Since the start of the COVID-19 pandemic in March 2020, remote medicine has grown exponentially in popularity.

Two years later, Quebec's auditor general is concerned that this sudden rise will have a negative impact on the quality of care offered to the population.

In her 2021-2022 annual report, made public on Wednesday, Guylaine Leclerc did not hide her concern by noting that the Ministry of Health has not provided the necessary supervision to doctors so that they carry out remote consultations according to the rules of the practice, such as consulting only when a physical examination is not required.

Moreover, she notes that the Ministry of Health, as well as health institutions in the province, were not ready to make such a change in their practices.

Since then, the ministry headed by Christian Dube has still not evaluated the extent to which remote medicine has been able to improve the quality of care provided to patients.

As a result, in the current state of affairs, practicing telemedicine "could have consequences on the quality of care offered," she wrote in her report tabled in the National Assembly.

The health emergency decree, adopted by the Legault government in March 2020, allowed doctors to be paid for medical acts performed remotely, which was not the case before.

In less than two years, the practice has spread like wildfire, but without any real oversight.

These remote consultations with a family physician were done by telephone, in 99 per cent of cases.

However, Leclerc points out that "certain medical procedures require visual contact with the patient, or even a physical examination."

Since the spring of 2020, telephone consultations have become the norm for a large number of physicians. In April 2021, 293 doctors said they were doing more than 90 per cent of their consultations remotely. This practice was preferred more than 40 per cent of the time for 2,367 physicians, according to data obtained from the department.

The practice of remote medicine is not new, however. Telemedicine has been in the works for years on an experimental basis with the aim of promoting better access to health care.

There have been several initiatives over the past 20 years to accelerate its expansion, but none have worked to date, the auditor says. Some have not even been followed up.

In 2018, the government set a goal of increasing the number of remote teleconsultations by 40 per cent by 2020.

The goal has not been met.

Often, the problem is technology. The infrastructure is not there.

The auditor general concluded that the ministry will need to provide better guidance on telemedicine in the future, including specifying which procedures can be performed remotely, safely for the patient.

The ministry responded to the findings and recommendations of the Quebec auditor general by pointing out that telemedicine was developed in an exceptional context, the COVID-19 pandemic, and by admitting that the changes that occurred "could not be deployed in the desired manner".

-- This report by The Canadian Press was first published in French on March 16, 2022.