Virtual care clinics did little to ease crowded ERs during COVID pandemic: study

Virtual care clinics in Ontario had a limited impact on diverting patients out of emergency room departments during the pandemic, according to a new study. 

Virtual care clinics in Ontario had a limited impact on diverting patients out of emergency room departments during the COVID-19 pandemic, according to a new study.

The study, published Monday in the Canadian Medical Association Journal (CMAJ), found that although virtual care clinics in Ontario were intended to alleviate the strain on overstretched emergency facilities, many of these patients still ended up heading to the emergency room for care.

“The shift to virtual care was intended to maintain safe access to medical care during the pandemic, it occurred despite lack of evidence regarding the comparability of in-person and virtual care models,” lead author Dr. Shelley McLeod, a clinical epidemiologist at Sinai Health, wrote in a press release.

In the early stages of the pandemic, when physical distancing was strongly encouraged, it was difficult to arrange a nonurgent, in-person health-care visit, according to the study. In response to this, in the fall of 2020, the Ontario Ministry of Health funded $4 million to a program involving 14 virtual urgent care initiatives across the province.

The program was intended to support emergency department diversion of patients with less severe health problems and reduce the need for in-person visits.

In order to find whether the pilot program made a dent in diverting patients away from emergency rooms, the researchers looked at more than 19,500 virtual urgent care visits across Ontario from December 2020 to September 2021.

Of all patients in the study who went to a virtual care clinic during this time, 12.5 per cent went to the emergency department within three days and 21.5 per cent within 30 days of the first visit.

The study found the most common complaints for patients who had a subsequent emergency department visit after their virtual care appointment were fever and abdominal pain, with COVID-19 being the top known diagnosis.