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Approach to creating guideline criteria

To create the criteria for virtual healthcare guidelines, the following sources were used to inform its model:

1. Officially published guidelines and literature by governing bodies in Canada. The review of this material can be found on this page: Review Review of Existing Relevant Virtual Health Guidelines and Practices.
2. Subject matter experts who are providing healthcare during the COVID-19 pandemic. Their input can be found on this page: Subject Matter Expert Interviews for Virtual Healthcare
3. People who have experienced barriers accessing healthcare in Canada. The process in which the project engaged participants can be found on this page: Co-Design with recipients of care.
4. Prior research and applied methods in inclusive design and accessibility.

Guideline Model

Based on understanding of functional barriers, input from subject matter experts, and ongoing co-design, the following is an evolving model inclusive guidelines in virtual healthcare.

Guideline criteria can be conceptually grouped in the following continua:

• Setting: things related to the individuals' physical context.
• Personal: matters related to the person's individual preferences and needs.
• Process: matters related to initiating, preparing, and attending virtual healthcare sessions. Much of the guidelines published by governing bodies focuses on process (also see Review of Existing Relevant Virtual Health Guidelines and Practices).

These criteria are not static - their significance changes over time depending on the individual and their contexts. For example, technology matters may not be significant when certain members of the family are in the proximity, but become significant barriers when those members are absent.

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Setting

Factors affecting a person's setting includes:

• Technology available, such as computers, phones, tablets, mice, keyboard, telephone
• Environmental conditions such as lighting, privacy, open space, noise, access to electrical outlet
• Connectivity situation such as cellular reception, Wifi quality, Internet bandwidth, telephone quality

Personal

An individual may have personal needs, preferences, and other situations affecting their ability to engage in healthcare. For example:

• dependency on members in their circle of care (i.e. a caregiver, or family member)
• comprehension (like language)
• ability to perceive (sight, touch, hearing)
• state of being (medication interactions, fatigue, etc.)
• personal trust, privacy, security
• cultural background

Process

For an individual to engage in virtual healthcare, they need to be able to initiate, prepare, and follow-through with an appointment. Many of the published guidelines from governing bodies in Canada focus on process (see Review of Existing Relevant Virtual Health Guidelines and Practices). Matters related to process include:

• finding a practitioner to contact
• use the accepted method of contact
• schedule an appointment
• preparing for the appointment and preparing any needed documentation or records
• attending the appointment using the practitioner's platform of choice
• technology privacy
• technology security
• etc.