How Telehealth Is Transforming Medical Monitoring

Lightning-fast adoption, accelerated by the pandemic

Before 2020, remote consultations were marginal. They existed mostly in specific programs (follow-up of patients in remote regions, specialist consultations for isolated communities) and were little known to the general public. The pandemic changed everything in a matter of weeks.

The Canadian Institute for Health Information (CIHI) found that between April 2020 and March 2021, across five Canadian provinces, 32% of physician services were delivered virtually, and as much as 42% in family medicine. Overnight, clinics that had never done a phone consultation had to completely reorganize the way they worked.

Usage has since levelled off, but there is no going back. According to Canada Health Infoway’s 2023 Canadian Digital Health Survey, 54% of Canadians have had a virtual visit and 82% are interested in the option. Statistics Canada reports that in 2023, more than four in ten health-care users had at least one virtual appointment during the year.

A telling detail: real-world “telehealth” is far less high-tech than people imagine. Also according to Statistics Canada, 77.9% of virtual appointments with a family doctor or nurse practitioner took place by telephone only. Far from images of sophisticated apps and high-definition cameras, the revolution happened mostly with the simplest tool there is: the telephone.

That reality has an important consequence, which we will come back to: on the phone, the professional hears, but does not see and does not touch. Everything that depends on observation or a hands-on procedure has to be done elsewhere, by someone else, at another time.

Telehealth in practice: what are we talking about?

The word “telehealth” actually covers several very different practices. Telling them apart helps clarify what each can (and cannot) offer.

Teleconsultation is the best-known form: an appointment with a doctor, nurse practitioner, or other professional, by phone or video. It replaces the office visit when a conversation is enough to make a decision.

Remote monitoring means following some of a patient’s health data at a distance: blood pressure, blood glucose, weight, oxygen saturation. The patient takes readings at home and the results are sent to the care team, which can react if something is off. It is particularly useful for chronic conditions such as hypertension, diabetes, or heart failure.

Tele-expertise lets a professional seek a specialist colleague’s opinion without the patient having to travel: for example, a family doctor sending a photo of a skin lesion to a dermatologist. Finally, related digital tools (results portals, prescriptions sent electronically to the pharmacy, online booking) round out the picture and simplify a host of tasks.

What all of these practices have in common: they move information, not the patient. That is both their great strength and their main limitation. For data to travel, someone first has to collect it properly, and that is often where the journey gets complicated.

• Teleconsultation: an appointment by phone or video
• Remote monitoring: readings taken at home and tracked at a distance
• Tele-expertise: a specialist opinion obtained between professionals
• Related tools: online results, electronic prescriptions, digital booking

What telehealth does really well

Patients like it, and the data bears that out. About eight in ten patients report being satisfied or very satisfied with their last virtual appointment, according to Statistics Canada; in Quebec, nearly 47% say they were very satisfied. And 85% of users surveyed by Infoway felt their health concern was addressed at their last virtual visit.

The reasons are easy to grasp. No transport, no parking, no time off work, no waiting room shared with other sick people. For those in remote regions, with reduced mobility, or without a car, the difference is huge. For a caregiver accompanying a parent, it often saves half a day.

Telehealth excels in several situations: renewing a prescription, discussing test results, adjusting an ongoing treatment, mental-health follow-up, getting an initial opinion on whether an in-person visit is needed. It also makes follow-ups more frequent, and therefore more proactive: a short call every two weeks is often better than a long appointment every six months.

It has less visible benefits too. In mental health, for example, some people open up more easily from their living room than in an office. For immunocompromised patients, avoiding a waiting room reduces the risk of infection. For families, being able to bring several relatives onto the same call (even hundreds of kilometres apart) makes important decisions easier.

Finally, telehealth helps steer patients to the right place. A first exchange of a few minutes can often separate what can wait, what needs an in-person visit, and what is an emergency. Used well, it avoids both unnecessary trips and dangerous delays.

A short call every two weeks is often better than a long appointment every six months.

A Quebec legal framework now in place

Long practised in a grey zone, telehealth is now regulated in Quebec. Since September 26, 2024, a regulation specifies which health and social services may be provided remotely, and under what conditions.

