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Ontario Medical Review
June 30, 2021
Kathy Tudor
Director, Communications & Marketing, OntarioMD

Virtual care: a pandemic silver lining seen in mental health

Physicians across Ontario have risen to the challenge of seeing their patients virtually when appropriate during the global pandemic. They have adopted new technologies quickly and adapted their workflows to incorporate virtual visits with patients.

Dr. Joy Zeglinski, a psychiatrist practicing in Ottawa, has been using a certified electronic medical record (EMR) since 2015 when she and her partner in practice took advantage of the last call to apply for funding from OntarioMD’s (OMD) EMR Adoption Program. What seemed like a daunting task to transition from paper charts to electronic records was facilitated by a tech-savvy office manager. The practice was soon up and running with the EMR and realizing the benefits for the practice and patients.

“Our EMR has been worth the investment and we appreciated the check-ins and advice from OMD,” Dr. Zeglinski said. Over the years, Dr. Zeglinski’s use of her EMR matured from initial data collection and record-keeping, to accessing digital health tools like the Ontario Laboratories Information System and BASE™ eConsult (not through her EMR), to mobile access and virtual care tools. This is her virtual care success story.

Virtual care during COVID-19

Dr. Zeglinski is an early adopter of her EMR’s mobile app to access her patient charts on her smartphone. She can finish charting during her children’s extra-curricular activities if she didn’t have enough time at the office. She can also check her schedule for the next day. This was especially handy until she could set up remote access to her EMR from home during the pandemic. The biggest reason she began using the mobile app was to manage photos from her therapy sessions (sand trays and artwork) from her patients.

In March 2020, when the state of emergency was declared in Ontario, Dr. Zeglinski transitioned to FaceTime and virtual visit platforms to continue to care for her patients. In May, she began using her EMR’s secure and PHIPA-compliant virtual platform with her patients.

“I like that my EMR’s virtual care platform is integrated with my calendar in the EMR,” Dr. Zeglinski said. “I simply click in the calendar and I’m in the virtual visit.”

She can also chart while using the platform and access what she needs in her EMR. She uses the virtual care platform daily unless her patients do not have access to a computer or smartphone or have issues with Internet bandwidth. When this happens, or if the video freezes, she reverts to the phone to conduct the session. Training for the virtual platform took about 15 minutes, virtually of course. Her office manager was also trained to set up the links to the sessions.

The majority of Dr. Zeglinski’s patients have adapted well to virtual therapy sessions once they realized COVID-19 was not going away soon and are grateful to remain connected to Dr. Zeglinski through video. Clinicians and patients alike have realized that virtual care is good care whether by phone or video-enabled device. Dr. Zeglinski helped to make her patients feel comfortable by telling them how to prepare for sessions in advance and creating a meditative state to start a session. She says that the majority of patients “felt a shift as they entered into a therapeutic state that allowed their process to continue.” 

She provided some valuable examples for other psychiatrists of how she and her colleagues have been using virtual care successfully while fully integrated with her EMR:

  • a patient who lives four hours away is spared travel time and expense with virtual therapy
  • patients can have a video therapy session and not cancel their sessions due to weather (unless the Internet goes down)
  • students who went back home during the lockdown can still be followed from their homes elsewhere
  • a patient with an illness who feels dissociative and unsafe to drive can now switch to a virtual session and the physician can still pick up on visual and auditory cues
  • a housebound patient with severe agoraphobia can use virtual therapy sessions to build trust; these patients can be assisted to gradually leave home at a pace that is manageable to them (they generally received no care prior to virtual options unless their case was mild to moderate or they could be accompanied to the office)
  • for dissociative patients, seeing themselves on screen as ‘adult’ can be used to orient to time and place

“Virtual care has been fantastic for these patients and more,” Dr. Zeglinski said. “I can now see patients from northern Ontario or anywhere in the province. The travel and distance barriers are eliminated. That wouldn’t be possible without virtual care tools.”

Before virtual care, Dr. Zeglinski would occasionally visit an agoraphobic patient at home, which took a lot of time out of her day. “Virtual care has saved me time by enabling me to coach and reassure these patients by video or phone. It provides care to these patients when they may not have received any care at all.”

Suggestions for improving virtual care

Virtual care has provided benefits to psychiatrists and their patients as well as to other specialists and family physicians. More can be done and improvements can be made to make virtual care even better:

  • include billing, secure texting/emails from the mobile app and provide admins access to schedules
  • unbundle the patient portal, online booking or secure email to communicate virtually and securely
  • include a ‘no reply’ email used to remind patients about their upcoming sessions at no additional cost to be used for sending useful resources to patients
  • add the option to screen share while in video sessions to provide teaching tools directly to patients in session
  • create a customized waiting room for patients; add a customizable doorbell to alert patients the provider has entered the room
  • enable emailing links to patients from the chatbox and add the ability to send the saved chat before closing the session by email

For Dr. Zeglinski, virtual care has been a success, but what she really likes is the option to provide a hybrid model of in-person and virtual care. She hopes that physicians will continue to be remunerated by the province and supported by OMD and vendors to make the most of the tools.

If you need help or advice on virtual care tools for your practice, OntarioMD can help. Our expert staff are available virtually at your convenience to support your practice needs. Contact us at

Top image: Ottawa psychiatrist Dr. Joy Zeglinski reflects on the adoption of new technologies, digital health tools and benefits of virtual visits to support the mental health care needs of patients during COVID.

Photo credit: courtesy of Dr. Joy Zeglinski.