Ontario funding cuts: Virtual health care access stripped

Amid a growing shortage of primary care physicians and increasing pressure on Canada’s hospital system, recent funding changes have significantly reduced access to virtual consultations in Ontario. Some patients have been forced to choose between potentially unnecessary emergency room visits and out-of-pocket payments for care they once had. It’s free, according to the founder of one virtual care platform.

Its platform, called Rocket Doctor, says the cut in funding has had a dramatic impact on its ability to serve patients.

The platform operates in BC, Alberta, and Ontario, but has asked Ontario patients to pay out-of-pocket since Ontario stopped funding doctors offering virtual consultations in December. Kixcare, another virtual care platform, has also switched to a paid format in response to the funding change.

Dr. William Cherniak is an emergency medicine physician and founder of Rocket Doctor. Rocket Doctor allows patients to connect with their doctors online through hospital partnerships for a variety of primary his care issues, including consultations, prescriptions, and lab referrals.

“I think the government has a very difficult job of sorting out where to allocate funds in the health care system, but one of the events that is unique to our program is that as a Canadian technology company, doctors allows people to practice medicine virtually and integrate it into their care system,” Cherniak told CTV’s Your Morning on Thursday.

“And when those cuts were made in December, we saw a 50% reduction in reimbursement for primary emergency physicians who had never seen a patient in person. It became really impossible to do.”

funds spent fairly even Physicians in Ontario can charge the government up to $80 per visit.

But now, doctors in Ontario only get $20 for video visits and $15 for phone visits unless they’ve seen a patient in person at least once in the last two years.

If you have an in-person medical history, you will receive full funding for future virtual visits with that patient.

“OMA believes that the best care lies in the patient-physician relationship,” the Ontario Medical Association said in December when the change went into effect. “Virtual Care will be fully funded by OHIP under this new agreement, provided there is an ongoing relationship.”

Officials say the move is aimed at ensuring that virtual care doesn’t replace comprehensive care, but other experts say it will help patients who have difficulty accessing a family doctor. He says he left it behind.

By 2022, more than a third of Canadians without a primary care physician say they have been looking for one for at least a year. In Ontario alone, approximately 1.8 million people do not have a primary care doctor and are not surveyed. Project published last fall If current trends continue, that number could balloon to 3 million by 2025.

According to Cherniak, one way virtual care can fill a gap in the healthcare system is to address situations where you may or may not need to rush to the hospital.

“People may not be lucky enough to have their own family doctor.” And maybe some people come to the ER with fevers and pains trying to sort out what’s going on urgently because they can’t see their family doctor in a few days.”

A 2014 study by the Canadian Institute of Health Information found that 20% of patients who visited emergency rooms across Canada could have been treated elsewhere.

Free virtual healthcare also provides rapid diagnosis for those who do not have access to a primary care physician or who do not have immediate access to a primary care physician.

“You can log in and chat with your care coordinator. If you have chest tearing pain, stroke symptoms, broken arm, etc., we can help you understand first. The ER is for you, but if it’s a medication refill or another condition that can be managed with virtual care, we can use the doctors on the platform to help you,” Cherniak said. says.

There are other options for getting advice on the need for an ER visit. In Ontario, for years, a toll-free phone service has connected patients and nurses for advice, sometimes plagued by long wait times. Renamed. Health Connect Ontario In 2022, days can be jammed early in a pandemic, showing that remote healthcare requires multiple options.

During the pandemic, virtual consultations began as many doctors switched to video calls and telephone consultations instead of face-to-face consultations.

While the goal was to ensure access to care was maintained without spreading COVID-19 transmission, many experts believe that virtual care could improve the health of people in remote areas and those with disabilities. We also found that access to care increased.

Canadian studies published in January According to the peer-reviewed journal BMC Primary Care, the expansion of virtual care, spurred by the pandemic, has removed long-standing barriers to access for many patients, including those who rely on public transport or who are unable to take time off from work. I was. simply.

“We have seen 1,000 patients[through Rocket Doctor]in the last few months and have effectively prevented unnecessary ER visits,” said Cherniak.

But that progress is currently being blocked in Ontario, he says.

Prior to the December funding change, speaking to a doctor virtually via Rocket Doctor’s platform cost patients in British Columbia, Alberta and Ontario the same amount. The service was fully funded.

Now, when you go to a page on Rocket Doctor’s website for accessing doctors in BC, you are only prompted to enter your information to be matched with a doctor for free.

But clicking the option to access doctors in Ontario takes a toll very different pagepay $55 for a one-time live chat with a doctor, or choose one of various healthcare packages ranging from $50 to $107 per month for ongoing service access. urge.

Below these payment options, the website states: in Rocket Doctor.

after that Link to petition launched last fall We urge the Ontario government to reconsider the reasons behind these funding changes and suspend any changes until then. Over 31,000 people have signed.

Rocket Doctor is not the first virtual practice platform to be affected by Ontario’s funding changes. Kixcare, a company that provides 24/7 virtual access to pediatric health professionals, announced in the fall that it would suspend emergency medical services and charge families a $29 monthly fee to access health care providers. started.

Alana Kaifetz, a parent who previously received full-coverage medical care for her 2-year-old son through Kickscare, told CTV News Ottawa that Ontario’s decision to remove funding for online care ” It’s really weird and backwards,” he said.

Dr. Harley Eisman of Kixcare told CTV News Toronto A 75% cut in government funding for doctors meant that continuing to provide access to public health care was not a “sustainable option” for doctors.

Cherniak believes Ontario funding should take into account a patient’s specific circumstances when deciding whether to fully fund a virtual treatment.

“To add some nuance to these changes, if a) a doctor is fully reimbursed if a patient doesn’t have a primary care doctor, or b) if they have a more serious condition that should go to the ER, we can do the job. I can reimburse the doctor for the full amount to do so,” he suggested.

In a letter sent to the Ontario and other provincial governments last week, Commonwealth Health Minister Jean-Yves Duclos said he was “extremely concerned about the recent increase in reports of patient claims. there is,” he said.

“Canadians pay for medical services through taxes and should not be asked to pay again as a patient when they need to access those services,” the letter read.

federal government weighed on friday On the rise in copays across Canada, it threatens future federal funding that could be recaptured if states allow states to charge patients for medically necessary services.

However, it’s unclear if the move will address funding changes such as Ontario’s cut funding for pure virtual health care.

Cherniak hopes that access to virtual health care will not be cut further, and that other states will accept virtual care funding.

“I think it’s important to note that across Canada, as you know, Alberta, British Columbia, we fund virtual care well enough that people can access services that way.” he said.

“Hopefully, what we are trying to find is that we will continue to engage with more and more technologies to ultimately improve equitable access to care and make healthcare better. I mean, that’s my goal.”

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