Three principles are worth knowing as a patient. First, services that require a physical examination are excluded: they must take place in person. Second, ongoing follow-up must include at least one in-person encounter. Third, the professional must obtain your informed consent, which includes explaining the limits of a remote consultation.

That consent is not a mere formality. It means you have the right to know what the professional will not be able to assess by phone or on screen, and to ask for an in-person visit if you feel your situation requires it. If something worries you (a wound that looks different, a new pain, a symptom that is hard to describe) it is perfectly legitimate to say so and ask to be seen.

In other words, lawmakers themselves recognize that telehealth complements in-person care, it does not replace it. The regulation does not hold telehealth back; it gives it its proper place in a care journey that necessarily includes in-person moments.

For patients, that is good news: the question is no longer “remote or in person?” but “what can be done remotely, and what must be done in person, ideally as close to home as possible?”

The limits: what a screen will never do

This is the blind spot of the digital shift. A large share of medical decisions rest on data that has to be collected from the patient: a blood draw, a specimen, a reliable blood-pressure reading, a glucose level, what a wound actually looks like. None of that travels over the phone.

The scenario has become a classic. The doctor talks with you for ten minutes by phone, then concludes: “I’m sending you a requisition for blood work.” And you are back to square one: find a slot at the test centre, travel there, wait. The consultation was virtual; the journey was not.

The same goes for all hands-on care: changing a dressing, removing sutures, giving an injection or vaccine, inserting or maintaining a catheter, ear irrigation. Telehealth can prescribe them; it cannot perform them.

Then there is everything you only notice by being there. A nurse who walks into a home can see whether medications are stored properly and taken at the right time, whether the patient moves with difficulty, whether the fridge is empty, whether a rug is a fall waiting to happen. These observations, impossible at a distance, often make all the difference to the safety of an older or recovering person.

Finally, even readings taken by patients themselves have limits. A poorly calibrated monitor, the wrong cuff size, or a reading taken right after exertion can skew results. A glucose level written down incorrectly can lead to the wrong adjustment. Without a professional check from time to time, remote monitoring risks resting on unreliable data.

• Blood draws, urine tests, and other specimen collection
• Dressings, wound care, and suture removal
• Injections, vaccines, and intramuscular or subcutaneous medication
• Reliable measurement of blood pressure, blood glucose, and vital signs
• Physical assessment: wound, swelling, breathing, general condition
• Observing the living environment: safety, medication, independence

The digital divide: the risk of leaving the most vulnerable behind

The second blind spot concerns the people who need care most. Quebec seniors are far more connected than many assume: according to the 2024 NETendances survey by Université Laval’s Académie de la transformation numérique, 85% of people 65 and over have a home internet connection and 66% own a smartphone.

But those averages hide gaps. Some seniors are still not connected, and 12% of senior internet users rate their own digital skills as low. Add hearing loss, reduced vision, cognitive impairment, or a language barrier, and a video consultation becomes an ordeal rather than a service.

It is probably no coincidence that the vast majority of “virtual” appointments still happen by phone. And over the phone, the professional sees nothing: not the complexion, not the wound, not the gait, not the living environment.

The divide is not only technological. It is social, too. A person who lives alone, with no one to help them connect or write down instructions, retains less of what they hear on the phone. Someone whose first language is neither French nor English may hesitate to ask questions. These are exactly the patients at risk of falling through the cracks of an increasingly digital system.

The answer is not to give up on telehealth, but to make sure it never becomes the only way in. For these people, a home visit is not a luxury: it is often the only way to get a complete assessment, in a familiar setting, with the time needed to explain things properly.

Three journeys that make it concrete

To make all this more concrete, here are three fictional situations that are nonetheless very representative of what many Quebecers experience. They illustrate the same idea: the teleconsultation solves part of the problem, and the rest happens at home.

First journey: Hélène, 74, lives alone in Laval and is being treated for hypertension. During a follow-up call, her doctor changes the dose of her medication and wants to see how her blood pressure evolves over the coming weeks, along with blood work. Hélène no longer drives. Without help, she would have to ask her daughter to take time off to bring her to the test centre. With a nurse coming to her, the blood draw is done in her living room, her blood pressure is measured under proper conditions, and the nurse checks along the way that she understands the new dosage.

