Quality measures of virtual care in ambulatory healthcare environments: a scoping review.

Objectives: Delivery of virtual care increased throughout the COVID-19 pandemic and persisted after physical distancing measures ended. However, little is known about how to measure the quality of virtual care, as current measures focus on in-person care and may not apply to a virtual context. This scoping review aims to understand the connections between virtual care modalities used with ambulatory patient populations and quality measures across the Quintuple Aim (provider experience, patient experience, per capita cost, population health and health equity).

An assessment of adaptation and fidelity in the implementation of an audit and feedback-based intervention to improve transition to adult type 1 diabetes care in Ontario, Canada.

Background: The fit between an intervention and its local context may affect its implementation and effectiveness. Researchers have stated that both fidelity (the degree to which an intervention is delivered, enacted, and received as intended) and adaptation to the local context are necessary for high-quality implementation. This study describes the implementation of an audit and feedback (AF)-based intervention to improve transition to type 1 diabetes adult care, at five sites, in terms of adaptation and fidelity.

Academic detailing to improve appropriate opioid prescribing: a mixed-methods process evaluation.

Background: Academic detailing, an educational outreach service for family physicians, was funded by the Ontario government to address gaps in opioid prescribing and pain management. We sought to evaluate the impact of academic detailing on opioid prescribing, and to understand how and why academic detailing may have influenced opioid prescribing.

Methods: In this mixed-methods study, we collected quantitative and qualitative data concurrently from 2017 to 2019 in Ontario, Canada.

Aligning Virtual Care in Canada with the Needs of Older Adults.

Public health measures associated with coronavirus disease (COVID-19) have accelerated the adoption of virtual health care across Canada. We explore the opportunities that virtual care presents in achieving the Quadruple Aim and challenges to navigate, through the lens of care for older adults. In particular, we recommend virtual care-related policies related to older adults that address (a) limited uptake among the socio-economically disadvantaged, (b) user-centered design of virtual care technologies, and (c) integration of iterative evaluations to ensure equitable and efficient achievement of desired outcomes.

A Novel Emergency Telepsychiatry Program in a Canadian Urban Setting: Identifying and Addressing Perceived Barriers for Successful Implementation: Un nouveau programme de télépsychiatrie d'urgence en milieu urbain canadien: Identifier et aborder les obstacles perçus d'une mise en œuvre réussie.

Objectives: To report on the perceived barriers surrounding the use of telepsychiatry for emergency assessments and our approach to overcoming those barriers to achieve successful implementation of a program to increase access to emergency psychiatric assessment in a Canadian urban setting.

Methods: We conducted a survey of emergency care staff to inform the implementation of an emergency telepsychiatry program in the urban setting of Winnipeg, Manitoba, where hospitals have variable on-site emergency psychiatric coverage. We analyzed survey responses for perceived barriers we would need to address in implementation.

A Web-Based Mental Health Platform for Individuals Seeking Specialized Mental Health Care Services: Multicenter Pragmatic Randomized Controlled Trial.

Background: Web-based self-directed mental health applications are rapidly emerging to address health service gaps and unmet needs for information and support.

Objective: The aim of this study was to determine if a multicomponent, moderated Web-based mental health application could benefit individuals with mental health symptoms severe enough to warrant specialized mental health care.

Methods: A multicenter, pragmatic randomized controlled trial was conducted across several outpatient mental health programs affiliated with 3 hospital programs in Ontario, Canada.

Acute Care Use for Ambulatory Care-Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions.

Objective: The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care.

Method: A retrospective, population-based cohort study using data from Ontario, Canada.

Usability and eHealth Literacy Evaluation of a Mobile Health Application Prototype to Track Diagnostic Imaging Examinations.

In the absence of a pan-Canadian electronic health record, unnecessary duplicate diagnostic imaging (DI) examinations are sometimes ordered when a physician is not aware of prior DI or prior DI is not available. Research suggests that physicians may ask their patient to recall their DI history; however, patient recall of DI can be unreliable. As a potential solution, a patient-facing mobile health application (app) prototype was developed for users to record their DI.