Skip to main content
Best Practices for Virtual Care: A Consensus Statement From the Canadian Rheumatology Association
Journal of Rheumatology
  • Claire E.H. Barber, Cumming School of Medicine
  • Deborah M. Levy, Hospital for Sick Children University of Toronto
  • Vandana Ahluwalia, Division of Rheumatology
  • Arielle Mendel, Centre Universitaire de Santé McGill
  • Regina Taylor-Gjevre, University of Saskatchewan, College of Medicine
  • Tommy Gerschman, The University of British Columbia
  • Sahil Koppikar, Women's College Hospital
  • Konstantin Jilkine, University of Manitoba
  • Elizabeth Stringer, Dalhousie University, Faculty of Medicine
  • Cheryl Barnabe, Cumming School of Medicine
  • Sibel Zehra Aydin, L'Hôpital d'Ottawa
  • Nadia Luca, Alberta Children’s Hospital Research Institute
  • Roberta Berard, Western University
  • Keith Tam
  • Jennifer Burt, Eastern Health, Canada
  • Jocelyne C. Murdoch, Arthritis Society
  • Graeme Zinck, Cassie + Friends
  • Therese Lane, Canadian Arthritis Patient Alliance
  • Jennifer Heeley, Cassie + Friends
  • Megan Mannerow, Cassie + Friends
  • Renee Mills, Cassie + Friends
  • Linda Wilhelm, Canadian Arthritis Patient Alliance
  • Nicole M.S. Hartfeld
  • Brent Ohata, The University of British Columbia
Document Type
Publication Date
URL with Digital Object Identifier

Objective. To develop best practice statements for the provision of virtual care in adult and pediatric rheumatology for the Canadian Rheumatology Association's (CRA) Telehealth Working Group (TWG). Methods. Four members of the TWG representing adult, pediatric, university-based, and community rheumatology practices defined the scope of the project. A rapid literature review of existing systematic reviews, policy documents, and published literature and abstracts on the topic was conducted between April and May 2021. The review informed a candidate set of 7 statements and a supporting document. The statements were submitted to a 3-round (R) modified Delphi process with 22 panelists recruited through the CRA and patient advocacy organizations. Panelists rated the importance and feasibility of the statements on a Likert scale of 1-9. Statements with final median ratings between 7-9 with no disagreement were retained in the final set. Results. Twenty-one (95%) panelists participated in R1, 15 (71%) in R2, and 18 (82%) in R3. All but 1 statement met inclusion criteria during R1. Revisions were made to 5/7 statements following R2 and an additional statement was added. All statements met inclusion criteria following R3. The statements addressed the following themes in the provision of virtual care: adherence to existing standards and regulations, appropriateness, consent, physical examination, patient-reported outcomes, use in addition to in-person visits, and complex comanagement of disease. Conclusion. The best practice statements represent a starting point for advancing virtual care in rheumatology. Future educational efforts to help implement these best practices and research to address identified knowledge gaps are planned.

Citation Information
Claire E.H. Barber, Deborah M. Levy, Vandana Ahluwalia, Arielle Mendel, et al.. "Best Practices for Virtual Care: A Consensus Statement From the Canadian Rheumatology Association" Journal of Rheumatology Vol. 49 Iss. 4 (2022) p. 408 - 418
Available at: