Virtual visits have been introduced as a care option during the COVID-19 pandemic. A virtual care includes a phone or video appointment with a patient. The goal is to help patients continue to access care while also reducing in-person patient visits to clinics and health facilities. 

It is relatively easy to shift many of your patient appointments to virtual visits. 

The College of Physicians and Surgeons recently updated its Standard of Practice for Virtual Medicine. The Standard, together with updated Contextual Information and Resources, Frequently Asked Questions, and Information on Virtual Medicine Across Provincial and International Borders, can be found here.

You are required to use your clinical judgment to ensure that a virtual visit is appropriate, and in your patient’s best interest. You are also required to be available to provide timely in-person appointments (within 24 – 48 hours).

The CPSM expressly states that most psychiatry and mental health encounters can be safety provided through virtual medicine with the occasional in person session. The CPSM also states that there is no maximum percentage of visits that can be provided through virtual medicine as long as they are appropriate and in the patients’ best interests.

The following considerations should be reviewed as you get ready to introduce virtual care.


Phone Visits

Leverage existing landline and cellular phones. You may want to consider functionality such as transferring calls to physicians from reception and placing patients on hold until the physician is ready. Conference call technology could be useful depending on your practice.

Video Visits

Video visits will require hardware and a video app or software.


  • Consider the device you will use to video chat: a computer, tablet or smartphone? Does it require a separate webcam, microphone and/​or speaker?
  • Consider your clinic’s internet capacity to have multiple physicians provide video visits at the same time.
  • Disable cameras when not in use by disconnecting them or using a lens cover.

Video Apps

  • A variety of apps and software are available for video calls, and it is important that physicians endeavor to find a solution that offers privacy and works for their patients.
  • Shared Health’s Digital Health recommends the use of Microsoft Teams (formerly Skype for Business) and Zoom for Health, but recognizes the need for flexibility to rapidly introduce video visits during the pandemic.

View our one-page overview of video app options and choose one that is right for your practice.

Appropriate Space

Consider the following when deciding where you will conduct phone or video visits:

  • Privacy: just like an in-patient visit, patient confidentiality should be maintained. The volume should be set at an appropriate level in a private room.
  • EMR/​chart access: where possible, have access to edit the patient’s EMR/​chart during or immediately following the visit.
  • Professional appearance: for video visits, ensure the patient sees a professional space around you, such as a clinic exam room or tidy office.

Conducting virtual visits from home?

If the considerations above can be met at home in a secure and private manner that meets standards, virtual visits can be done at home. In fact, as social distancing advice from public health officials evolves, it may be preferable for you to offer virtual visits from home.

Note: Both the physician and patient must be in Manitoba.

Patient Contact Information

If you’re not already collecting email addresses and mobile phone numbers, get set up to start obtaining this information from patients. It can likely be stored in your EMR.

You may consider using a mail application to send notifications to patients, such as Mail Chimp or Office 365 Business.

Patient Suitability for Virtual Visits

Consider the types of health concerns that are generally suitable for phone and video visits. Then consider whether a virtual medicine visit is appropriate and in your patient’s best interest. Reflect on your practice and the types of concerns you see and treatments you offer. You could review patient visits over the last week or two and review which could have been offered virtually. Determine what is safe and appropriate for your practice.

Consider limitations of virtual visits: you can’t feel a lump or administer a vaccine over the phone or video. But patients may have home blood pressure monitors and can give you a blood pressure reading.

For family medicine practices, clinical considerations have been offered by Dr. Jose Francois, the Head of the Department of Family Medicine at the University of Manitoba and Provincial Specialty Lead — Family Medicine with Shared Health. Examples of the types of concerns or conditions that may be suitable for virtual visits include:

  • Follow-up care for chronic conditions
  • Follow-up to in-person visit within last 2 weeks
  • Cold/​flu symptoms (ensure you review COVID-19 screening protocols)
  • Conjunctivitis
  • Nausea/​vomiting/​diarrhea
  • Minor injuries/​aches and pains
  • Skin conditions like a rash or bug bites
  • Urinary issues.
  • Sleep or mood problems
  • Medication questions
  • Contraception advice
  • Mental Health
Workflow – How to Introduce Video Visits in Your Clinic Operations

Whether patients call in to book or schedule appointments online, you will need to introduce a process change to offer virtual visits when appropriate.

Work with reception on modifying your clinic scheduling process. This includes screening patients for clinical suitability, informing patients about virtual visits, and obtaining patient consent. Email confirmation messages are particularly useful for video visits.

As a team, consider your daily workflow. It may be appropriate, during the pandemic, to stagger in-person and virtual visits to help reduce and spread out patient traffic to your clinic, rather than doing all virtual visits as a block.

Professional and Legal Obiligations

Like in-person visits, virtual appointments must comply with CPSM standards and applicable legislation, such as PHIA. Doctors Manitoba has incorporated virtual care standards into this guide, but physicians are encouraged to review the extensive CPSM materials on virtual care here.

Your virtual care to patients is generally protected by CMPA. However, if you intend to provide care to patients across provincial borders, you should consult with CMPA to make sure you are protected. You can find useful resources from CMPA here.

Privacy and Security

Professional and legal obligations include considering the risks to privacy and security and taking steps to mitigate those risks. During the coronavirus public health emergency, it is reasonable to approach privacy compliance in a streamlined manner to avoid delays in decreasing the risk of exposure to COVID-19.

The basics still apply. Take precautions to ensure both and the patient are in a private setting. Patients should be encouraged to use their own device in a private location, rather than at work or in a public place. For video visits, inform patients of the inherent risks of using a third-party video app and obtain their consent.

Test First!

Before conducting virtual visits with patients, especially using new technology, test your set-up first. This is also an opportunity to help you get comfortable with the new format.

DISCLAIMER: This document provides general information and advice. We strongly recommend that you retain a knowledgeable and qualified professional to regularly assess and maintain your clinic’s technology. We recommend you review applicable standards and requirements to ensure you are meeting professional and legal obligations. Please monitor for updates as advice on virtual care could change as more information emerges.