Best of both worlds: How this health team integrated patients in with virtual care

A program in a rural part of Ontario that links patients without a primary care provider to to a physician providing virtual appointments helped improve preventative care for those patients. Even though appointments with the physician were virtual, the patients were integrated into a local primary healthcare team.The program was launched in Renfrew County, Ont., which has a population of 106,365. About 20% of residents don’t have a primary care provider. Petawawa, the largest community in Renfrew County, is home to a military garrison. While military personnel receive primary care on the base, their family members must find primary care in the community.Patients unattached to a primary care provider were enrolled in an “integrated virtual care” (IVC) program. They were matched to one of three family physicians who provided virtual appointments but was connected to the Petawawa Centennial Family Health Centre, a family health team. The team has a blended salary and patient enrollment model of remuneration. Other healthcare professionals (i.e., other physicians, nurse practitioners) provided in-clinic options for these patients.The goal of the program is to attach patients to a family health team so they can receive comprehensive primary care. It can also reduce volumes at the local emergency department. An earlier version of the model showed that 90% of the initial 121 patients were satisfied or very satisfied with care from their integrated virtual care physician.The current study looked at 760 patients who were enrolled in the program for at least three months between November, 2021 and June, 2022. During that time, the patients made 2,823 appointments through the program, 70% of which were virtual, with their integrated virtual care program physician. The other 30% of appointments were in-person with one of six allied health professionals at the Petawawa Centennial Family Health Centre.The prevalence of chronic conditions was low, with 22.8% of patients having hypertension. Mental health problems were more common, with 38.5% of patients having depression or anxiety and 15.2% experiencing both. Read: Seniors getting specialized emergency careThe program included a review of cancer screening and enrollment in smoking cessation programs. During the study period, the proportion of eligible integrated virtual care patients who were up-to-date on preventative screening rose.The number of patients considered up-to-date increased for the following cancer screening:Colorectal cancer, from 6.9% to 33.9%Cervical cancer, from 22.4% to 58.9%Breast cancer, from 17% to 39.2%One in five of the current smokers were enrolled in a smoking cessation program after enrollment.“These findings show clearly that residents without a family doctor are ready and willing to embrace innovative ways of increasing access to primary care. They also show that patients were happy with the process of joining IVC,” said co-author Dr. Jonathan Fitzsimon, assistant professor at the department of family medicine at the University of Ottawa.Renfrew County also has a special paramedic service where paramedics can assess, monitor and treat some patients in the home. “When care is provided by allied health professionals, nurse practitioners and other physicians in the local family health team, these interactions are communicated efficiently with the patient’s doctor,” said Dr. Fitzsimon, who is also clinical researcher at Institut Savoir Montfort in Ottawa. “Partnership with the existing community paramedicine programme allows a range of at-home care options for vulnerable, housebound patients.”Future studies will evaluate patient and physician experience with the system, the study authors note. The paper was published in the Canadian Journal of Rural Medicine.

Best of both worlds: How this health team integrated patients in with virtual care

Register for free access or login.

Related Topics