An Environmental Scan of Virtual "Walk-In" Clinics in Canada: Comparative Study.

Spencer Matthewman,Lindsay Hedden,Sarah Spencer,Rita K Mccracken,M Ruth Lavergne

doi:10.2196/27259

Abstract

BackgroundCanada has been slow to implement virtual care relative to other countries. However, in recent years, the availability of on-demand, “walk-in” virtual clinics has increased, with the COVID-19 pandemic contributing to the increased demand and provision of virtual care nationwide. Although virtual care facilitates access to physicians while maintaining physical distancing, there are concerns regarding the continuity and quality of care as well as equitable access. There is a paucity of research documenting the availability of virtual care in Canada, thus hampering the efforts to evaluate the impacts of its relatively rapid emergence on the broader health care system and on individual health.ObjectiveWe conducted a national environmental scan to determine the availability and scope of virtual walk-in clinics, cataloging the services they offer and whether they are operating through public or private payment.MethodsWe developed a power term and implemented a structured Google search to identify relevant clinics. From each clinic meeting our inclusion criteria, we abstracted data on the payment model, region of operation, services offered, and continuity of care. We compared clinics operating under different payment models using Fisher exact tests.ResultsWe identified 18 virtual walk-in clinics. Of the 18 clinics, 10 (56%) provided some services under provincial public insurance, although 44% (8/18) operated on a fully private payment model while an additional 39% (7/18) charged patients out of pocket for some services. The most common supplemental services offered included dermatology (15/18, 83%), mental health services (14/18, 78%), and sexual health (11/18, 61%). Continuity, information sharing, or communication with the consumers’ existing primary care providers were mentioned by 22% (4/18) of the clinics.ConclusionsVirtual walk-in clinics have proliferated; however, concerns about equitable access, continuity of care, and diversion of physician workforce within these models highlight the importance of supporting virtual care options within the context of longitudinal primary care. More research is needed to support quality virtual care and understand its effects on patient and provider experiences and the overall health system utilization and costs.

Highlights

Canada has lagged behind other countries in its uptake of virtual care as an integrated component of the health care system [1,2,3]
In addition to community-based physicians adapting their brick-and-mortar practices to include virtual care provision, the new fee codes for virtual visits provide an opportunity for the development of on-demand, “walk-in” virtual clinics that provide low-acuity, low-complexity care disconnected from existing physician-patient relationships
Each term consisted of 3 words, with the first being Canada, the second relating to virtual care, and the final relating to the physician or clinic

Summary

Introduction

Canada has lagged behind other countries in its uptake of virtual care as an integrated component of the health care system [1,2,3]. The onset of the COVID-19 pandemic in Canada dramatically increased virtual care owing to the need for physical distancing to prevent disease transmission This shift was supported by new or temporary billing codes and updated provincial mandates for providing virtual care where possible; in areas where provincial insurance plans, physician funding models, and limits on billable virtual visits had previously hindered physician uptake of virtual care, telephone or video consultations have been adopted [5]. In addition to community-based physicians adapting their brick-and-mortar practices to include virtual care provision, the new fee codes for virtual visits provide an opportunity for the development of on-demand, “walk-in” virtual clinics that provide low-acuity, low-complexity care disconnected from existing physician-patient relationships Some of these services are funded through provincial health insurance plans while others charge patients or are funded by supplemental private insurance plans directly. More research is needed to support quality virtual care and understand its effects on patient and provider experiences and the overall health system utilization and costs

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