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Regulating professionals in virtual practice: Protecting the public interest in rapidly changing digital workplaces

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About the project

Virtual practice is transforming work in many professions, particularly with the accelerated shift to virtual work during the COVID-19 pandemic. Professional regulatory bodies face intense pressures to facilitate this work while upholding their legal mandate to protect the public. In this knowledge synthesis project, we examine how the public interest is protected when regulating professionals engaged in virtual practice, discuss policy and practice implications related to professional regulation of virtual practice, and make recommendations for future research.

The primary method of knowledge synthesis for this project was a scoping review of academic and grey literature. Throughout the scoping review, particular challenges and promising practices emerged regarding professional regulation of virtual practice. We developed five of these as deeper dive case reports in the Canadian context. These policy case reports were on the following topics:

  1. regulatory sandboxes for innovative technology
  2. for-profit telehealth and professional regulation in Canada
  3. interjurisdictional registration pilot project for nurses in two Canadian provinces
  4. the Essilor case: competition, disruptive technology and the public interest
  5. legal professionals’ duty of technological competence

Key findings

  • There was a clear focus on the health and social care professions in the literature on regulating virtual practice. Most articles reviewed were based in the United States and about physicians.
  • The literature contained several definitions to interpret aspects of virtual practice and numerous and varied terms based on a combination of profession or specialty, service provided, technology and tools used, area of care, client population and location of care.
  • Regulatory changes across professions related to virtual care proliferated during the COVID-19 pandemic, as governments and regulators sought to ensure access to virtual professional services while maintaining public protection.
  • Critical to regulating virtual practice is the issue of cross-jurisdictional practice, and the literature identified regulation—specifically, licensure—at the subnational level as a barrier to equitable access to virtual professional services.
  • The concept of the public interest continues to evolve in relation to virtual practice, with the literature we reviewed focusing on balancing public safety with equitable access to services and economic competitiveness when discussing the public interest in virtual professional services.
  • The literature did not always touch on the public interest explicitly; hence there is a need for more research on the public interest in regulating virtual practice in Canada.
  • There is a need to understand how the public can best be engaged in the regulatory process, particularly around understanding the public interest when receiving virtual professional services, and how this should translate into regulatory policies and practices.
  • Virtual professional services have the potential to improve quality and accessibility of services, but may introduce new areas of risk, potential harm and inequity that regulators need to grapple with as technology-driven professional practice continues to evolve.

Policy implications

  • Professional regulators have an important role in adapting to new technologies that impact professional practice, and providing clear standards and guidelines around virtual practice. This should include what is required for competent practice, since traditional definitions of competence and quality may be outdated in the era of digitally enabled service provision.
  • Professional regulators need to grapple with pressing and emerging virtual practice issues: AI-enabled practice, for-profit telehealth, and disruptive technologies were all raised in this review as having regulatory implications but remaining unresolved. The idea of a regulatory sandbox for innovative technologies should be considered in professions outside of finance and law, including in the health- and social care professions.
  • Governments and regulators need to consider how to facilitate virtual services across jurisdictional borders. Regulation at the subnational (provincial/territorial/state) level emerged historically to regulate providers providing in-person services locally; however, in the context of virtual service provision, this no longer holds true. To leverage virtual care to its fullest extent in both steady state and in the event of future global public health threats, it is important for governments to work with regulators to standardize the regulation of virtual care.

Further information

Read the full report

Contact the researchers

Kathleen Leslie, Assistant Professor, Faculty of Health Disciplines, Athabasca University; kleslie@athabascau.ca

The views expressed in this evidence brief are those of the authors and not those of SSHRC, NSERC, CIHR and the Government of Canada.

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