Support tools

​​When conducting a virtual visit, you may also using other communication methods and tools to support the process. 

Email

Email is a complementary method of communication, to be used along with other methods. It is a form of one-way communication – it does not allow for an immediate exchange of ideas.

When to use it

Email can be used to communicate with patients/clients for:
  • Content that is longer than a text message
  • Content often saved for future reference
  • Attachments such as prescriptions, instructions, test results, etc.

Best use

  • Appointment reminders, follow ups, check-ins
  • Provide directional, important and timely information 
  • Share detailed information and data, such as educational information
  • Ensure there’s a record of your communication
  • Direct the receiver to an online source for more information
  • Provide brief status updates

Technical requirements

  • PHSA cell phone, desktop or laptop that can be used by the health care team
  • Access to the Internet through Wi-Fi or cellular data
  • PHSA staff email account
  • Patient’s personal email account

Benefits

  • Secured and encrypted for PHSA staff email
  • Patient needs to login to email account with username and password to retrieve email
  • Archived

Privacy and security 

Email accounts based in Canada (for example, Canadian providers such as TELUS) are covered by Canadian privacy laws, but those based in the United States (such as Gmail and Hotmail) are subject to American privacy laws.

Risk and limitation

  • No guarantee that patient is viewing/will respond to email
  • Could be sent to the wrong patient 
  • Difficult to document text message conversations in patient records (EMR)
  • No analytics 
  • Policy constraints if user was on external Wi-Fi or public setting

Guideline and policy

Get started with email​

  1. Introduce virtual health to patients: Introduce virtual health to patients by phone/email/text. Check the technical readiness of your patients. Obtain the patient's personal email and send an initial email to validate their email address and provide notification of risks (see APPENDIX 1: Client Notification Form, (PDF) and APPENDIX 2: sample validation script (PDF)).
  2. Add patient's personal email address to your patient contact list in your PHSA email account. Storing patient contact info can include: 
    1. Patient's first and last name
    2. Personal health number
    3. Patient's email address​
  3. Provide patient email tips below: Copy and paste these key points to patients:
    1. ​​Do not email or text us if you have an emergency. If you have an emergency, call 9-1-1 or go to the nearest emergency department.
    2. ​Connect with us for: Quick check-ins and follow up; appointment reminders; educational information.
    3. This email account is not continuously monitored.
  4. Email patient​.
    1. Longer content than SMS
    2. Content often saved for future references
    3. Attachments such as prescriptions, instructions, test results, etc.

​


SRFax

SRFax is a web-based platform that allows you to send or receive faxes via your health authority email account.

About SRFax

​SRFax is a web-based solution that enables users to send electronic faxes by emailing an attachment to the fax machine of the user’s choice. Users can also receive a faxed document electronically. Currently, receiving of faxes is not yet approved by PHSA privacy and will be reviewed on a case by case basis. 

SRFax can be used when a PHSA provider/staff does not have access to a fax machine and needs to send or receive a fax containing clinical information, such as a prescription. 

Note: PHSA Privacy and Security have only approved the use of SRFax through the enterprise account, which is administered by Provincial Virtual Health.  Any other use of SRFax is not approved as there are numerous risks to patient privacy, which may result in breaching policy/confidentiality/data access agreements as a PHSA employee.​​​
​
​​

Technical requirements

  • Access to a health authority (HA) issued email
  • Wi-Fi/data enabled device 
Note:
PHSA Privacy recommends that PHSA phones be used as much as possible. If personal phones must be used, iCloud or automatic cloud uploading of photos must be disabled as you are not authorized to store personal information on your personal device or cloud storage solution.​​
​
​

​Privacy and security


SRFax is endorsed for the use of sending or receiving of faxes containing clinical information. Security and privacy reviews have been completed.

PHSA programs interested in using SRFax must request a licence by sending an email to VirtualHealthTechnicalSupport@phsa.ca.  No other SRFax licensing is permitted. 

