Access to virtual care growing on P.E.I. because of billing change and pandemic

Access to virtual care by P.E.I. physicians expanded in the past year — that's because, since April of 2020, doctors have had the option to bill for care that doesn't happen in person. 

A new master agreement — the contract between government, Health PEI and the Medical Society of P.E.I. — was ratified in April 2020, and as part of that, new fee codes were established that would allow physicians to bill for care via telephone, text message or video conference. 

And the timing couldn't have been better. As the country shifted into pandemic lockdown in the middle of March 2020, details were already in place to enable doctors to continue caring for patients, from a safe distance. 

"There were some, I guess, silver linings," said Gail Scott, director of medical affairs at Health PEI. "And one of them was that we were in a position of being ready for virtual care. We had contemplated that and we were ready to build on it."

Prior to the pandemic, physicians were only allowed to bill for in-person care. But lockdowns and pandemic precautions made it essential to enable physicians to assist patients remotely, and some non-face-to-face billing codes were enabled. 

"Many offices and walk-in clinics were closed," said Scott. "And there was a recognition that there was a real need to have something in place to provide support to islanders. Recognizing that we needed to provide options for physicians and their patients, we were able to open up some of those codes." 

Positive feedback from Island doctors

In order to protect the privacy of patients, physicians offering virtual care are only allowed to use technology approved by Health PEI. Scott said, at this time, no formal evaluation of virtual care is underway, but anecdotal feedback from Island doctors has been positive. And most who are using virtual care now, hope to be able to continue post-pandemic. 

"I think that those who have really engaged with virtual care will continue to do so. And as we evaluate more, as we learn more, and we evolve with our virtual care, I think it will become just like any other part of the health-care system, just a standard way that we do business."

Many patients have had a lot of fear throughout this period.— Dr. Trina Stewart

Scott said it's not about replacing in-person care — it's about supplementing existing health-care services, and better serving patients. 

"I think that's one of the possibilities, that we're able to probably streamline what kinds of issues and concerns are brought to the attention, to physicians, by virtual care," said Scott. 

"There's always going to be a need to continue to recruit physicians on P.E.I. Ultimately, it's still a physician that's on the other end of the virtual care work. But I do think there's ways to provide health care in a more efficient manner by using virtual care, and that's something that we'll continue to explore." 

Right now, this billing option is only available in relation to the COVID-19 pandemic. Scott said more feedback is needed on how it's working and what adjustments might be needed before making this a permanent option.

Health PEI will continue to evaluate it, she said, as something that could help with everything from reducing the number of people on the patient registry to minimizing appointment no-shows.

Virtual health 'the way of the future'

For Island physicians, the change has meant added flexibility during an exceptionally challenging time. 

"It's meant everything because we've been able to continue servicing our patients in a way that we felt we were managing things," said Dr. Trina Stewart, a family physician in Summerside who is also president of the Medical Society of P.E.I. 

Stewart said at the beginning of the pandemic the phones at her clinic were eerily quiet — and having the option to call and connect with certain patients, and bill for that time, was helpful. 

"Many patients have had a lot of fear throughout this period," said Stewart. "And some stayed home at the expense of their own health. So it gave us the opportunity to check in if we weren't hearing from our most vulnerable patients and it saved people a trip. If it was something as simple as changing a medication related to, you know, a level, say, thyroid or diabetic management, that kind of thing, which you can often safely do over the phone." 

She said there will always be a need for in-person care for assessments and chronic disease management. But she said now that some patients have experienced the convenience of virtual care, she expects the demand for it — where appropriate — will only increase. 

"I absolutely think it's a patient expectation and, you know, a general expectation that we become more technologically savvy," Stewart said.

"And that convenience is what patients expect. They want to be able to text. They want to be able to email. They want to be able to phone. And, you know, if we can set things up in a way that their data is protected and we can provide that care safely, I think it's absolutely the way of the future."

More from CBC P.E.I.