Second journey: Marc, 52, has just had day surgery. His follow-up with the surgeon happens by phone, but his dressing needs changing and the wound needs watching. Getting to a clinic while still sore is a real ordeal. A home nurse redoes the dressing, assesses healing, and flags any sign of infection before it gets worse.

Third journey: Sophie and Karim, new parents, receive a lab requisition for their baby and for Sophie during a teleconsultation. Organizing two trips with a newborn, in the middle of winter, is an expedition. A home visit lets both samples be collected in a single appointment, at nap time, with no waiting room.

In all three cases, telehealth did its job: it allowed a quick decision without travel. But it was home care that turned that decision into action, without forcing the patient (or their family) to reorganize everything.

The missing link: hands at home

The logical next step for telehealth is not more screens. It is a hybrid model: medical advice at a distance when that is enough, and clinical care brought to the home when it is needed.

That is precisely where home nursing fits. Your doctor gives you a requisition during a teleconsultation? A nurse comes to your home to draw the sample, and the results go to the prescriber. Your blood-pressure treatment was just adjusted over the phone? A nurse measures your pressure under proper conditions and documents the trend. Just home from day surgery? The dressing is redone at home and the wound assessed by a professional.

Together, the virtual consultation and the home nursing visit close the loop: the patient no longer has to travel, not for the consultation, and not for the care that follows from it.

This model benefits the rest of the system, too. Every blood draw done at home frees a slot at the test centre. Every dressing changed at home is a visit avoided at the ER or a clinic. Every complication a nurse spots early is a hospitalization that may never happen.

Nurses are especially well placed for this role. Their training covers hands-on procedures, health assessment, patient teaching, and communication with other professionals. In Quebec, they belong to a professional order, the Ordre des infirmières et infirmiers du Québec (OIIQ), which regulates their practice and protects the public.

The consultation on screen, the clinical care at home: together, the two close the loop.

The nurse: the pivot of follow-up in the digital age

Telehealth is often associated with a doctor consulting remotely. Yet much of patients’ day-to-day follow-up rests on nurses. They are the ones who measure, collect samples, dress wounds, teach, monitor progress, and connect with the rest of the team.

In Quebec, the nursing profession is regulated by the Ordre des infirmières et infirmiers du Québec (OIIQ). To practise, a nurse must hold a licence and be entered on the Order’s roll, which means following a code of ethics and continuing-education requirements. The public can check that a nurse is authorized to practise.

Nurses’ role has also evolved over the years. Specialized nurse practitioners (IPS), for example, can now make certain diagnoses and prescribe within their field. Other nurses hold prescribing rights in specific situations. This evolution makes nurses increasingly central players in primary care.

At home, the nurse plays a particular role: she is often the only professional who sees the patient in their real living environment. She can notice what no teleconsultation shows, adapt her explanations to the person’s reality, and send the doctor precise, reliable information. In a hybrid journey, she becomes the eyes and hands of the care team.

That is why MobiSoins pays particular attention to selecting its nurses: licence verification with the OIIQ, interview, references. The quality of the hybrid model depends directly on the quality of the people who go into patients’ homes.

In a hybrid journey, the home nurse becomes the eyes and hands of the care team.

How a MobiSoins visit will work after a teleconsultation

MobiSoins is built around this hybrid journey. Here, step by step, is how the visits we are preparing in Quebec will work.

It all starts with an online request that takes a few minutes: the type of care, your postal code, the time that suits you and, if you have one, the requisition or prescription your doctor gave you. A coordinating nurse then reviews the request to make sure the care can be provided safely at home, and contacts you to confirm the details.

On the day of the visit, an OIIQ-registered nurse arrives at your home with the necessary equipment. She takes the time to confirm your identity, go over the requisition with you, answer your questions, and explain what she is going to do. The care happens in your own surroundings, at your own pace.

After the visit, the information follows: samples go to the lab, results are sent to the professional who ordered them, and relevant observations are documented. You receive instructions for the days ahead, in writing if needed.

The goal is simple: the decision made during your teleconsultation becomes concrete care, without you having to leave home, find parking, or sit in a waiting room.

