Guide feedback from NRC research staff
General Feedback
- The guide seems more directed at health recipients and health practitioners, family doctors and nurses delivering virtual care. Vendors developing virtual care tools may not feel directly concerned as the guide has very generic suggestions (software approaches). These software approaches are intended for virtual visits, and do not address the other features included in platforms for remote patient monitoring.
- The guide suggestions that could be used by vendors in developing virtual care platforms/apps are already addressed in many of their offerings. This may have resulted from the limited adoption in virtual care practices (beyond standard phone and videoconferencing system) by the interviewed clinicians, and very limited to no exposure to virtual care tools by the co-designers that were selected to participate. Recruitment of co-designers with exposure to virtual care should be considered for future co-design iterations.
- Same comment for procurement officers who may be looking at specificities. How would you recommend they use the guide concretely ?
- Certain guide suggestions (sections 2.5 and 2.6) might be hard to implement due to the current digital infrastructure, healthcare burden and workflow in Canada.
- Page 14, “Understandability is fundamental to quality care” section addresses the challenges of literacy and health literacy and could be strengthened in future versions and have its own guideline (as part of the Health Recipient section ?).
- The challenges of literacy that extend to digital health literacy and the use of virtual care technology could be more specifically articulated in the guide. Again, maybe a specific section or guideline on these topics could be relevant.
- The guide seems more directed at virtual visits and could benefit from co-designers who had or have experience with remote health monitoring.
- A focus on the following 3 groups (elderly, culturally diverse and cognitively challenged) was originally discussed to assess their challenges in accessing and using virtual care. We fully understand your model and the importance of addressing mismatches affecting individuals rather than homogeneous groups in the guide. That said, to our knowledge, only culturally diverse individuals were represented, out of the 3 groups, as co-designers. Given that WCAG version 2 is acknowledged as not addressing the needs of people with cognitive challenges, recruitment of cognitively challenged co-designers should be considered for future co-design iterations.
Specific Feedback
This is feedback extracted from the Word doc. See the Word doc for the context.
- Some typos, grammar, and punctuation changes needed.
- "Guidance can be reformulated to better situate with the reader. For example, "Practices" should lead with a verb, and "Functional needs" should utilize appropriate verbs like "enabling" "satisfying" "providing", etc.
- Guidance appears though general, appears to imply synchronous visits. Guidance can be revised to include asynchronous situations or contexts such as self-assessments, remote patient monitoring / devices, etc.
- Unclear how "Humanizing wait queues" is related to virtual healthcare.
- "Avoid use of jargon. What is the meaning of flex?"
- Page 18 "Understandability is fundamental to quality care" - "Should we mention health literacy and digital health literacy in the context of virtual healthcare. Maybe add some references?"
- "Practices" lists should start verbs since a practice is an action.
- Some inconsistency in scope - some guidelines mention computing and analog devices like phones, but other guidelines only specifically mention computers. Ex. #3.3
- Advocacy and policy can be more relevant in certain sections, esp. regarding standards of care. For example, 5.4.
Additional comments in the Word doc: