Tia Health / Insig Health / VirtualClinic+

2.1.10: Meets Web Content Accessibility Guidelines (WCAG) 2.0 Level AA requirements or higher

Solutions should have web and user interfaces that provide accessibility to Ontarians with disabilities; and comply with the Accessibility for Ontarians with Disabilities Act (AODA).

2.1.11: Provide seamless integration with Point of Service systems

Stand-alone solutions should demonstrate seamless integration, which should include elements such as;

• Single sign-on with PoS login credentials
• Receiving patient context (identification) information from PoS systems
• Automatically sending clinical information to PoS patient records as discreet data
• Sending virtual visit notifications to the PoS
• Calendar information

2.1.12: Support identification of virtual visits eligible for claims submission

Solutions should not automatically trigger claims submission for all completed virtual visits.

Solutions can assist clinicians to identify virtual visits that are eligible for claims (e.g., offering a “billable” vs “nonbillable” flag).

2.1.13: Provide automated verification of patient's Ontario Health Insurance Plan (OHIP) number

Automated OHIP verification can assist clinicians from a claims and medico-legal perspective. It can also make patient registration processes more efficient.

Solutions should verify that the 10-digit OHIP number format is valid.

Solutions can also:

• Verify that number is associated with the patient by matching with registration details
• Verify that the patient’s OHIP number is valid through MOHLTC Health Card Validation (HCV)

2.1.14: Support distribution of patient surveys

Virtual visit solutions will allow providers to send surveys to patients in order to: 

• Administer certain types of clinical questionnaires prior to an encounter (e.g., relating to mental health, child development, post-operative care)
• Support quality improvement efforts and patient experience reporting (e.g., at the end of a virtual care encounter)

2.1.15: Provide ability for virtual visit information to be shared with patients and their caregivers

2.1.16: Enable verification of provider identity using a provincial identity management service

Solutions should integrate with provincial provider identity and access management services and Ontario Identity Access Management (ONEID) using latest standards (e.g., OAuth).

Once available, solutions should integrate with the provincial patient digital Identity Authentication and Authorization (IAA) services.

Future versions of the standard will provide further guidance.

2.1.17: Will support Canadian English and Canadian French languages

Solutions will support Canada’s official languages of English and French. Clinicians should be able to use (read, write, and edit) information in the chosen language.

The Solution Provider’s website can also be read in chosen language, including but not limited to training materials and release notes.

2.1.18: Enable verification of clinician identity using multi-factor authentication

Clinicians should authenticate using more than one piece of evidence to access the solution (2FA).

Examples:

• FOB + PIN
• Password + Security question
• Password + Authentication app
• Authenticator + SMS/Phone call

2.1.9: Manage patient agreements for virtual visit services

Solutions should allow clinicians to send and receive patient agreements and other educational materials relating to virtual services.

3.2.10: Enable a virtual waiting room

Solutions may allow clinicians to enable a waiting room. This allows clinicians to control when participant(s) join the synchronous video event.

3.2.11: Enable clinicians to export a secure calendar entry and URL for a scheduled video visit

Solutions should enable a scheduled video visit to be integrated into the external calendaring systems of other clinicians (e.g., HIS, EMR, Outlook).

3.2.12: Provide a visual indicator of poor call quality to all participants in an ongoing video virtual visit event

3.2.13: Provide an audio-only option

An audio visit may be an acceptable alternative if insufficient bandwidth is available to support a video visit.

3.2.14: Provide the ability to switch audio and/or video inputs (USB peripherals) during an active video visit

Solutions should allow different audio and video sources to be used during an event. For example, the clinician could use a standard webcam and a hand-held exam camera in the same event.

3.2.15: Provide additional data for operational statistics and information

This data could include:

• Negotiated media codecs
• Role of each participant (host, guest) in the event.
• Performance data such as packet loss, jitter.

A common issue that would require investigation is degraded video and audio during a video visit.

3.2.16: Enable a videoconferencing endpoint to be added to a video visit using a dialing alias

H.323 ID, E.164 or SIP URI.

3.2.17: Provide equipment and connectivity testing

Solutions will allow patients and caregivers to perform equipment (i.e., audio and/or video) and connectivity tests (i.e., Wi-Fi) and send reports to clinics prior to virtual visits.

3.2.18: Enable patient to save a virtual visit calendar entry and URL to their virtual calendar application

Solutions will enable patients to import a scheduled event into their calendaring systems (e.g., Google calendar, iCal, Outlook, etc.). Solutions will enable patients to forward a scheduled event to caregivers to participate in the event.

3.3.1: Enable clinicians to import and launch a video visit from a secured iCalendar data source

Enables health care organizations and clinicians to launch a secure video visit.

3.3.2: Enable clinicians to support an interoperable video visit with sites using codec-based videoconferencing systems and peripheral devices

Supported Interoperability Protocols:
H.323, SIP, WebRTC

Audio Protocols:
G.711(a/µ), G.719, G.722, G.722.1, G.722.1 Annex C, Siren7™, Siren14™, G.729, G.729A, G.729B, Opus, MPEG-4 AAC-LD, Speex, SILK, AAC-LC

Video Codecs:
H.261, H.263, H.263++, H.264 (Constrained Baseline Profile, Baseline Profile and High Profile), H.264 SVC (UCIF Profiles 0, 1)
VP8, VP9

Content Sharing:
H.239 (for H.323)
BFCP (for SIP)
VP8, VP9 (for WebRTC high framerate)

Firewall Traversal:
H323 – H.460.17, H.460.18, H.460.19
SIP/WebRTC: STUN, TURN, ICE

4.2.10: Enable multiple authorized clinicians to participate in a secure messaging visit

Solutions should allow other care team members to join in a secure messaging visit. This can include reading or creating messages.

4.2.11: Allow clinicians to flag patient messages as urgent or requiring attention

Physicians participating in the provincial pilot identified the ability to flag patient messages for review as important for triaging and care team collaboration purposes.

4.2.12: Provide a read receipt for messages that can be filtered

Physicians participating in the provincial pilot identified this feature as important in order to confirm that medical advice has been received before a visit can be completed.

4.2.9: Separate clinical and administrative messages

Clinician experience and efficiency can be improved by creating separate inboxes (groups) for administrative versus clinical messages.

5.2.1: Therapeutic Area of Care

Area of Practice.

5.2.2: Name of Regulatory College

5.2.3: Professional Registration Number

5.2.4: Clinical Provider Location (Event Host)

IP Address.

5.2.5: Participant Location (participants)

IP Address.

5.2.6: Participant Location (patient)

IP Address.

5.2.7: Participant Identification (patient)

Participant's name, date of birth, gender, and unique identifier i.e., Health card number

5.2.8: Event Outcome

5.3.1: Create Date

Date the Event was created.

5.3.2: Last Modified Date

Date the event record was last modified.

5.3.3: Event Actor

Author of the event creation or last modification.