• Online request in a few minutes, with your requisition or prescription
• Review by a coordinating nurse and appointment confirmation
• Home visit by an OIIQ-registered nurse
• Samples sent to the lab and results forwarded to the prescriber
• Clear instructions for next steps, with follow-up available

Preparing well for a teleconsultation

A teleconsultation is often short. To make it truly useful, preparation makes all the difference, and that is as true for you as for a parent you are helping.

Before the call, write down your complete medication list, including over-the-counter products and supplements. Note your symptoms: when they started, what makes them better or worse, and how they have changed. If you have a blood-pressure monitor or glucose meter, write down your latest readings with the date and time. Also prepare, in writing, the two or three questions that matter most to you.

During the call, sit somewhere quiet, with good lighting if it is a video visit. Keep something to write with close by. Do not hesitate to ask the professional to repeat or rephrase an instruction. If a family member is with you, they can take notes while you talk.

Before hanging up, make sure you know exactly what comes next: is blood work needed? A medication change? Blood-pressure readings for a few weeks? A call back if a symptom appears? Also ask which signs should prompt you to seek care sooner.

Finally, if the doctor gives you a lab requisition or care order, keep it safe: that document is what will allow a nurse to provide the care at your home.

• Complete medication list, supplements included
• Symptoms written down: onset, changes, what helps
• Recent readings (blood pressure, glucose, weight) with dates
• Two or three priority questions, written in advance
• A family member present to listen and take notes
• Next steps clearly understood before hanging up

Privacy and security: the right reflexes

Digital health means sensitive information on the move. In Quebec, the protection of personal information is governed by law, and health professionals are bound by professional secrecy whether they see you in person or remotely.

A few simple habits protect you. Use the platforms offered by your clinic or professional rather than improvised apps. Be wary of emails or text messages asking you to click a link to “confirm” your health or payment information. For a video visit, choose a spot where you will not be overheard, and avoid public Wi-Fi.

The same principle applies to home care. A nurse who comes to your home should identify herself clearly, and you have the right to ask for her name and licence number. The documents she gives you and the information she collects must be handled with the same rigour as in a clinic.

At MobiSoins, privacy is built into the service itself: the information collected is used only to organize and deliver your care, and is never shared without your consent, except where the law requires it.

The essential role of family caregivers

In many families, it is a relative (an adult child, a spouse, a neighbour) who books appointments, prepares the questions, and makes sure instructions are followed. Telehealth has lightened part of that load, since joining a call is easier than taking time off for a trip.

But it has sometimes shifted the burden elsewhere. When the consultation ends with a blood-work requisition or a dressing to redo, it is still the caregiver who has to find the time, arrange transport, and accompany the person. For those who work or live far away, that logistics can become exhausting.

Home care directly eases that load. The caregiver can be present at the visit if they wish, or simply be kept informed. They no longer have to coordinate everything themselves: the visit comes to the person they care for, at the agreed time.

A few tips for caregivers: keep a shared health notebook up to date (medications, appointments, results, professionals’ contact details), ask to be present at important consultations with the person’s consent, and do not hesitate to report a change in behaviour or condition, however subtle. You are often the first to notice that something is wrong.

The true cost of a trip

People often talk about waiting times at the ER or the clinic. Far less is said about the hidden cost of every trip made for care that could have been done at home. That cost is not measured only in money; it is measured in energy, in risk, and in time taken away from everyday life.

For an older or recovering person, leaving home can be an expedition: getting dressed, going down the stairs, waiting for adapted transport or a taxi, braving ice in winter, crossing a parking lot, waiting standing up or on an uncomfortable chair. Each step carries a risk of falling or exhaustion. It is not unusual for a frail person to come home from a simple blood draw more tired than before.

For family members, the cost is often professional. Taking a parent to a fifteen-minute appointment can require half a day off, or even a full day if the distance is significant. Repeated several times a month, that burden weighs heavily on families balancing work, children, and support for an aging parent.

For young families, the logistics become unmanageable: finding a sitter for the other children, working around the baby’s nap, facing a waiting room with an infant. For self-employed workers, every hour spent in a waiting room is an hour not billed.

And there is the cost to the system itself. Someone who gives up on follow-up because the trip is too hard risks seeing their condition deteriorate until they end up in the ER. Making certain care available at home does not just save a trip: it increases the chances that the planned follow-up actually happens.

