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Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario

INTRODUCTION: As part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the d...

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Autores principales: McLeod, Shelley L., Mondoux, Shawn, Hall, Justin N., Dainty, Katie, McCarron, Joy, Tarride, Jean-Eric, Abraham, Lency, Tse, Sandy, Lim, Rodrick, Fitzgibbon, Megan, Montpellier, Renee-Anne, Rivlin, Leon, Rodriguez, Carla, Beck, Lisa, McLean, Lianne, Rosenfield, Daniel, Mehta, Shaun, Welsford, Michelle, Thompson, Cameron, Ovens, Howard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666976/
https://www.ncbi.nlm.nih.gov/pubmed/36380242
http://dx.doi.org/10.1007/s43678-022-00407-9
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author McLeod, Shelley L.
Mondoux, Shawn
Hall, Justin N.
Dainty, Katie
McCarron, Joy
Tarride, Jean-Eric
Abraham, Lency
Tse, Sandy
Lim, Rodrick
Fitzgibbon, Megan
Montpellier, Renee-Anne
Rivlin, Leon
Rodriguez, Carla
Beck, Lisa
McLean, Lianne
Rosenfield, Daniel
Mehta, Shaun
Welsford, Michelle
Thompson, Cameron
Ovens, Howard
author_facet McLeod, Shelley L.
Mondoux, Shawn
Hall, Justin N.
Dainty, Katie
McCarron, Joy
Tarride, Jean-Eric
Abraham, Lency
Tse, Sandy
Lim, Rodrick
Fitzgibbon, Megan
Montpellier, Renee-Anne
Rivlin, Leon
Rodriguez, Carla
Beck, Lisa
McLean, Lianne
Rosenfield, Daniel
Mehta, Shaun
Welsford, Michelle
Thompson, Cameron
Ovens, Howard
author_sort McLeod, Shelley L.
collection PubMed
description INTRODUCTION: As part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the demographic characteristics, outcomes and experience of patients using the provincial pilot program. METHODS: This was a prospective cohort study of patients using virtual care services provided by 14 ED-led pilot sites from December 2020 to September 2021. Patients who completed a virtual visit were invited by email to complete a standardized, 25-item online survey, which included questions related to satisfaction and patient-reported outcome measures. RESULTS: There were 22,278 virtual visits. When patients were asked why they contacted virtual urgent care, of the 82.7% patients who had a primary care provider, 31.0% said they could not make a timely appointment with their family physician. Rash, fever, abdominal pain, and COVID-19 vaccine queries represented 30% of the presenting complaints. Of 19,613 patients with a known disposition, 12,910 (65.8%) were discharged home and 3,179 (16.2%) were referred to the ED. Of the 2,177 survey responses, 94% rated their overall experience as 8/10 or greater. More than 80% said they had answers to all the questions they had related to their health concern, believed they were able to manage the issue, had a plan they could follow, and knew what to do if the issue got worse or came back. CONCLUSIONS: Many presenting complaints were low acuity, and most patients had a primary care provider, but timely access was not available. Future work should focus on health equity to ensure virtual care is accessible to underserved populations. We question if virtual urgent care can be safely and more economically provided by non-emergency physicians. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43678-022-00407-9.
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spelling pubmed-96669762022-11-16 Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario McLeod, Shelley L. Mondoux, Shawn Hall, Justin N. Dainty, Katie McCarron, Joy Tarride, Jean-Eric Abraham, Lency Tse, Sandy Lim, Rodrick Fitzgibbon, Megan Montpellier, Renee-Anne Rivlin, Leon Rodriguez, Carla Beck, Lisa McLean, Lianne Rosenfield, Daniel Mehta, Shaun Welsford, Michelle Thompson, Cameron Ovens, Howard CJEM Original Research INTRODUCTION: As part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the demographic characteristics, outcomes and experience of patients using the provincial pilot program. METHODS: This was a prospective cohort study of patients using virtual care services provided by 14 ED-led pilot sites from December 2020 to September 2021. Patients who completed a virtual visit were invited by email to complete a standardized, 25-item online survey, which included questions related to satisfaction and patient-reported outcome measures. RESULTS: There were 22,278 virtual visits. When patients were asked why they contacted virtual urgent care, of the 82.7% patients who had a primary care provider, 31.0% said they could not make a timely appointment with their family physician. Rash, fever, abdominal pain, and COVID-19 vaccine queries represented 30% of the presenting complaints. Of 19,613 patients with a known disposition, 12,910 (65.8%) were discharged home and 3,179 (16.2%) were referred to the ED. Of the 2,177 survey responses, 94% rated their overall experience as 8/10 or greater. More than 80% said they had answers to all the questions they had related to their health concern, believed they were able to manage the issue, had a plan they could follow, and knew what to do if the issue got worse or came back. CONCLUSIONS: Many presenting complaints were low acuity, and most patients had a primary care provider, but timely access was not available. Future work should focus on health equity to ensure virtual care is accessible to underserved populations. We question if virtual urgent care can be safely and more economically provided by non-emergency physicians. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43678-022-00407-9. Springer International Publishing 2022-11-16 2023 /pmc/articles/PMC9666976/ /pubmed/36380242 http://dx.doi.org/10.1007/s43678-022-00407-9 Text en © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Research
McLeod, Shelley L.
Mondoux, Shawn
Hall, Justin N.
Dainty, Katie
McCarron, Joy
Tarride, Jean-Eric
Abraham, Lency
Tse, Sandy
Lim, Rodrick
Fitzgibbon, Megan
Montpellier, Renee-Anne
Rivlin, Leon
Rodriguez, Carla
Beck, Lisa
McLean, Lianne
Rosenfield, Daniel
Mehta, Shaun
Welsford, Michelle
Thompson, Cameron
Ovens, Howard
Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title_full Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title_fullStr Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title_full_unstemmed Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title_short Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario
title_sort demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in ontario
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666976/
https://www.ncbi.nlm.nih.gov/pubmed/36380242
http://dx.doi.org/10.1007/s43678-022-00407-9
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