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Doctors seeing urgent-care patients in Grey-Bruce with virtual visits


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There’s a new virtual urgent-care option designed for people who need to see a doctor but whose condition is not so serious that they need to wait in an emergency department in person.

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By seeing qualifying patients virtually, doctors should ease the load on Grey-Bruce’s 10 emergency departments, and wait times for ER patients should be reduced.

That’s the aim of a Grey Bruce Health Services’ three-month pilot project, which began March 2. This week home and community-care nurses were able to refer their patients to it, in cases where a nurse thinks a virtual visit with a doctor would do.

The virtual visits using the Maple Corp. virtual visit platform, whose access details are found on the GBHS website, use local physicians to conduct virtual visits either by video link or occasionally by phone. They aim to do at least 10 visits per day, Monday, Wednesday and Friday, between noon and 5 p.m.

The virtual visits are for urgent health matters for patients who need to be seen that day but can’t get in to see their doctors, but who are not sick enough to require critical care, said Dr. Sunil Mehta, chief of emergency medicine at Owen Sound hospital.

Those who need emergency medical attention should call 911 or go to their closest ER, the hospital said in a news release to announce the virtual service.

So far, Mehta has seen people virtually who needed a doctor’s note for work, a prescription renewal and an evaluation of a rash — all appropriate uses of the service.

As of Thursday morning, 55 people had sought virtual urgent care visits, 43 of whom were seen. Twelve were deemed inappropriate for virtual visits, including because prescriptions for restricted substances like opioids can’t be renewed with a virtual visit, Mehta said. Exit surveys show satisfaction rated at 4.8 out of five.

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But it’s not for people who require a hands-on assessment, say to assess whether an ankle broken, nor for significantly ill people, including those with difficulty breathing, chest pain or who are vomiting.

It is for people with mild allergies in need of advice, or if they don’t have a family doctor and have minor symptoms for which they would otherwise have gone to a walk-in clinic, and don’t need a physical exam, Mehta said.

People may still end up being referred to an emergency room, or to a family doctor, he said. The virtual visit doctor would then send a note to the family doctor recommending they see the patient. They don’t make the appointment for the patient.

Mehta said concerns arose during the COVID-19 pandemic that it was dangerous for people to come to an ER and sit with COVID-19-infected people in the waiting room. That led to more use of virtual visit  technology and to health ministry support, he said.

“The reality is that while it’s now safer for people to present (in an ER), it’s never completely safe to be staying in an emergency department room with a low-acuity thing, surrounded by people who are sick.

“And as volumes increase again at all of our emergency departments, where we can avoid having patients come into the department . . . it’s beneficial for them and reduces the wait-times for the individuals who do present.”

The aim is to see four to five patients per hour and to expand the program beyond three months, if the volume of patients justifies the time and expense, he said. Currently doctors are seeing two or three patients per hour.

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Mehta noted physicians aren’t available to do other work when they are involved in providing virtual visits. Family physicians participate on their days off, when they might otherwise do home visits, Mehta said.

“I don’t think any physician who is participating is cancelling one of their normal days of work to be able to do this,” he said. But if their participation in the virtual visits were to lead to physician burnout to cover the required hours, that would be a problem for the service, he said.

Internet access is a problem for the service in some rural area, Mehta said. One video consultation he did took 30 minutes when it could have taken 10 or 12 minutes, had the connection been better. People also have to have their own computer or device to access the Internet.

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