In response to COVID-19, paediatric providers have shifted to providing outpatient health care appointments through telehealth.

While research has been published previously on this topic, we felt it important to add current Canadian youth perspectives to the mix, specifically on changes due to COVID-19.

Semi-structured discussions were held on virtual care in June and October 2020 with our youth members, who are patients with various health conditions, aged 13 to 19 years which allowed us to glean their unique opinions regarding virtual care in the midst of a pandemic.

Youth who contributed to this commentary reported that major benefits of virtual care included time savings, ease of access, continuity of care, and ability to participate in health appointments from the comfort of one’s own home without a risk of COVID-19 exposure. These youth also recognized limitations to virtual care, including the inability to complete laboratory or imaging tests, and the lack of physical examination capabilities.

Additionally, they stressed the importance of visual components of virtual appointments and health care providers needing to consider privacy restrictions youth may have. Overall, our cohort of youth feel positive about virtual care and hope care providers can work with youth individually to determine the best solution for them.

No significant relationships.

Stroke is a common and serious disorder. With optimal care, 90-day recurrent stroke risk can be reduced from 10% to about 1%. Stroke prevention clinics (SPCs) can improve patient outcomes and resource allocation but lack standardization in patient management. The extent of variation in patient management among SPCs is unknown. Our aims were to assess baseline practice variation between Canadian SPCs and the impact of COVID-19 on SPC patient care.

We conducted an electronic survey of 80 SPCs across Canada from May to November 2021. SPC leads were contacted by email with up to five reminders.

Of 80 SPCs contacted, 76 were eligible from which 38 (50.0%) responded. The majority (65.8%) of SPCs are open 5 or more days a week. Tests are more likely to be completed before the SPC visit if referrals were from clinic’s own emergency department compared to other referring sources. COVID-19 had a negative impact on routine patient care including longer wait times (increased for 36.4% clinics) and higher number of patients without completed bloodwork prior to arriving for appointments (increased for 27.3% clinics). During COVID-19 pandemic, 87.9% of SPCs provided virtual care while 72.7% plan to continue with virtual care post-COVID-19 pandemic.

Despite the time-sensitive nature of transient ischemic attack patient management, some SPCs in Canada are not able to see patients quickly. SPCs should endeavor to implement strategies so that they can see high-risk patients within the highest risk timeline and implement strategies to complete some tests while waiting for SPC appointment.

Seamless Care-Optimizing Patients Experience-Mental Health (SCOPE-MH) is a hub-based integrative case management and psychiatric care program supporting family physicians (FPs). SCOPE-MH provides patient resource navigation, social support, counselling, psychiatric consults, and short-term follow-up. Due to COVID-19, SCOPE-MH pivoted to serve patients completely online.

To assess current utilization and evaluate patients’ and FPs’ experiences using SCOPE-MH as an online service before and during COVID-19.

This evaluation was developed under the RE-AIM framework (Reach, Adoption, Implementation and Maintenance). Two surveys, one for Patient Reported Experience Measures (PREMS), and one seeking FPs perspective on the service, will complement the evaluation.

Past data showed that 66.4% of referrals to SCOPE-MH were women (ages 14-97), and 33.6% were men (ages 14-91). The most common diagnoses were anxiety and depression, followed by adjustment reaction and PTSD. 72% of referred patients had more than one psychiatric diagnosis. 35.4% of the referrals were resource navigation and brief coordination of care. 39.2% required long term involvement. The main recommendations provided were counselling resources in the community and referral to local community mental health teams. Data on patient and FP experiences using SCOPE-MH, and perspectives on unique needs for psychiatric care in COVID-19, is still being collected. Surveys will be sent within 6 months.

SCOPE-MH is an effective model to support FP’s addressing patients’ psychiatric needs. The information obtained from the evaluation will be used to modify the online service to address unmet needs during COVID-19 and optimize current resources to serve more patients.

The study sought to explore the experiences of participants affected by stroke with home video visit (HVV) for follow-up visits in order to understand the determinants, barriers, and benefits associated with HVVs.

Semi-structured interviews were conducted with (n = 23) participants to gather insight and descriptive information about patients’ experiences with HVV. Specifically, we sought to collect descriptions about the (1) costs and time associated with in-person visits, (2) facilitators and barriers to in-person and virtual visits, and (3) their values attached to traditional and virtual forms of patient care.

HVVs were perceived to be a mode of healthcare that is time-saving and convenient for both participants and physicians. However, our study also found some participants felt uncomfortable using technology to conduct medical visits while others still supported a positive view of traditional forms of in-person visits because they valued the in-person interactions and safe environment of the hospital.

While HVVs were considered to be useful in addressing geographical barriers to health care, technological and digital health literacy may serve to impede seniors from using the service, with some of them opting to go to the hospital despite geographical barriers. Resultantly, HVVs may serve both to alleviate and exacerbate certain determinants to health care.

To outline features of the neurologic examination that can be performed virtually through telemedicine platforms (the virtual neurological examination [VNE]), and provide guidance for rapidly pivoting in-person clinical assessments to virtual visits during the COVID-19 pandemic and beyond.

The full neurologic examination is described with attention to components that can be performed virtually.

A screening VNE is outlined that can be performed on a wide variety of patients, along with detailed descriptions of virtual examination maneuvers for specific scenarios (cognitive testing, neuromuscular and movement disorder examinations).

During the COVID-19 pandemic, rapid adoption of virtual medicine will be critical to provide ongoing and timely neurological care. Familiarity and mastery of a VNE will be critical for neurologists, and this article outlines a practical approach to implementation.