Last November, the Yukon Medical Association agreed that implementing virtual care is a priority for the territory, but a new report suggests that multiple roadblocks currently stand in the way of progress.

The report was drawn by Canada’s Virtual Care Task Force (VCTF), a collaboration between the Canadian Medical Association and two federal colleges of physicians.

Dr. Ewan Affleck, the VCTF co-chair and a physician based in the Northwest Territories, recently spoke with the Star about the findings of this report and how it might affect northerners.

“In the North, there are people distributed in places that don’t have a full scope of service,” Affleck said.

Affleck told the Star that virtual care could drastically cut down medical travel for Yukoners living in these rural areas.

Rather than travelling to Whitehorse to keep an appointment with a physician, Yukoners could have a consultation via text, phone or video chat.

“Imagine, if you could reduce by 20 per cent all transportation of patients to Whitehorse for care,” Affleck said.

“That would be really cool; you’d save a lot of money and you’d provide care more quickly to those people.”

Additionally, Yukoners could receive their medical records via electronic files. He said Yukoners are the rightful owners of their medical records, but obtaining those records is cumbersome.

With the implementation of virtual care, there is potential for patients to request prescription refills over the phone, send blood work requisitions automatically, or receive answers to medical questions over text.

“It has the opportunity to make a huge difference,” Affleck said.

Affleck said the technology is readily available to make these opportunities a reality.

In the United States, a huge percentage of medical care is conducted remotely. It is generally agreed upon, Affleck said, that Canada has fallen behind on virtual care.

The report on barriers to virtual care in Canada was released on Feb. 11. It aims to help Canada take the first steps toward progress by assessing the work that needs to be done.

These barriers include licensing, confusion in pay structure, workflow and education, Affleck said.

Licensing poses a challenge because, under current regulations, physicians require a licence to practise in each province or territory.

This means Yukoners aren’t currently able to seek virtual care from most doctors outside the territory, for example, and acquiring multiple licences is costly for physicians.

Affleck said the Federation of Physicians has already committed to creating transportable licensure, which would help to solve this problem.

Secondly, there is no set guideline for how doctors providing virtual care are paid. Some doctors are paid per service, while others receive a blanket salary.

“It’s a whole hodgepodge,” Affleck said.

“It would probably be smart if the provinces talked to each other, and said, ‘OK, how can we standardize this?’”

The VCTF’s report recommends a salaried model as the easiest and most supported avenue of compensation, but it is up to each jurisdiction to decide on a structure.

Currently, without a decided compensation structure, some physicians are hesitant to provide virtual care.

The third barrier is workflow and culture.

“Most clinics and hospitals are designed around seeing people face-to-face,” Affleck said.

It would take an overhaul of service structure to make virtual care work, including the implementation of a universal system of medical charting. This would allow physicians in any part of the Yukon to gain access to a patient’s files.

For virtual care to work, it needs to be more broadly accepted in the Yukon’s culture of health care provision.

Affleck said the inconsistent implementation of new technologies has made things confusing and difficult for physicians, causing burnout and mistakes.

The final barrier is education.

Currently, there is no virtual care accreditation standard in medical schools. Affleck suggested that medical programs need to start requiring a certain level of digital age competency to receive accreditation.

It’s been several years, he noted, since these accreditation standards have received a technology update.

The VCTF held a panel in Ottawa on Feb. 11 to outline its recommendations based on the report’s findings.

Affleck says physicians, medical regulators and federal medical associations all need to collaborate to solve these problems.

“These are not all government things,” Affleck said.

“I think I can suggest quite strongly that this is not going to improve unless we all work together.”

Katharine Smart, the president of the Yukon Medical Association, said last November that Yukon physicians are committed to implementing virtual care.

“We all want to learn about it; we all recognize the desire from our patients,” she said.

The YMA’s annual general meeting focused on virtual care last fall, with promises made to work toward virtual care in the territory.