Virtual Service

What is a virtual service? 

Virtual services refer to using information and communication technologies to provide occupational therapy services when clients and occupational therapists (OTs) are not together in-person. 

Virtual services (also known as telepractice, remote service, online or virtual care) can include phone calls, video conferencing, or other technology-assisted formats. 
 
Occupational therapists providing virtual services are encouraged to review and follow ACOTRO's Virtual Services guidance document. 

What is new?

 Effective December 12, 2023: 

  • Occupational therapists registered in British Columbia, or Quebec require registration in Nova Scotia when providing virtual services.  

  •  To provide virtual care to clients in British Columbia, Saskatchewan, Alberta (for Restricted Activities), or Quebec, occupational therapists must be registered within those provinces. 

When an OT does not need to be registered in a secondary jurisdiction 

When services are delivered remotely to a client who resides in a different province than where an occupational therapist is registered, the occupational therapist does not need to be registered in that province in the following situations:  

  • The occupational therapist is providing education, in the form of an online workshop/ webinar, etc. to an audience in another province(s). The presenting therapist(s) must introduce themselves as an occupational therapist currently registered/licensed to practice in their own jurisdiction. 

  • The client is located in a province other than British Columbia, Quebec, or Saskatchewan. 

For out-of-province occupational therapists providing virtual services to clients in Nova Scotia 

From British Columbia or Quebec: Occupational therapists must register to practice in Nova Scotia to provide virtual services to clients in Nova Scotia. This is a change effective December 12, 2023. 

It is the OT’s responsibility to advise any current clients in Nova Scotia about this change. Contact COTNS immediately to apply for registration to continue providing remote services in Nova Scotia. 

 [Application for Registration with COTNS – click here] 

For all other OTs registered to practice in Canada: The position of COTNS is that virtual occupational therapy service delivery occurs in the province where the occupational therapist is registered, rather than where the client resides. It is expected that occupational therapists providing virtual services to clients in Nova Scotia follow the rules and regulations of the province where they are registered. 

 The occupational therapist must: 

  • Disclose the province where they are registered/licensed, to their clients. 

  • Notify the client of the location from which they are providing the service. 

  • Only practice within the limits of their registration/license and competencies in the province where they are registered. 

  • Follow the regulatory Code of Ethics and applicable professional standards and/or guidelines in the jurisdiction where they are registered/licensed. 

  • Document the occupational therapy assessment and/or treatment as per provincial standards and guidelines. 

  • Ensure their liability insurance provides coverage for virtual activities. 

  • Ensure they have adequate information about resources in the location where the client resides. 

  • Have a contingency plan should virtual services be no longer appropriate. 

  • Determine if remote practice is the appropriate format for delivering the occupational therapy service. 

  • Ensure that the technology at both ends (client’s location and therapist’s location) is in good working order and utilizes safeguards for confidentiality. 

  • Carry out informed consent for the use of remote practice, including risks and limitations of remote practice; and the collection, use and disclosure of personal health information. 

  • Take necessary measures to maintain the client’s privacy and confidentiality of their personal health information. 

  • Develop a process to deal with any adverse or unexpected events during a remote practice session. For example: fall, medical emergency, etc. 

  • Establish and maintain professional boundaries during remote practice sessions. 

  • Discuss any additional risks and benefits of receiving virtual services. 

 The rules for in-person services are unchanged.   All occupational therapists must be registered in Nova Scotia to provide in-person services to a client residing in Nova Scotia. 

 

Occupational therapists registered in Nova Scotia providing virtual services outside the province 

To clients in other provinces 

Contact the regulatory organization in that province for information on registration requirements for providing virtual services.Occupational therapists must be registered where the client lives to provide virtual services within British Columbia, Saskatchewan, and Quebec(effective December 11, 2023).  

To clients outside of Canada 

For any other secondary jurisdiction, occupational therapists should contact the regulatory authority in that region and determine if registration is required to provide virtual occupational therapy services. 

To clients from Nova Scotia travelling outside of Nova Scotia 

Occupational therapists registered only in Nova Scotia may only provide virtual services to clients who are located in Canada.  

Occupational therapists should contact the regulatory authority of the region they are residing to confirm any rules and requirements that will need to be followed in that jurisdiction. 

 

What if a client has concerns about the occupational therapy services they received?  

Occupational therapists must abide by regulatory Code of Ethics and applicable professional standards and guidance in the province where they are regulated. 

If a client has concerns about the services they received, they can file a complaint with any regulatory organization where the occupational therapist is registered. 

List of provincial regulatory requirements 

Province(s) 

Regulation for Remote Practice 

Quebec 

Special authorization must be obtained from Quebec to deliver remote services from occupational therapists outside of Quebec. 

Saskatchewan 

 Any occupational therapist not registered in Saskatchewan must obtain an Extended Access Membership to deliver remote services to Saskatchewan residents. 

Alberta 

Occupational therapists must register in Alberta to provide any restricted activities to Alberta residents. 

British Columbia 

Must obtain appropriate registration in British Columbia to provide remote services to British Columbia residents. 

Ontario  
Manitoba 
New Brunswick  
Nova Scotia Newfoundland 
PEI 

Occupational therapists may provide remote services to clients in these provinces, using their registration/license from another Canadian province.  
 
The ACOTRO Position Statement on Remote Practice applies. 

   

List of provincial occupational therapy regulators 

 

Please contact Kevin Wong, Registrar/Executive Director, with any questions regarding the provision of virtual services.