Health service providers are required to communicate directly with virtual care solution providers (vendors) and are encouraged to ask questions. The following seven areas of inquiry can be used to help health service providers develop their own questionnaires.
- Reliability
There will inevitably be times where technical support is needed. Whether it is a member of your staff or a patient who requires assistance, the solution you choose must have a support team ready to assist with the solution’s features or technical issues. Access to 24/7 support will help to resolve issues in a timely manner and provide better patient experience.
- Patient Care
Consider which virtual visit features will meet the patient care needs of your practice (e.g., review the recommended requirements in the standard; consider if a solution is tailored to any specific clinical area or patient population) and if there are other functionalities you might like provided through the same solution (e.g., online appointment booking, remote care management). Ask vendors of interest for demonstrations to understand the features they offer to understand if they will meet the patient care needs of your practice.
- Device Compatibility
Ensure the virtual care solution is compatible across multiple devices such as mobile phones, tablets, laptops and traditional desktop computers.
- Patient Facing User Interface
Ask the vendor to demonstrate the solution to ensure the user interface is simple and easy to understand. Many patients are not fully comfortable using virtual care solutions. Ask about accessibility of the technology and how the vendor can support accessibility needs of your patients.
- Security
This is covered under the standard, but ensuring the solution has regular security audits and reviews is important.
- Training
Ask about training, how it is delivered and the approximate cost. For instance, does the vendor support ongoing training as needed?
- Implementation
Ask how the solution has been implemented to date across similar organizations and request references. The vendor should also share the approximate time span of how long implementation may take and the process or steps involved.
Sample Statement for Contacting Virtual Care Solution Providers
Questions regarding the status of solutions that are not on Ontario Health’s ‘Verified Solutions List’ should be directed to the respective solution provider (vendor). We do not disclose information regarding the status of vendors in the Virtual Visits Verification program pipeline. The sample statement below is provided to support you in communicating with the appropriate vendor:
I intend to participate in the Ontario Virtual Care Program: Secure Messaging Proof-of-Concept (PoC) Pilot and I am considering solutions that may meet the needs of my practice and have been verified by Ontario Health.
I do not see your solution [solution name] verified for secure messaging on Ontario Health’s Verified Solutions List and would like to understand whether you plan to verify [solution name] for secure messaging and if so by when. Vendors are required to submit a package to Ontario Health – if you haven’t already please reach out to the Virtual Visits Verification program at verification@ontariohealth.ca and visit the program page at http://ontariohealth.ca/verification for further information.
Differences between Text, Email, Instant Message and Secure Message
The purpose of this table is to provide a general overview of the features and functions of different messaging modalities for those involved in the Secure Messaging Proof-of-Concept Pilot. It does not intend to be a technical or exhaustive comparison of all possible scenarios. We recognize that there may be variations and exceptions that are not captured by this table.
| Texting / SMS | Instant Messaging | Secure Messaging | ||
|---|---|---|---|---|
| Exchange | Generally, texting / SMS (Short Message Service) is the act of sending and receiving short electronic messages between mobile devices. | An exchange of messages, which may or may not be exchanged in a private and secure manner and may not meet Virtual Visits Solution Requirements. | Email is the act of exchanging messages which may or may not be exchanged in a private and secure manner by electronic means over a network. | Secure messaging allows users to transmit confidential (end-to-end encrypted) messages to recipients in a secure solution. Secure messaging solutions ensure that all text, images, attachments, etc. are encrypted. |
| Platform | Texting requires only a phone connected to a cellular network to communicate. | Instant messaging normally requires a mobile application to communicate, such as WhatsApp, Facebook Messenger, iMessage. | Email requires an email client and a web interface or a mobile application to communicate. | Secure messaging requires a secure messaging solution. |
| Connection | Texting requires a cellular network. | Instant messaging requires an internet connection. | Email requires an internet connection. | Secure messaging requires an internet connection. |
| Content limits | Text only content is limited to 160 characters. | Every instant messaging application has different size (MB) limitations. Limits are larger than text messages. | Every email application has different size (MB) limitations. Limits are larger than text messages. | Every secure messaging solution has different size (MB) limitations. Limits are larger than text messages. |
| Communication method | Texting enables communication by text (SMS), images and video (MMS), etc. | Instant messaging enables communication by text, images, attachments, etc. | Email enables communication by text, images, attachments, etc. | Secure messaging enables communication by text, images, attachments, etc. |
| Encryption |
If you send a standard SMS/MMS text message through your cellular provider, for example, it is not encrypted and is sent over open networks therefore making it easy for hackers to intercept the data. Cellular network providers store communications in their systems. |
Many well know instant messaging solutions take precautions to protect user data but you should not assume your Instant Messaging solutions are private or secure. Many instant messaging solutions are not encrypted end to end. | In general, email is encrypted if the sending and receiving email service providers both support transport layer security (TLS). But each email solution is different, and a sender can never be sure what the recipient’s solution supports, so data is not guaranteed to be secure. | Secure messaging solutions ensure that all exchanges, including their text, images, attachments, etc. are encrypted at all times since both the recipient and sender are using the same solution. |
| Authentication | No authentication is required to send SMS. Anyone with a phone can send and receive SMS. | Username and password is required to authenticate the user to an instant messaging solution. | Username and password is required to authenticate the user to send emails. | Username and password is required to authenticate the user to a secure messaging solution. |
| Security | Texting is less secure than email messaging. If you send a standard SMS/text message through your cellular provider, for example, it is not encrypted and it is sent over open networks. | Instant messaging is more secure than text messages, but may not meet Virtual Visits Solution Requirements. | Email is more secure than text messages, but it is possible for emails to be read as they journey through the internet. | Secure messaging is more secure than texting, instant messaging, or email, because the solution can ensure messages are always encrypted and protected. |