits), for referred patients only, provided by specialists via telephone or secure videoconference; 10+ minutes physician: patient direct time.

Rates will be equal to an in-person follow-up assessment (HSC 03.03F) and vary by skill

03.08CV

Comprehensive consultations provided via telephone or secure videoconference; consultation requirements apply.

Rates will be equal to an in-person comprehensive consultation (HSC 03.08A) and vary by skill.

08.19CX

Comprehensive psychiatric consultation provided via telephone or secure videoconference; consultation requirements apply.

Rates will be equal to an in-person psychiatric consultation (HSC 08.19A) and vary by skill.

08.19CV

Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a Psychiatrist or a Generalist in Mental Health.

Rates will be equal to an in-person psychiatric assessment (HSC 08.19GA) and vary by skill.

08.19CW

Psychotherapy and other psychiatric services (such as group therapy) provided via telephone or secure videoconference by a GP or Pediatrician, per full 15 minutes.

Rates will be equal to an in-person psychiatric assessment (HSC 08.19G) and vary by skill.

Virtual Codes (with limitations)

03.05JR $20.00

Physician Telephone Call Directly to Patient to Discuss Test Results. Maximum of 14 per week per physician.

03.01S
$20.00

Physician to Patient Secure Electronic Communication. Maximum 1 per patient per week to a maximum 14 per week per physician.

03.01T
$20.00

Physician to Patient Secure Videoconference. Maximum 1 per patient per week to a maximum 14 per week per physician.

For further information or questions on Virtual Care billing codes, please refer to the AMA Billing Corner or contact norma.shipley@albertadoctors.org.

Alberta Medical Association continues to advocate on behalf of members for Alberta Health to address the fee code constraints. We will update this as it changes. 

Please refer to Active Panel Management During the Pandemic: Principles to Guide Physicians’ Billings for information intended for physicians seeking to actively manage their patient panels during the pandemic using virtual care codes. 

Toolkit and Workflow Algorithm

A deeper dive on implementing Virtual Care in your practice: Download the toolkit.  

Visit Meeting Patients’ Needs: Algorithm for Today’s Primary and Specialty Care Teams for a stepwise approach to conducting patient care management and access to all tools associated with this algorithm.

The AMA thanks the Doctors of BC for providing valuable material that we continue to leverage to support our members.

Additional Resources

Updates to this webpage will be made as new information becomes available.

If you have any questions please contact caroline.garland@albertadoctors.org

The AMA advances patient-centered, quality care by advocating for and supporting physician leadership and wellness.