Getting Started with Telehealth as a Nurse Practitioner in Canada

Several factors are driving explosive growth in NP-led telehealth:

• Doctor shortage: Over 6.5 million Canadians lack a family physician. Provinces are expanding NP scope of practice to fill the gap.
• Patient demand: Post-pandemic, patients overwhelmingly prefer virtual care for non-urgent issues. Convenience is the new standard.
• Provincial support: Ontario, Alberta, BC, and other provinces have modernized regulations to fully support NP-led virtual care, including prescriptive authority for controlled substances.
• Technology: Secure platforms make it easy to conduct consultations, prescribe medications, and manage patient care remotely.

To practice telehealth, you must hold an active NP license in the province where your patient resides. Here is the regulatory landscape:

• Ontario (CNO): NPs registered with the College of Nurses of Ontario can practice telehealth with full prescriptive authority, including controlled substances. No additional telehealth-specific license required.
• Alberta (CRNA): NPs registered with the College of Registered Nurses of Alberta have full independent practice authority. Telehealth is permitted within the existing scope.
• British Columbia (BCCNM): NPs under the BC College of Nurses and Midwives can practice telehealth. Full prescriptive authority including controlled substances.
• Saskatchewan: NPs can practice telehealth under existing licensure with full prescriptive authority.
• Nova Scotia: NPs can practice telehealth with full prescriptive authority.

Key rule: You must be licensed in the province where the patient is located at the time of consultation, not where you are physically sitting.

Telehealth consultations come in two primary formats, each with different workflows:

Asynchronous (async) consultations:

• Patient completes a detailed health questionnaire
• You review the information on your own time
• You provide a diagnosis, treatment plan, and prescription (if appropriate)
• Best for: ED, hair loss, skin conditions, prescription renewals, straightforward weight loss cases
• Time per review: 3-10 minutes

Video (synchronous) consultations:

• Scheduled appointment with the patient via secure video
• Real-time clinical interview and assessment
• Best for: ADHD assessments, complex mental health, menopause/HRT, cases requiring deeper evaluation
• Time per consultation: 20-60 minutes

Most NPs on MedRelay choose a mix of both, depending on their schedule and preferences.

Before starting telehealth, ensure your professional liability insurance covers virtual care. Key points:

• Most major NP insurance providers (CNPS, private insurers) cover telehealth as part of standard NP practice
• Confirm that your policy explicitly includes telehealth/virtual care
• Ensure coverage extends to all provinces where you are licensed and practicing
• If you are doing telehealth as a side practice, confirm your policy covers independent contractor work (not just employment-based practice)

If you are unsure, contact the Canadian Nurses Protective Society (CNPS) — they provide free legal advice to NPs.

Telehealth documentation follows the same standards as in-person care, with a few additional considerations:

• Document the consultation method: Note whether the consultation was async or video, and the platform used
• Verify patient identity: Platforms like MedRelay handle identity verification during patient onboarding
• Confirm patient location: Document the province the patient is in at the time of consultation
• Prescribing: Use electronic prescribing to send prescriptions directly to the patient's pharmacy. All standard prescribing guidelines apply
• Follow-up plan: Document when and how follow-up will occur

Getting started on MedRelay takes less than 5 minutes:

1. Create your account: Sign up at medrelay.ca and select "Nurse Practitioner" as your role
2. Complete your profile: Add your license number, province(s) of licensure, areas of clinical interest, and availability
3. Verification call: Our team will contact you to verify your credentials. This typically takes 1-3 business days
4. Start accepting patients: Once verified, you can begin reviewing patient consultations immediately

There are no fees to join, no minimum hours, and no long-term commitments. You earn per consultation, paid weekly via Stripe.