Virtual Care Best Practices

Find best practice information and tips for incorporating video visits into primary care practice. Refer to the Primary Care Guidance for Clinically Appropriate Use of Virtual Care for additional guidance on integrating virtual care into your practice.

On this page

  1. Considerations for Video Visits
  2. Preparing Patients for Successful Video Visits
  3. Getting Consent for Virtual Visits
  4. Best Practices for Clinical Video Calls

Considerations for Video Visits

Patient Considerations

  • Video visits may be suitable when an in-person physical exam is not needed. If a physical exam is required, a video visit may be appropriate if another care provider is present to assist with the patient. The Patient Access Network can provide convenient access sites with clinical support for patients.
  • Review the information about preparing patients for successful video visits to help you assess your patients’ comfort level with and ability to receive virtual care.
  • When planning a real-time virtual interaction with a patient, you must confirm that the patient's physical environment for the virtual care is appropriate and safe in the circumstances. For more information, see the College of Physicians and Surgeon’s (CPSO) Virtual Care Policy.

Office Considerations

Have mechanisms in place to order laboratory tests, diagnostic imaging and prescriptions (to be faxed to licensed pharmacies).

Physical Environment

The best setting for video visits is one that assures privacy and that is conducive to an effective interaction between physician and patient. For more information, review the best practices for clinical video calls.

Documentation

  • See the CPSO Virtual Care Policy, which sets out requirements for documentation.
  • Consider using tools within your electronic medical record to track a patient’s email address, consent and appropriateness for video visits.
  • For helpful information about documentation, use the short micro-learning tool, Write it down: 4 pearls in virtual care, from the Canadian Medical Protective Association (CMPA).

Consent

  • See the CPSO Virtual Care Policy, which sets out requirements for consent.
  • To learn more about consent, use the CMPA micro-learning tool, Virtual Care: What about consent?

Preparing Patients for Successful Video Visits

Just as you would prepare a patient for an in person visit by providing directions, parking instructions or registration information, it is important to prepare patients for their video visit. Make sure the patient knows what to expect in the email and that they are both comfortable with, and have access to, the right technology.

What to ask the patient:

  • Do they consent to an appointment over video?
  • Do they have a private, quiet place with a strong internet connection that is good enough to watch videos?
  • Do they have a device with a camera and microphone, like a laptop with a webcam, a smartphone or a tablet? If not, does someone in their household have a device that they can use?
  • What is their personal email address? Verify its spelling (if required).
  • Do they require a caregiver to attend the video visit with them? If so, ensure the caregiver is prepared to support the patient before, during and after their video visit, as appropriate.

Advise the patient of these things:

  • They should test the video connection as soon as they can.
  • They should join the video visit at least 15-minutes early.
  • Who to contact if they need to reschedule or if they have questions about their health.
  • What to do if they are unable to connect to the video call (i.e., the backup plan).

You must have informed consent from a patient or their substitute decision maker to deliver virtual care. This is a requirement of the College of Physicians and Surgeons of Ontario (CPSO). See the following for further information and guidance:

Use your practice’s established consent policies and procedures. You may also find these resources helpful:

Best Practices for Clinical Video Calls

  • Introduce everyone on the video call.
  • Confirm the patient’s identity and their current location in case of emergency.
  • Look at the camera when you are speaking to make “eye contact.”
  • Speak clearly and naturally. The microphone will automatically amplify sound.
  • Allow for pauses during the call, as there may be a slight audio delay.
  • Reduce background noise. Have the video call in a quiet and private space, with closed windows and doors.
  • Ensure you are appropriately framed and visible in your self-view:
    • Ideally, frame yourself so that the top of your head is just below the top of the screen and the bottom of the screen hits mid-thigh. This allows your body language to be clearly visible, a key for clinical video visits.
    • The camera should be facing straight on, not facing up or down at you.
    • Do not sit in front of a window, as this will black you out.
  • Enhance your video display:
    • Avoid rapid movements.
    • Avoid wearing reflective clothing or clothing with loud patterns or stripes, or solid red, black, or white.
    • Avoid cluttered backgrounds.
    • Consider disabling virtual background unless it is required. Examine the benefits and risks before connecting and discuss them with the patient. If the consensus is to have a background, start it after the patient has joined and can see your actual background first.

Find links to virtual care guidance, best practices and verified solutions for health service providers, and learn about the Patient Access Network.

Last Updated: June 9, 2023