Manitoba to extend nurse/patient virtual care program

BRANDON, Man. – A short-term pilot project that paired nurse practitioners with virtual patients in Westman was so successful, says Virden’s mayor, Tina Williams (pictured), that she along with council, have asked the province’s health minister to make it permanent.

During the last three months of 2023, and the first week of 2024, nurse practitioners across Manitoba saw patients on QDoc, which is a web-based platform that connects patients to physicians in real-time through virtual appointments.

As the pilot project using nurse practitioners was winding down, Williams said she, and members of council decided to make an official ask to the province. So, they sent a letter addressed to Premier Wab Kinew, Health Minister Uzoma Asagwara, and the Progressive Conservative MLA for their area, Greg Nesbitt.

“Having the nurse practitioners here has been great, it’s extra people,” Williams said. “And being on QDoc, you’re getting a response faster. The more people that are answering your calls on QDoc, the better, right?

“So, we brought it to council to say, we know it’s a pilot, but we think it’s worth continuing. That was our letter of support,” said Williams.

Marc Savy, Virden’s deputy mayor said he was concerned about losing the nurse practitioner connection and agreed with sending the letter.

“A nurse practitioner can give the same advice and prescriptions as a doctor for the most part, so we would not want to see nurse practitioners be removed from the QDoc system,” Savy said.

“If you lose nurse practitioners, you lose another level of being able to access healthcare in the province.”

Savy added that he and other municipal politicians spoke with Kinew about the pilot project at a powwow near their town on New Year’s Day.

“The premier did assure us that he would bring it back to his people. He [Premier Kinew] told us, ‘I will look into it, and get back to you,’” Savy told the Sun.

When the Brandon Sun asked the provincial health department about the nurse practitioner pilot project being extended, a government spokesperson said, “We are now working with QDoc to extend the agreement.”

“Our government is committed to seeing this innovative platform continue to serve Manitobans. Our priority is to make sure everyone can get quality care, when they need it,” the spokesperson stated in an email to the Sun.

The first step in extending the pilot project could come as early as this week.

The co-founder of QDoc, Dr. Norman Silver, a Winnipeg-based pediatrician, said he has a meeting with the province’s health minister soon to discuss having nurse practitioners available on QDoc permanently.

When patients logged on to QDoc, they were given a choice if they wanted to see a doctor or a nurse practitioner.

“During the pilot, we saw 2,500 visits,” Silver said. “More than half – or three quarters by the end of it – chose that they would see a nurse practitioner.

“Out of those 2,500 visits, the ratings that we had internally for nurse practitioners is 4.8 out of five, and for doctors during the same time period is 4.7 out of five. So, that’s probably not a big difference, but those people loved seeing them as well,” Silver said.

The project was popular with the health professionals too, added Silver.

During the last week of October 2023, when the pilot project was just starting, QDoc had two nurse practitioners, Silver said, but by the end of it there were 30.

In Manitoba, nurse practitioners can conduct physical and pre-natal exams, pap tests, diagnose chronic conditions, prescribe medications, and order tests like blood work, X-rays, ultrasounds, CT scans and MRIs.

Darlene Jackson, president of the Manitoba Nurses Union, has told the Sun that they are “incredibly valuable and very underutilized,” and can perform minor procedures like suturing, biopsies, wart and mole removal, and often refer cases to other health providers, including specialists.

Silver created QDocs with his business partner, David Berkowits (the two are also brothers-in-law).

Berkowits, has numerous years designing sophisticated medical technology applications in Alberta.

The system Berkowits designed for QDoc uses natural language processing to self-populate forms. Every QDoc appointment is recorded, and the patient and family doctor receive summaries. QDoc automatically bills Manitoba Health and retains 15 per cent of the fee as its source of revenue.

But the medical need that Silver said he wanted QDoc to fill was to service areas that don’t have a doctor, or locations where patients are hours away from seeing one.

“There are about 4,000 doctors in Manitoba, and we have 110 on QDoc now. But if we can get 1,000 doctors on the service, on average seeing two or three patients each a day, it does not impact their lives much.

“But what an impact on the province if you see an extra 2,000 patients a day – you see an extra 700,000 visits a year,” Silver said.

In Virden, speaking from her home before heading out to a meeting with other municipal leaders to talk about healthcare, Williams said they too, think “big picture”.

“We’re never going to have a doctor in every little town like we used to. And in today’s climate, it’s not just a Virden thing. We’re not alone, nobody has enough doctors or nurses.

“And we may not have as many doctors as we need all the time or enough consistency, but we’re holding our own, and that’s why we concern ourselves with the little towns around us,” Williams said.

Source: Brandon Sun