• Jamie K Fujioka, Megan Nguyen, Michelle Phung, Onil Bhattacharyya, Leah Kelley, Vess Stamenova, Nike Onabajo, Michael Kidd, Laura Desveaux, Ivy Wong, R Sacha Bhatia, and Payal Agarwal.
• Research coordinator at Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV) in Toronto, Ont.
• Can Fam Physician. 2023 Apr 1; 69 (4): e86e93e86-e93.

ObjectiveTo understand the impact of virtual visits on primary care physician (PCP) work flows.DesignQualitative semistructured interviews.SettingPrimary care practices within 5 regions in southern Ontario.ParticipantsPhysicians representing primary care practices of various sizes and remuneration models (eg, capitation and fee-for-service models).MethodsInterviews were conducted with PCPs involved in a large-scale pilot project implementing virtual visits (via a Web-based application) into clinical practices. Convenience and purposive sampling were used to recruit PCPs between January 2018 and March 2019. To obtain a representative sample, participants were sought from a variety of practice types and geographic regions. High and low users of virtual visits were included. Interviews were audiorecorded and transcribed. An inductive thematic analysis was used to identify prominent themes and subthemes.Main FindingsTwenty-six physicians were interviewed (n=15 using convenience sampling and n=11 through purposive sampling). Four themes were identified: PCPs employ diverse approaches to integrate virtual care into their work flow; PCPs recognize that implementing virtual visits requires upfront time and effort but have variable perceptions regarding long-term impact of virtual care on processes; asynchronous messaging is preferable to synchronous audio or video visits; and strategies were identified to improve the integration of virtual visits.ConclusionThe potential of virtual care to improve work flow is dependent on the way these visits are implemented and used. Dedicated time for implementation, emphasis on using asynchronous secure messaging, and access to clinical champions and structured change management support were associated with more seamless integration of virtual visits.Copyright © 2023 the College of Family Physicians of Canada.

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