Pandemic-fuelled virtual health-care boom shows no signs of slowing, experts say

For years, Scott Lear tried to convince British Columbia's health authorities to adopt a virtual cardiac rehab program he developed for patients recovering from conditions like heart attacks.

Participants were monitored from home while they exercised and would consult with specialists online. Promising pilot runs of the program showed they made fewer trips to the hospital and had a reduced risk of early death.

But despite the results, finding long-term funding was always a challenge.

"The very common answer over multiple years was that this is a great program — we just don't have money for it," said Lear, a health sciences professor and cardiovascular prevention researcher at Simon Fraser University.

Then, the COVID-19 pandemic hit. Many doctors stopped seeing patients in person, and hospital admissions dropped. Health-care providers scrambled to adopt virtual models. That's when Lear said his program was swiftly picked up by the Fraser Health Authority — where it still operates. 

"The pandemic hit, and it took us two weeks to restart it," he said.

Virtual health care has seen substantial growth since the onset of the pandemic, with increased investments and infrastructure emerging provincewide and across Canada.

According to the Canadian Institute for Health Information, between April 2020 and March 2021, physicians provided an average of 152 virtual services per month, compared with 39 virtual services per month the year before.

Canadian Health Infoway says 33 per cent of all patient-reported visits between January 2021 and March 2022 were virtual.

Virtual care researchers and stakeholders say all signs point to a future where more Canadians receive care from home, while improvements in technology open the door for more advanced health monitoring from afar.

At-home monitoring

According to the Provincial Health Services Authority, ​​​​​before the pandemic, a few hundred patients in B.C. were being monitored remotely each year. Now, roughly 20,000 patients are being monitored.

Devices are commonly used to measure patient biometrics, including heart rate and temperature and even fitness tracking.

These technologies are expected to grow and become more sophisticated.

On Monday, life sciences company Masimo broke ground for a new research and development facility in Vancouver. The company specializes in home monitoring technology.

"The last 100 years, we've had a thermometer at home," said CEO Joe Kiani. "What if we now go beyond the thermometer, help you better diagnose yourself, and that way better reduce unnecessary emergency visits."

The company is one of many players in a remote monitoring market that's expected to grow to $152 billion US by 2027.

"The hospitals are a fairly age-old technology in themselves," said Angela Chapman, the president and CEO of the VGH and UBC Hospital Foundation. "We need them ... but there's no doubt, the technology to help people age well at home and stay healthy at home, be monitored perhaps from a distance, all of that is the way that we're moving."

The swinging pendulum and virtual hospitals

Still, health experts like Lear, the principal investigator of the B.C. Alliance on Telehealth Policy and Research, notes that virtual health should not be viewed as a replacement for in-person care but rather a supplement to it.

"We want to take the best of what we've learned in the past few years and merge it with what we were doing before," he said.

"There's definitely value in face-to-face," he added, noting certain measurements can only be done in person and that many patients enjoy social interactions. And some patients simply need to be in hospital or visit a doctor to be diagnosed.

But Lear says he expects virtual hospitals to soon emerge in B.C., where more patients are sent home with monitoring technology.

"From a cost, it's a lot cheaper than taking up a bed in a bricks-and-mortar hospital," he said.

Lear says the appearance of doctors on someone's home computer or tablet marks a modern incarnation of house calls that defined health care for much of the 20th century.

"Remote and virtual care has been around since the telephone was invented, and still, there are community nurses who do home visits," he said. "A lot of this is just going back to the future."