Contributed by Dr. Anil Maheshwari
In this time of ongoing changes in our healthcare system, technology has emerged as one of the most promising ways to provide better care for our patients. One of the key areas of focus for the new Ontario Health Teams is digital health. The government clearly envisions technology tools such as virtual visits playing an important role in the province’s healthcare system.
You may be asking yourself, “What is a virtual visit?” My definition of a virtual visit is an interaction that occurs between a patient and healthcare provider without having to be in the same place at the same time.
In the Waterloo Wellington area, 67 clinicians have conducted over 10,000 virtual visits so far and the feedback has been overwhelmingly positive. Feedback indicates that 94% of patients thought that their virtual visit was the same or better than an in-person visit, and 94% of patients would recommend the solution to friends and family. In addition, 91% of providers indicated that the solution is easy to use, and 81% would recommend the solution to their colleagues.
We have rolled out three types of virtual visits at our 15-physician Family Health Team – secure messaging, phone calls and video visits. We currently have over 2,800 patients signed up on our platform.
Our physicians have been predominantly using secure messaging, which provide a variety of benefits:
- Patients and physicians are able to send and receive messages at their convenience;
- Patients document their visit, which means less documentation to be done by the physician;
- Everything that is documented is saved for the patient to come back and look at later, which leads to fewer communication mishaps;
- Providers can send documents including handouts, prescriptions, laboratory and radiology requisitions;
- Patients can send pictures of rashes, medicine bottles and other documents to their providers, who are able to save this information in the patients’ charts; and
- The messaging takes less time than standard, telephone or video visits.
We are now looking to do more phone calls and video visits, which need to be scheduled. The biggest advantages to these are that the provider is able to hear and/or see the patient and is reimbursed at the same rate as an office visit for most standard visits. It can be more convenient for both the patient and the physician.
Virtual visits are clearly an important part of the future for the healthcare system. According to Kaiser Permanente CEO Bernard J. Tyson, out of 100 million patient-provider visits in 2016, 52% were done virtually. While Kaiser Permanente is a fully capitated model in the United States, virtual visits also work in our current system because the government understands the value of these types of visits and is reimbursing phone and video visits at the same rate as office visits. Physicians in a rostered model continue to shadow bill and fee-for-service physicians continue to receive the full fee-for-service rates. Messaging pays a slightly lower rate in both models but, as discussed above, has several advantages.
Overall, the most active virtual visit adopters in our group feel that using technology is a great way to provide care and avoid unnecessary face-to-face visits, saving both patients and clinicians a lot of time. We also understand that virtual visits will only improve with better integration into our electronic medical record.
Virtual visits should also allow us to prevent outside usage by patients. According to our data, high users of our platform were able to retain 8.5% more of their access bonuses while our control group’s access bonuses actually fell by an average of 5% during the same time period. A net difference of 13.5% provides some evidence that this technology does in fact prevent outside usage.
As we are better able to integrate these new types of visits into our office flow, we believe that many more physicians will see the benefits and embrace this technology.
Hear more insights from OntarioMD Peer Leader Dr. Maheshwari at his session, Virtual Care: Hype or Hope?, at OntarioMD’s EMR: Every Step Conference in Toronto. Register to join us on September 26. You can also get more information and support from OntarioMD anytime at support@ontariomd.com.
