Which telehealth platforms are approved or recommended?  

Posted on April 15, 2020 by Kate Jackson

Summary

In general, physicians are encouraged to use telemedicine platforms that ensure adequate privacy, security, and ability to assess the patient’s presenting problem. This article includes a comparison of specific telemedicine platforms outlined by Doctors of BC. 

I.   BACKGROUND

    • Many Colleges are encouraging physicians to provide virtual care, when possible, during the COVID-19 pandemic (1,2).
    • Virtual care may be as basic as a telephone call or may involve video-conferencing or other internet-based tools (1). 
    • There is currently no formal approval process or official recommendations regarding specific virtual care platforms.
    • However, health care providers have been advised to: 
      • CMPA: ensure that “reasonable and legally compliant security protocols are in place to adequately protect patient information being transmitted via electronic means” (1).

 

  • CPSBC: “consider whether the telemedicine medium affords adequate assessment of the presenting problem, and if it does not, arrange for a timely in-person assessment” (3).

 

  • A comparison of various virtual care platforms, including privacy and security features, is provided below (adapted from Doctors of BC) (4).
  • Please note that there are province-specific guidelines for virtual care. Please visit the Royal College of Physicians and Surgeons of Canada website for telemedicine guidelines and resources by province (2).

II.   OBTAINING CONSENT FOR USE OF TELEMEDICINE

  • Physicians must explain the appropriateness, limitations, and privacy issues related to telemedicine to the patient.
  • Examples of verbatim scripts for obtaining consent for telemedicine can be found in the CMA’s Virtual Care Playbook (5).
  • If the tool that you are using does not record consent electronically, please be sure to obtain and document verbal patient consent in your patient’s chart (4). 

III.   TELEHEALTH VS. NON-TELEHEALTH TOOLS (6)

Telehealth tools (designed specifically for patient care)

  • More likely to have transparent architecture/privacy/security measures and some have independent reviews certificates for best-practice security and Canadian legislation.
  • Some of these tools meet privacy legislation requirements in different ways – some by not storing any patient information at all, and some by handling the patient data they do store appropriately. 
  • Many have been evaluated for PIPEDA (Canada) and PHIPA (Ontario) compliance and from a computer/technical standpoint should give you and your patient a high degree of confidence. JaneApp is the first tool claiming local PIPA (BC) compliance.

Non-telehealth tools

  • Consumer/social media tool (e.g. FaceTime, Skype, Google Hangouts)
    • The telehealth literature typically advises against the use of social media platforms for patient interaction. It is not so much that they don’t have some security measures (encryption), but how they handle data is generally not as transparent as telehealth platforms and security expectations in the context of healthcare.
  • Business tools (e.g. Zoom, Skype for Business)
    • Security tends to be more robust than social media tools.

IV.   PLATFORM COMPARISON (4)

 

FEATURES PRIVACY & SECURITY
VIRTUAL CARE TOOLS Cost Compatible with Health Technology Authority Video Video Multiple Attendees Secure Text Online Booking Patient Portal Servers in CAN Encryption
Doxy.me (Free)
Doxy.me (Paid) $
FaceTime
InTouch $
Livecare $ TBD TBD
Medeo $ TBD
Medex $ TBD
Novari $ TBD
OnCall Health $
P2P Doctor $ TBD
Skype
Skype for Business $ (if PEXIP is deployed)
Synaptek $ TBD
Think Research $
Vsee $
WebEx $
WelTel Health $
Zoom TBD
Zoom for Healthcare $
Memora Health
Hush Mail (email)
SMS Text Messaging

Questions? Comments? Does this need to be updated? Do you have valuable points to add ? Please email ask.reakt@ubc.ca.

References

  1. CMPA – CMPA COVID-19 Hub [Internet]. Cmpa-acpm.ca. 2020 [cited 2020 Apr 15]. Available from: https://www.cmpa-acpm.ca/en/covid19
  2. ‌Telemedicine and virtual care guidelines for health professionals | Royal College of Physicians and Surgeons of Canada [Internet]. Royalcollege.ca. 2020 [cited 2020 Apr 15]. Available from: http://www.royalcollege.ca/rcsite/documents/about/covid-19-resources-telemedicine-virtual-care-e?fbclid=IwAR3Zxg0Hk7lPr-Ugq8BqM-RodlVmzDJddoV_hhuf6PqHHe_cq3A0Gx40lRI
  3. Practice Standard College of Physicians and Surgeons of British Columbia [Internet]. 2013 [cited 2020 Apr 15]. Available from: https://www.cpsbc.ca/files/pdf/PSG-Telemedicine.pdf
  4. M-Files Web [Internet]. Doctorsofbc.ca. 2020 [cited 2020 Apr 15]. Available from: https://mfiles.doctorsofbc.ca/SharedLinks.aspx?accesskey=0fb37be366f7d872e6e7baa0f4c0257b53877b239fdafabbb0057b2be382824b&VaultGUID=D43316D7-A660-4C25-A7F3-285FB47DAEC5
  5. How to set up virtual care in your practice [Internet]. Canadian Medical Association. 2020 [cited 2020 Apr 15]. Available from: https://www.cma.ca/how-set-virtual-care-your-practice?utm_source=member-comm-310320
  6. Telehealth vs. Non-Telehealth Tools [Internet]. Physiotherapy Association of British Columbia; 2020 [cited 2020 Apr 15]. Available from: https://bcphysio.org/sites/default/files/2020-03/Telehealth%20vs.%20Non-Telehealth%20Tools.pdf

Disclaimer

The above is intended to serve as a rapidly-created, accessible source of information curated by medical students and healthcare professionals. It is for educational purposes only and is not a complete reference resource. It is not professional medical advice, and is not a substitute for the discretion, judgment, and duties of healthcare professionals. You are solely responsible for evaluating the information above.