Nova Scotia Nurse Practitioner embraces virtual care for patients

Screen shot of Susan Savage in Zoom, to show what the patient would see during a video appointment

Screen shot of Susan Savage in Zoom, to show what the patient would see during a video appointment

Susan Savage joined the collaborative family practice team at North Queens Medical Centre in Caledonia, Nova Scotia two years ago as a nurse practitioner.

The collaborative practice’s two nurse practitioners and family doctor provide primary care for residents of the small, close-knit community, along with those living in the surrounding areas.

At the end of March, Savage began providing virtual appointments for patients using Zoom for Healthcare, like many others, once it became available for health care providers in Nova Scotia.

“When it was indicated that we should limit in-person appointments due to the spread of COVID-19, our practice adopted virtual care overnight” said Savage.

“We talked about using Zoom one day, and the next day we were doing it.  I’ve been providing many of my appointments with patients over the past three weeks online.”

Savage found it easy to adapt to virtual appointments, as she routinely provides appointments for her patients by phone.

“I have been providing telephone appointments for patients all along, as many health care providers do. Some patients are not able to afford to travel to the clinic, so I will speak with them by phone to ensure they receive the advice and care they need.”

“The real benefit of phone appointments are for those quick things – providing a result, adjusting medications – this saves time for the patient, and creates efficiencies in my schedule. Phone calls are fairly quick compared to an in-person visit, so you can do more of them in a day, increasing access for patients, and patients have care when and where they want it.”

Sometimes an appointment by phone just isn’t enough, and that’s where a virtual appointment with a video component can be helpful.

“As a primary care provider, there is so much you gather through observation. By adding video, you can see the patient’s rash, wound, droopy eye lid or issues with mobility, which you can’t get from a telephone call.”

Savage does note that there are physical assessments that can’t be completed virtually, and in-person appointments are arranged for patients as clinically warranted.

As a relatively new provider to the collaborative family practice team, Savage has been accepting new patients into her practice from the Need a Family Practice Registry. She finds that the initial appointment with a new patient can be done virtually with Zoom for Healthcare.

“It can be difficult to build a trusting and therapeutic relationship by phone. Facial expression and body language are important, and when there is video, they see you smile and your response to what they are saying, just like being face-to-face in the office.  My patients have been so positive about it.”

Even though it has only been a few weeks, Savage has plans to increase the use of virtual appointments with her patients, and particularly focus on how it can help increase access for patients who experience barriers attending in-person appointments at her practice.

“Virtual care is a way to make appointments in family practice more accessible for patients. The patient population that I am really interested in using virtual care with are those who find it difficult to come in to the office, which could be for a variety of reasons; such as a mom with several young children, or an elderly patient who doesn’t drive. It’s important to critically evaluate the benefit of being in-person, and whether I can provide the same care through video or over the phone.”

Access to Wi-Fi or a data package on a mobile phone is another consideration that needs to be weighed when offering a virtual appointment.

“This is also the same group of patients who might not be able to afford online access. The cost of internet can be a barrier, and using data on a cell phone can also be costly. High speed internet is supposed to be coming to this area later this year, so that will make a big difference for this community, and hopefully it will be affordable for patients.”

Overall, adopting virtual care appointments has been well received.

“There have been some growing pains, but that’s the case with anything new. This will possibly be the new normal in my practice, as there is huge value for clinic patients, as well as for primary care providers.

For example, when the weather is bad and the roads are poor, rather than reschedule, we can quickly change a patient’s appointment to be done virtually; it really will change how we deliver care. I feel there are a lot of positives yet to uncover, and we will discover them together and make it work well for our patients.”

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