Virtual care policy recommendations for patient-centred primary care: findings of a consensus policy dialogue using a nominal group technique

TLDR

Rapid expansion of virtual care technologies creates significant health‑policy and planning challenges worldwide. A nominal group technique involving diverse stakeholders, structured priority ranking, open‑ended note‑taking, and thematic analysis was employed to identify priorities and develop virtual‑care policy recommendations. The study recommends clear leadership, patient‑centric decision‑making, incentive alignment, and workflow integration, arguing that shifting the focus from technology to patient engagement and adopting a guiding conceptual framework is essential for effective virtual‑care policy.

Abstract

Background The development of new virtual care technologies (including telehealth and telemedicine) is growing rapidly, leading to a number of challenges related to health policy and planning for health systems around the world. Methods We brought together a diverse group of health system stakeholders, including patient representatives, to engage in policy dialogue to set health system priorities for the application of virtual care in the primary care sector in the Province of Ontario, Canada. We applied a nominal group technique (NGT) process to determine key priorities, and synthesized these priorities with group discussion to develop recommendations for virtual care policy. Methods included a structured priority ranking process, open-ended note-taking, and thematic analysis to identify priorities. Results Recommendations were summarized under the following themes: (a) identify clear health system leadership to embed virtual care strategies into all aspects of primary and community care; (b) make patients the focal point of health system decision-making; (c) leverage incentives to achieve meaningful health system improvements; and (d) building virtual care into streamlined workflows. Two key implications of our policy dialogue are especially relevant for an international audience. First, shifting the dialogue away from technology toward more meaningful patient engagement will enable policy planning for applications of technology that better meet patients' needs. Second, a strong conceptual framework on guiding the meaningful use of technology in health care settings is essential for intelligent planning of virtual care policy. Conclusions Policy planning for virtual care needs to shift toward a stronger focus on patient engagement to understand patients' needs.