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Inclusive Section - Guide for Reducing Barriers to Virtual Healthcare Guidelines (Section Home)

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Virtual meeting tools

  • Finding an application that is broadly used and PHIPA compliant is a challenge.
  • Microsoft Teams available through one employer is PHIPA compliant, but is not preferred by many clients.

Criteria for virtual visits

  • Computer access
    • If computer is not available, then a tablet or other device may be okay - depends if they can screen share and allow remote access
    • May have to ask to borrow a computer
  • Internet access
  • Screen sharing
  • Screen control
  • If client has limited or no access to these things, then it will need to be dealt with on a case-by-case basis.

Major functions during an assessment

  • See client’s screen
  • Remote control client’s device
  • Changing camera position
  • Asking remote helper to assist in being the clinician’s “hands”

Clients Transition to Virtual

  • At one place of employment, students are required to have a computer
    • Transition to virtual assessments has been rather seamless.
  • Students were happy to have convenience of virtual service
  • Virtual service also meant that client’s personal computer was used in the assessment
    • This made the service more personal and relevant as clinician can directly remote control client’s computer.
    • Otherwise if assessments were done in person clients would be using the clinic’s computers
  • Connectivity is generally not an issue (clients mostly in Toronto area)
  • Audio quality is more an issue, especially when on speaker phone.
  • Built-in cameras in monitors are a challenge as they’re hard to move

Clinician Transition to Virtual

  • In a place of employment, one Zoom account is shared with multiple clinicians, so booking can be complicated
  • Takes longer to do things than in-person
    • Multiple forms that need to be sent back and forth
    • Voice call and equipment check (can take 1 to 1.5 hours)
      • Check remote control ability
      • Install software etc.
      • Set up permissions for screen share and remote control
      • In the past whole sessions were just installing stuff, so now all of that is done ahead of the appointment.
  • Remote assessments almost always requires a support person with the client to help with moving the camera, adjusting things, or fixing tech issues.
  • Clinician had to figure a lot of things on their own and come up with their own procedures.
  • Clinician had to come up with their own screening “checklist” which is a list of questions to ask. This list changes over time based on experiences with clients.
    • Example:
      • _ what are known needs and can it be provided
      • _ do you have computer?
      • _ do you have internet?
      • _ are you comfortable using something for X hours
      • _ are you comfortable with using zoom?
      • _ are you okay with remote access?
  • Clinician always initiates the call so it sets the expectation that they are the ones to re-establish any dropped connections


  • There’s a script that was developed to help run through to set reasonable expectations
  • This was developed based on experience
  • Vendors provide training on equipment, but have not been doing so because of COVID.
    • All training is now virtual

Expression of Needs and Preferences

  • A lof of this is done during the assessment
  • Take client’s feedback and figure out why - maybe it’s more training, or different equipment needed.

Privacy and security concerns

  • In some cases using tools that are not Phipa compliant - in these cases the risks are explained to client and informed consent is given.
  • In most cases clients aren’t really concerned about privacy and security, but clinicians are regulated and obligated in this area.
  • Some clients lack private space
    • Family members around
    • One client was even in their car
  • At the start of the call, confirm their identity, ask who’s in the room, and ask who else may come in.
  • “Ongoing consent” if contexts change