This page outlines some of the considerations to think about for different types of patient care delivery, communication with patients/staff/colleagues, clinical placements, etc.
Telephone and virtual visits
- Adequate telephone lines
- Block your number on call display
- Documenting start/stop time (use EMR stamps to help with this)
- Tips for communicating with the hearing impaired – Ontario Health West
- Can I refuse service to a patient who refuses to wear a mask?
- CPSO response: if you encounter a situation where a patient declines to wear a mask (or another face covering), sensitively explain the expectation that they wear a mask and the importance of protecting all involved by following the recommendations of public health organizations. Depending on your patient’s needs, and your ability to safely isolate and provide care, you may need to defer or reschedule their appointment or redirect them to a setting that can safely provide care to them. Be aware that some patients may have a health condition that makes it difficult or uncomfortable to wear a mask.
- CMPA response
- Can I charge patients for masks or PPE?
- CPSO response: it is not appropriate to charge patients for any masks you provide or for any other increase in costs associated with managing your practice at this time.
- CPSO position on communicating negative tests: “The CPSO has updated its’ position on communicating negative COVID-19 results.
- A “no news is good news” approach may be used to communicate negative test results, particularly given the fact that patients can access their results via the province’s COVID-19 test results website.
- If choosing this approach, physicians should clearly explain to patients that they can check their results on the website and that they will only be contacted directly in the event of a positive result.
- Positive COVID-19 results must be communicated directly to the patient as soon as possible, given their significance”.
Requests for work accommodation
- Patient requests for work accommodation: information for family doctors – OCFP, September 9, 2020
- Sample mask exemption template letter (updated Sep 11, 2020)
- What to continue doing, what to shift, and what to delay – Centre for Effective Practice
- How patients can prepare for a home visit
- Housecalls 101
- How to clean equipment used in home visits; ensure you carry wipes in your car as well as a garbage bag for used wipes.
- COVID safety
- PPE for Home visits
- “How to” YouTube video from Niagara North Family Health Team on PPE for home visits
- Where to don/doff (keep clean/dirty bins in your trunk)
- ask family to have an open garbage container at the front entrance
In-person visits – contact tracing
- Person presenting with COVID-19 symptoms – document list of everyone who interacts with the patient for contact tracing purposes later?
- Create EMR stamp or scheduler per provider?
- Medico-legal concerns – see CMPA article on using electronic communication and protecting privacy
- Secure messaging between:
- patients and providers
- staff/colleagues who may be working from home
- Digital platforms and resources for:
- use the Apple App or Android App for wait times
- email requisition to lab – firstname.lastname@example.org
- fax requisition to the lab
- email or mail requisition to patient
- Gamma Dynacare
- Hospital Diagnostic Imaging – what’s available or not, modified hours?
- Private/Community Diagnostic Imaging Centres – modified hours?
- COVID Symptom assessment centre/swab
- Telephone consult billing codes (physician to physician – not new!)
- E-Consult set up and billing codes
- If you use Ocean, their platform provides e-Referral set up to send and receive/ manage referrals electronically
- Search www.southwesthealthline.ca for resources within your region
- Virtual physio
- South West Self-Management – online workshops
- Ask for guidelines or expectations from learner’s institution on breakdown of rotation (i.e., % of rotation they are allowed to perform virtual visits vs see patients in-person)
- Faculty Development Resources Repository – CFPC
- Supervision of Family Medicine Learners for Virtual Visits – CFPC
- Supervising Learners in Virtual Care Environment – Northern Ontario School of Medicine
- Peer Tips – CFPC
- Layered Learning: Integrating Learners into your clinical practice – CPFC (1 hour YouTube video)