Risk and limitations

  • Unauthorized sharing of personal information through email or fax
  • Unauthorized retention of personal information on personal devices/cloud storage solutions

Risk mitigation strategies

  1. Delete emails sent through the SRFax solution from both the sent and trash folder of your mail application. This applies to generic/clinic department emails as well.
  2. If photos/scanned images of documents are accidentally stored on a mobile device or cloud storage, delete these immediately after sending the SRFax email. 
    • This is a privacy breach, and a report should be submitted to the PHSA IAP office. 
  3. Use a cover sheet for all faxes. 
    • This is in the event that a fax is misdirected, or the receiving fax machine is in a public location.
    • Check that fax numbers in address books are accurate before sending.​​
​

Getting started with SRFax


1Take the SRFax course to accept the Terms of Use and request a licence. 

This course is built for PHSA clinical users and support staff to help them get started with SRFax. In addition to privacy, clinical, and practice considerations, it includes specific instructions for your device and the SRFax Terms of Use.

Accepting the Terms of Use and completing the course will trigger the process to request a licence through your clinical program lead. 

If you have questions about this process, please email VirtualHealthTechnicalSupport@phsa.ca.


2On your laptop/desktop/mobile device, make sure you are using your health authority email.

SRFax is only permitted to be used in conjunction with your health authority email account. No personal email accounts are to be used (e.g. Shaw, TELUS, Gmail, etc.).

Note that your corporate devices (laptop/desktop/mobile) should already be set up to send and receive via your health authority email account.

3Turn off the cloud uploading function on your mobile devices.

When this function is on, your mobile photos and videos are automatically saved on the cloud (i.e. servers that are accessed over the Internet). This may be a violation of the Freedom of Information and Protection of Privacy Act (FIPPA).

For iOS instructions on how to turn this function off for your Mail application, follow the link below:
  • iOS – Turn off iCloud for Mail app​​​

​Instructions

​
Instructions by device
You can use your health authority email to access SRFax in multiple ways. Follow the links below to view or download specific instructions for your device:
Practice considerations
There are existing PHSA policies and guidelines that should be reviewed and considered in the context of using SRFax:
 
Additionally, there may be applicable policies and guidelines within respective programs. There may also be related direction and resources from regulatory/professional bodies (e.g., Community Pharmacy Standards of Practice – Transmission of Facsimile, Doctors of BC’s Guide to E-Faxing When Working Remotely).
 
Please ensure you are familiar with applicable guidance from your program area and/or professional body as appropriate. ​​​


Phone consults

Telephone care has been a long-standing way of connecting with patients that can include consultations, assessment, diagnosis, treatment and education. 

When to use it 

Telephone is very familiar to providers and patients and is best used when an in-person visit is not required, and an audio call meets the patient's needs.  

Best use

  • Appointment reminders (note that other virtual solutions in this toolkit include a patient appointment reminder)
  • Simple information delivery and direction 

Technical requirements 

  • PHSA cell phone or landline (recommended), or personal telephone

Benefits

  • Very familiar to providers and patients
  • Good for use when clinician and patient already have a relationship 
  • Simple information sharing 

Limitations

  • Patient may not be prepared unless appointment is made prior to call
  • Patient/provider will not have any visual contact, which can impede assessment, communication and a sense of connection  

Privacy and Security 

  • Cell phone call by patients may be routed outside Canada 
  • Providers cannot see if the patient is alone, or in a public space 

Guidance 

  1. Obtain patient's preferred phone number. 
  2. Document patient phone number used for clinical call.
  3. Clearly identify yourself, your role, your program and the purpose of the call.
  4. Verify patient identity by requesting 2 unique patient identifiers (full name, date of birth, PHN). 
  5. Obtain verbal agreement from patient and document in patient record. 
  6. Ask patient if they are ready for the conversation and are in a private space where they will not be overheard. 
  7. Document the call, as you would usually document patient care (call results, patient response, agreement for next steps in their test care). 

Tab Heading