Ontario has been called out in a sweeping report published by the auditor general for moving too slow in virtual care expansion. According to the report, Ontario has lagged when it comes to integrating virtual care services with its health-care system. This report comes at a time when the healthcare sector is undergoing a massive transformation all over North America in response to the raging pandemic.
Ontario is one of the first provinces to initiate the concept of Health Teams meant to provide coordinated and connected care throughout the province. However, issues like hallway care and a growing number of retirement homes with residents who should be in long-term care are quite prominent in the province.
But that is not all, the auditor also found the Ontario Telemedicine Network (OTN), which provides remote care, and the Ministry of Health “do not have effective systems and procedures in place to offer virtual care services more long term in a cost-efficient manner to meet Ontarians’ needs.” The audit unearthed “numerous cases” where physicians had “significantly high” billings for virtual care, including one case where a doctor billed $1.7 million for remote services in 2019-2020 and another $1.9 million for in-person services. That doctor reported seeing as many as 321 patients virtually in one day, the report said.
Because of the COVID-19 pandemic, the Ministry of Health came to rescue of Ontario physicians by issuing temporary billing codes that allowed to bill for virtual-care services provided through telephone video visits, in addition to the virtual visits through the Telemedicine Network platform. While this increased data security and privacy concerns, it was an important step to providing virtual patient care during the pandemic.
But even enabling virtual health and telehealth comes with its own set of challenges. Since the onset of the pandemic, Telehealth Ontario has experienced long wait times and technical issues despite expanded capacity and resources. For example, in March 2020 i.e., the first month of the COVID-19 pandemic, Telehealth Ontario received 46,000 calls (with about half related to COVID-19), an increase of 24 per cent from February 2020. This 24 per cent increase in call volume increased the average wait time, including the time spent waiting for a call-back from Telehealth Ontario, from 1 hour in January and February 2020 to 28 hours in March for a non-COVID related phone call.
While the province is now on-pace to clock more than 2 million virtual care visits combined in 2019-2020, the pace of technology adaptation has remained slow. This is however, expected to change in the coming years as initiatives like Ontario Health Teams take shape and enable virtual connected care in the province.