Physician perspectives on providing virtual emergency department care for equity-deserving populations.

Objective: Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQIA + community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing and receiving care through virtual models. The objective of this qualitative study was to describe physician perspectives on their experiences providing care to patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada.

Methods: We interviewed 14 Virtual ED physicians from different sites across the Greater Toronto Area. Semi-structured interviews were conducted to explore ED physicians' experiences with treating patients from equity-deserving populations who used the Virtual ED. Inductive thematic analysis was used to identify themes from the interview data.

Results: Three themes were identified, which included: (1) Considerations for Virtual ED Inclusivity; (2) Beliefs about Compassionate Virtual ED Care Practices; and (3) Proposed Innovations for Advancing Equity through Virtual ED Care. An overarching and connecting theme was accessibility. Across these themes, providers highlighted factors that influenced Virtual ED accessibility for many equity-deserving populations.

Conclusions: The Virtual ED holds many promising applications for the delivery of equitable and compassionate care for equity-deserving populations. There are several patient, provider and system level issues that need to be considered to ensure its inclusivity and accessibility. One suggestion for innovation includes creating community hubs offering access to the Virtual ED to make it easier for equity-deserving populations who may face barriers to using it or need a safe space to do so.