COVID-19 has pushed ahead virtual solutions to improve health care in rural and remote communities

We have an opportunity to use the expansion of virtual health care resulting from COVID-19 to improve accessibility for people living in rural and remote areas of Saskatchewan, writes Dr. Amy Morris.

Expanding virtual offerings needs to be done thoughtfully, though, to avoid current inequalities

Lumeca is one of a growing number of Canadian companies offering patients direct video chats, phone calls or texts with doctors for a fee. (Lumeca)

We have an opportunity to use the expansion of virtual health care resulting from COVID-19 to improve accessibility for people living in rural and remote areas of Saskatchewan. 

Prior to COVID-19, Canada lagged behind other countries in the integration of virtual care. Clinicians had good reason to be hesitant due to a lack of clear direction on professional standards and compensation, and only a few technology options that met Saskatchewan health information privacy standards. 

When the pandemic reached Saskatchewan, nearly all of these barriers were addressed resulting in the expansion of virtual care. COVID-19 may have forced us into our homes, but it enlightened us to possibilities when it is not ideal to physically enter a health care clinic.     

Between March 13 and June 15, 2020, there were nearly 370,000 virtual physician services, according to the provincial Ministry of Health. Those services were accessed by almost 20 per cent of Saskatchewan's population.

A personal perspective on rural health care

Like many Saskatchewanians, I grew up in a small town. It is the norm to drive over an hour one way to get tractor parts or to see a family doctor. Compound that commute with a long waitlist to see the few physicians in that centre. If you have a preference in a clinician's qualities (e.g. specific gender or communication style) you will need to travel even farther.

For people in rural communities, this is a health care system that is not all that simple to access. 

Growing up in a small town and the daughter of a cattle rancher, Amy Morris knows how difficult it can be for farmers and others in rural areas to dedicate the time to travel for a doctor's appointment. (Submitted by Amy Morris)

During the spring calving season, for my cattle rancher father to spend two to three hours away from his livestock to see a healthcare provider is nearly out of the question. Many people delay accessing care until an illness has progressed or they must use an emergency room. Both options are poor for the individual and the system. 

While virtual care should never completely replace in-person clinical visits, it can support existing care. When an in-person assessment is not required (e.g. mental health consults or chronic disease follow-up), virtual appointments can offer high-quality, patient-centred care, meeting the patient where they are while limiting travel and time away from work and family.

Thoughtful implementation of virtual care needed

That said, people in rural Saskatchewan aren't necessarily advocating for virtual health care. Virtual options to date have been less than ideal. The lack of continuity of care is concerning as the clinician-patient relationship is critical to positive health outcomes.  With an increase in technology-based companies offering virtual care in Saskatchewan, there needs to be an option to see the same clinician at each appointment. 

Understanding the culture in rural Saskatchewan is essential, too. People want to help their hometown thrive. They prefer to back local businesses that, in return, support and grow their community. A large, technology-based company isn't likely to order pizza from the local bar or volunteer for rink duty.  Technology companies or virtual health care providers should support target communities to gain acceptance and uptake of services. 

Amy Morris recognizes that 'there are important barriers to consider when offering virtual care in Saskatchewan.' (Submitted by Amy Morris)

Further expansion of virtual health care into rural and remote Saskatchewan also needs to be done thoughtfully to avoid current inequalities. There are many locations with unreliable internet access, some people are challenged in using technology, and others may not own a personal and private electronic device. Providing virtual services strictly through personal electronic devices will not completely improve access to care for people in rural and remote communities. 

There are important barriers to consider when offering virtual care in Saskatchewan.  It should not be used with the intention of replacing in person visits, but supporting access to care.

Many lessons can be taken from the expansion of virtual health care in Saskatchewan due to COVID-19. We now face an opportunity to apply what works, leave what is less than ideal, and continue to evolve to meet the province's dynamic needs. People in rural and remote Saskatchewan struggle with obstacles to reasonably accessible care. Virtual health care options could keep our farmers healthy and in the field. 

This column is part of CBC's Opinion section. For more information about this section, please read this editor's blog and our FAQ.

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Amy Morris grew up in rural Saskatchewan and continues to provide care to Saskatchewanians as a pharmacist. She completed her undergraduate degree in pharmacy at the University of Saskatchewan and doctorate of pharmacy at the University of Toronto.