During the pandemic response and recovery, many health units are moving to virtual care. With this transition there is a risk that vulnerable individuals and communities will be excluded. This not only harms and poses risks for the excluded individuals but the community and country as a whole.
Through a collaboration between the Inclusive Design Research Centre and the National Research Council under the Pandemic Response Challenge Program, the project will:
- co-design inclusive design guidelines for virtual care systems that address the diversity of human needs, including cognitive, age-related and cultural barriers. See: Section - Guide for Reducing Barriers to Virtual Healthcare.
- develop an architecture plan for an openly licensed software platform that enables interaction and interface personalization to meet currently unmet needs faced by individuals when engaging in virtual healthcare. See: Section - Software Approaches for Expressing Personal Preferences for Healthcare.
What is meant by "Vulnerable Populations"
When understanding barriers to access, it is helpful to use the social model of disability as the standpoint. The social model views the product, environment, design or even society as the source of disability. In this way, a barrier or a disability can be viewed as a mismatch between the needs of the individual (based upon their skills and constraints) and the options provided by the service.
Systems that are flexible and responsive to individual needs and preferences are most likely to be accessible and able to meet the needs of diverse populations, even needs not yet articulated. Therefore, it is helpful to treat mismatches as affecting individuals rather than homogeneous "vulnerable populations".
To state in another way: A person is made vulnerable due to a mismatch between their individual needs and preferences, and the inflexibility of the system or service they are accessing.
- Implement updates and changes based on feedback.
- Explore areas of interest: remote patient monitoring, remote access, digital and health literacy, etc.
- Iterate and revise guidelines with recipients of care; and healthcare professionals including practitioners, policy makers, procurers, system developers and integrators.
- Collaborate with healthcare professionals to implement aspects of the guideline in their practice.
- Collaborate with healthcare professionals to implement aspects of the software approach for expressing personal preferences for healthcare.
- Utilize the guideline and software approach in other related projects.
- Through the Fluid open source community, support any practices or businesses seeking to utilize outcomes from this project.
- Guide for Reducing Barriers to Virtual Healthcare
- Methodology used to create the Guide
- Co-Design with recipients of care
- Initial Expert Feedback on the Guide
- Subject Matter Expert Interviews for Virtual Healthcare
- Functional Barriers to Access for Virtual Care
- Guidelines and standards
- Legislation and articles of interest
- Other Barriers and Gaps
- Software Tools for Patient-Centred Care and Personalized Therapy
What is virtual healthcare?
"Virtual Care" is any interaction between patients and/or members of their circle of care, occurring remotely, using any forms of communication or information technologies with the aim of facilitating or maximizing the quality and effectiveness of patient care.
- Virtual care, telemedicine and telehealth all refer to providing healthcare without having the care provider seeing the patient.
- Telemedicine (or telehealth) refers to treatment of various medical conditions without seeing the patient in person.
- Virtual care encompasses all the ways healthcare providers remotely interact with their patients.
Gaps and Barriers in virtual healthcare
The project has identified 3 areas to address in the virtual healthcare experience where gaps can appear:
- lack of guidelines that represent the broad diversity of patients, caregivers, and healthcare providers
- interaction barriers between the healthcare provider and patient
- inflexible systems or processes create or widen gaps that prevent patients from engaging fully in their healthcare
With stakeholders, inclusive co-design activities and research will be used to identify issues, create inclusive guidelines for virtual healthcare, and design a flexible, intelligent personalization tool for virtual healthcare systems.
Virtual health COVID response and scope of this project
The COVID pandemic has magnified the fragility and limitations of prior healthcare guidelines and existing healthcare software systems. This is indicated by the vast amount of new COVID and virtual healthcare guidance published by various governing bodies across Canada since March 2020 (see Review of Existing Relevant Virtual Health Guidelines and Practices), and the various software tools being used in healthcare (see Software Tools for Patient-Centred Care and Personalized Therapy).
Work in this project initially set out to create guidelines and software tools in context of the COVID-19 response, but has adjusted its scope through the course of research, and collaboration of various stakeholders. This guideline aims to avoid the fragility and limitations of prior examples by being:
- generally applicable to virtual healthcare scenarios in general, not just during the COVID-19 pandemic; and
- intentionally incomplete and continually changing and evolving to meet needs and address evolving barriers.
IDRC Project Team
- Jonathan Hung
- Lisa Liskovoi
- Justin Obara
- Vera Roberts
- Caren Watkins