Making care available at home does not just save a trip: it increases the chances that follow-up actually happens.

Chronic conditions: where the hybrid model changes everything

It is in chronic-disease follow-up that combining telehealth with home care makes the most sense. Hypertension, diabetes, heart failure, chronic obstructive pulmonary disease: these conditions require regular follow-up over years rather than one-off interventions.

For hypertension, for example, a single reading taken at the clinic (often in a stressful setting) gives an incomplete picture. Repeated readings at home, taken correctly, reflect reality much better. The teleconsultation then lets the doctor adjust treatment based on that data. A nurse who checks the measurement technique, the cuff size, and the regularity of readings improves the reliability of the whole process.

For diabetes, follow-up relies on blood glucose, periodic blood tests, foot examination, and medication adjustment. Part of that can happen remotely; another part (specimen collection, foot exams, injection teaching) requires someone to be there. Combining these in a single home visit makes the patient’s life considerably simpler.

For heart failure, watching weight, leg swelling, and shortness of breath can signal deterioration before it becomes serious. A nurse who knows the patient will more easily notice that something has changed since the last visit.

In every case, the principle is the same: telehealth ensures continuity and frequency of follow-up, and home visits guarantee data quality and the hands-on care needed. Together, they make it possible to detect earlier, adjust faster, and often avoid a hospital stay.

• Hypertension: reliable home readings and treatment adjusted remotely
• Diabetes: specimen collection, foot exam, and teaching in the same visit
• Heart failure: monitoring weight, swelling, and shortness of breath
• Respiratory conditions: observing breathing and reviewing inhaler technique

After the hospital: the first days at home

Coming home after a hospital stay or surgery is a delicate period. The patient is often tired, sometimes disoriented, with new medications, a dressing to watch, and a list of instructions they did not always fully take in at discharge.

Follow-up in those first days increasingly happens by phone: a call from the surgical team, a teleconsultation with the family doctor. These exchanges are useful, but they rely on what the patient can describe. And someone who has just had surgery is not always best placed to judge whether a wound is “normally” red or whether their fatigue is unusual.

A home nursing visit during this period makes it possible to check the wound in person, redo the dressing as instructed, remove stitches or staples at the right time, review medications with the patient, and make sure they know the signs that should prompt them to seek care.

It also allows a broader check that the return home is going well: is the patient eating? Moving around safely? Getting the help they need? These seemingly simple questions often make the difference between a calm recovery and a readmission to hospital.

For family members, knowing a professional will come by in the days after discharge brings considerable peace of mind, especially when they cannot be there all the time.

Public network and private services: how they fit together

In Quebec, the public network provides home support services, notably through CLSCs, based on eligibility criteria and the resources available in each territory. These services play an essential role, especially for people losing autonomy and for long-term care.

But not every need fits those criteria, and wait times can vary. An independent person who simply needs a blood draw at home, a one-off dressing, or a few weeks of blood-pressure follow-up will not necessarily be seen quickly. That is where private home nursing services can complement the public offer.

The goal is not to replace the public network, but to offer an additional option when the patient wants an appointment at a specific time, is not eligible for certain services, or would rather avoid a trip for one-off care.

MobiSoins positions itself clearly in that complementary role: planned nursing care, provided by OIIQ-registered nurses, that fits with the follow-up done by your doctor, your clinic, or your public-network team. Results and observations are sent to the relevant professional so that follow-up stays consistent.

If you already receive services from your CLSC, nothing changes: both can coexist. Simply let each provider know about the care you receive, so everyone has the same information.

Teleconsultation, home visit, clinic, or ER: which to choose?

Faced with a health problem, it is not always easy to know which kind of care to turn to. Here are some general guidelines, which never replace a professional’s judgment, nor calling 911 in an emergency.

A teleconsultation works well when talking is enough: renewing a prescription, discussing results, asking about a treatment, getting advice on a mild symptom, mental-health follow-up, or finding out whether you need to be seen in person.

A home nursing visit fits when a procedure or reliable measurement is needed but the situation is not urgent: blood draw on requisition, dressing, suture removal, injection, blood-pressure or glucose follow-up, vaccination, assessing an older adult in their living environment.

