Canada Develops Comprehensive Indicators for Virtual Care Quality
Canada, Tuesday, 17 June 2025.
A 25-indicator set, crafted via a Delphi panel, will assess virtual care in Canada, focusing on patient experience, cost, and equity, ensuring quality and effectiveness in healthcare delivery.
Analyzing Virtual Care Through the Quintuple Aim Framework
The development of a set of quality indicators for monitoring virtual care in ambulatory environments in Canada was a project aimed to address the significant increase in virtual healthcare visits, a trend greatly accelerated by the COVID-19 pandemic. The 25-indicator set was framed within the Quintuple Aim, focusing on improving care experience, population health, cost, health equity, and sustainability—a holistic strategy to ensure comprehensive evaluations of virtual healthcare
The Rigorous Process of Indicator Development
This comprehensive effort utilized a modified Delphi panel process, conducted between June 2023 and February 2024, engaging a 19-member panel comprising clinicians, patients with lived experiences, policymakers, and academics. Over three rounds, the panelists collaborated to evaluate 140 identified indicators, ultimately refining the list to include 25 that aligned most closely with the desired domains of quality. The collaborative approach enabled the inclusion of diverse perspectives, especially the critical insights from individuals with lived patient experiences [1].
Metrics for Monitoring and Improving Healthcare Quality
The final set of indicators includes 13 focused on patient experience, 6 on provider satisfaction, and additional metrics on population health, health equity, and health system costs. These indicators are structured to form part of a comprehensive scorecard that jurisdictions across Canada can use to compare virtual care programs and identify priority areas in need of improvement. This approach ensures that any disparities or inefficiencies in care delivery are highlighted and addressed
Challenges and Future Directions
One of the ongoing challenges identified lies in effectively measuring complex domains such as equity and cost within virtual care frameworks. The panel’s approach also highlighted the importance of ongoing updates and adaptations to local contexts, allowing for continuous improvement. As Canada moves forward, the practical application of these indicators will involve testing their feasibility and incorporating them into existing healthcare systems. This ensures that virtual care not only meets current needs but is dynamically responsive to future demands