Ontario must do better on virtual care: AG

TORONTO – Auditor General Bonnie Lysyk (pictured) said in her 2020 Annual Report that the Ontario Ministry of Health does not have long-term goals and targets for virtual care, adding progress has continued to be slow in integrating virtual care into Ontario’s healthcare system – despite the progress made during the COVID-19 pandemic.

The audit found that the Ministry’s billing rules around virtual care were relaxed earlier this year because of COVID-19 and the growing need for remote care. However, post-COVID, additional work will be needed to plan for fully integrating virtual care services into Ontario’s healthcare system.

“Our audit concluded the Ontario Telemedicine Network and the Ministry of Health do not have effective systems and procedures in place to offer virtual care services, more long term, in a cost-efficient manner to meet Ontarians’ needs,” said Lysyk.

The audit also identified numerous cases where physicians had significantly high virtual-care billings. “In one case, a doctor had virtual-care billings of $1.7 million in 2019/20 while having reported seeing as many as 321 patients virtually in one day. That was on top of that doctor billing another $1.9 million for in-person services,” said Lysyk.

Meanwhile, the report concluded that the Telemedicine Network and Telehealth Ontario, which is a 24/7 free phone line for people to obtain health-related advice, need to identify opportunities for co-ordination and integration of services between the two organizations, while evaluating the impact of virtual care on patient outcomes.

The Ministry took actions to reduce restrictions on virtual care during COVID-19, such as allowing physicians to use and bill for virtual care over the phone or through a non-Telemedicine Network platform. However, barriers to virtual care have not been fully removed as the new virtual-care billing codes introduced by the Ministry are only temporary.

While Telehealth Ontario increased staff by 214% (from about 200 staff pre-COVID-19 to about 600 staff) and the number of phone lines by seven times (adding 3,300 phones lines to the existing 450), callers continued to face long wait times to receive advice. In January and February 2020, the average wait time (including waiting for a call-back) was between 30 minutes and one hour.

In March, wait times increased significantly to 21 hours for a COVID-19 call and 38 hours for a non-COVID call. In April 2020, it was still long, at about eight hours for a COVID-19 call and 17 hours for a non-COVID call.