The clinic or an in-person doctor remains necessary for a full medical exam, a diagnosis requiring a physician’s physical examination, or imaging. The ER, finally, should be reserved for serious situations or ones that are deteriorating quickly: chest pain, difficulty breathing, signs of stroke, heavy bleeding, sudden confusion.

If you are unsure how serious a situation is, Info-Santé 811 can guide you at any hour. And if a life is in danger, call 911 immediately.

• Teleconsultation: discuss, renew, triage, follow up
• Home nursing visit: draw samples, dress wounds, inject, measure, assess at home
• Clinic: full medical exam, diagnosis, imaging
• ER and 911: serious or rapidly worsening situations
• Info-Santé 811: when in doubt, to find out where to go

Prevention can happen at home, too

Telehealth is often used to react to a problem. But health is also shaped upstream, through prevention: vaccination, screening, health check-ups, monitoring children’s growth. Here again, part of it can be discussed remotely, and part requires a hands-on procedure.

During a teleconsultation, a professional can recommend a vaccine, review your immunization record, or suggest preventive blood work. But the injection or the blood draw has to be done in person by a professional. For many people, that is the step where prevention gets put off, for lack of time to travel.

Home visits lower that barrier. A family can have several members vaccinated in a single visit, at a time that suits them. An older adult can get a flu shot without facing a line in the middle of autumn. A traveller can update vaccines before a trip without taking time off.

Prevention at home is also an opportunity for a deeper conversation. The nurse can review the immunization record, point out upcoming boosters, answer questions about side effects, and explain which signs to watch for in the following days.

The easier it is to get vaccinated or screened, the more likely it is to happen. And every illness prevented or caught early is a health problem that will not need treating later.

The right questions to ask before booking home care

Letting a health professional into your home takes trust. Before booking, whether with MobiSoins or another service, here are questions you are entitled to ask.

Who will come to my home? Make sure the care will be provided by an OIIQ-registered nurse, or another professional duly authorized for the care requested. Ask how professionals are selected and whether their licence is verified.

What happens to my results? For a blood draw, for example, ask which lab the samples go to and who receives the results. Follow-up should go back to the professional who ordered the test.

Which documents should I prepare? Depending on the care, you may need a requisition, a prescription, your health insurance card, or your medication list. Knowing in advance prevents a visit from being postponed.

How is my information protected? A serious service should be able to explain clearly how it collects, stores, and uses your health information. Finally, ask what happens if the care cannot be done as planned, and how to reach someone after the visit if a question comes up.

• Is the professional an OIIQ member, and is her licence verified?
• Where do samples go, and who receives the results?
• Which documents should I have on hand?
• How is my health information protected?
• Who can I contact after the visit if I have a question?

What the future holds

Telehealth will keep evolving. Connected measuring devices are multiplying, health records are becoming more accessible to patients, and decision-support tools are becoming more capable. More and more chronic-disease follow-up will likely happen partly at a distance.

But the more digital medicine becomes, the more crucial the quality of the data collected at the source. A remote-monitoring platform is only useful if the readings it receives are reliable. An algorithm does not replace the eye of a professional who sees that a wound is becoming infected or that a patient is more confused than last week.

That is why the future of care will, in all likelihood, be hybrid and decentralized: fewer patients in waiting rooms, more care organized around the home, and closer coordination between those who consult remotely and those who provide care in person.

In that model, home nurses become a central link: they collect reliable data, perform hands-on procedures, spot warning signs, and connect the patient, their family, and other professionals. That is the role MobiSoins wants to make accessible, simply, wherever we operate in Quebec.

A new patient-caregiver relationship

Beyond the technology, telehealth changed something deeper: patients no longer wait for the system to come to them, they choose how and when to access it. They view results online, prepare their questions, measure their blood pressure at home. They become active participants in their own health.

Home care extends that shift. When a nurse travels to you, the relationship flips: care adapts to your life, not the other way around. Time together is spent understanding, asking questions, and learning which signs to watch for.

That relationship rests on trust. Trust that the professional entering your home is competent and duly licensed. Trust that your information is protected. Trust that what was decided during the teleconsultation will be done, correctly and on time.

That is the vision behind MobiSoins: planned nursing care, delivered at home by OIIQ-registered nurses, booked in minutes. We are preparing our first visits in Quebec. The waitlist is open.