Health Care Ontario says that less than half of Ontario citizens are able to see a primary care provider when they’re sick. That means added load on hospital emergency departments; research shows that 15 per cent of ER visitors said they were there because their family doctor wasn’t available. In Waterloo, Wellington, only 41 per cent said they were able to see a primary care provider on the same or next day when they were sick.
To improve accessibility to health care, the eHealth Centre of Excellence in Waterloo implemented Virtual Visits, collaborating with the Ontario Telemedicine Network to implement the Enhanced Access to Primary Care initiative connecting patients and healthcare providers via secure chat, phone, or video. Think Research, a Toronto-based company that provides digital tools to enable evidence-based care, developed the supporting virtual visits solution.
Both patients and providers can request Virtual Visits. Currently, said Dr. Mohamed Alarakhia, managing director, eHealth Centre of Excellence, 22 per cent are initiated by the provider.
“Patients are requesting visits related to their chronic conditions, medications, diagnostic test results, new health issues, and as a follow-up to a previous appointment,” he noted. “Providers are initiating visits with their patients to follow-up on test results, follow-up on patient’s existing condition or a previous appointment and discuss medications.”
The practitioners’ remuneration model was adjusted to pay providers for these not previously covered services. Over 90 per cent of virtually initiated visits were completed virtually, with only 7 per cent requiring an in-person follow-up appointment.
“Through a virtual visit, these appointments can be completed more efficiently, saving both the patient and the family doctor valuable time,” Dr. Alarakhia explained. “Doctors can also address preventative care measures at the same time with patients through virtual visits, reaching some patients who are not able to come in otherwise. And virtual visits allow additional time for in-person appointments to address more complex patient care needs.”
Follow up research shows that it works: 95 per cent of patients in Waterloo Wellington accessing primary care through a Virtual Visit received a response within two days, more than double the 41 per cent who access it in person. Patients found the process convenient and a time-saver and recommended it to friends and family, and many patients use Virtual Visits repeatedly – almost 17,000 virtual visits were made by around 8,400 patients.
“We do find that patients who have experienced a virtual appointment are likely to try it again,” Dr. Alarakhia said. “It’s a fast and effective way to receive care and particularly convenient for patients who live in remote locations, have mobility issues, limited access to transportation, or cannot take time off work to visit their primary care provider in-person.”
He was pleased with one unexpected result: Over one-third of patients noted that the quality of care they received was better than in-person, with over 60 per cent noting the quality of care was the same.
“Although we aimed to ensure that we preserve the quality of care similar to an-in person visit, the results that over 30 per cent of patients perceive a higher-quality of care was a nice surprise for us,” he said.