• Shelley L McLeod, Shawn Mondoux, Justin N Hall, Katie Dainty, Joy McCarron, Jean-Eric Tarride, Lency Abraham, Sandy Tse, Rodrick Lim, Megan Fitzgibbon, Renee-Anne Montpellier, Leon Rivlin, Carla Rodriguez, Lisa Beck, Lianne McLean, Daniel Rosenfield, Shaun Mehta, Michelle Welsford, Cameron Thompson, and Howard Ovens.
• Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, ON, Canada. shelley.mcleod@sinaihealth.ca.
• CJEM. 2023 Jan 1; 25 (1): 657365-73.

IntroductionAs part of the COVID-19 pandemic response, the Ontario Ministry of Health funded a virtual care pilot program intended to support emergency department (ED) diversion of patients with low acuity complaints and reduce the need for face-to-face contact. The objective was to describe the demographic characteristics, outcomes and experience of patients using the provincial pilot program.MethodsThis was a prospective cohort study of patients using virtual care services provided by 14 ED-led pilot sites from December 2020 to September 2021. Patients who completed a virtual visit were invited by email to complete a standardized, 25-item online survey, which included questions related to satisfaction and patient-reported outcome measures.ResultsThere were 22,278 virtual visits. When patients were asked why they contacted virtual urgent care, of the 82.7% patients who had a primary care provider, 31.0% said they could not make a timely appointment with their family physician. Rash, fever, abdominal pain, and COVID-19 vaccine queries represented 30% of the presenting complaints. Of 19,613 patients with a known disposition, 12,910 (65.8%) were discharged home and 3,179 (16.2%) were referred to the ED. Of the 2,177 survey responses, 94% rated their overall experience as 8/10 or greater. More than 80% said they had answers to all the questions they had related to their health concern, believed they were able to manage the issue, had a plan they could follow, and knew what to do if the issue got worse or came back.ConclusionsMany presenting complaints were low acuity, and most patients had a primary care provider, but timely access was not available. Future work should focus on health equity to ensure virtual care is accessible to underserved populations. We question if virtual urgent care can be safely and more economically provided by non-emergency physicians.© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

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