Nova Scotia Virtual Care program expanding this Sunday

Concerns people are paying for virtual care in NS There are concerns people are using their credit cards instead of their health cards to access virtual care in N.S. Sarah Plowman reports.

Family doctors and nurse practitioners will be providing virtual care to Nova Scotians on the Need a Family Practice Registry on a trial basis this Sunday as demand outpaces supply.

The move expands a service that has, until now, only been offered between Monday and Friday.

“At times, the wait to see a provider online may take up to three hours,” a Nova Scotia Health news release said.

The release says that if patients see a message that Virtual Care NS is "at capacity," they should try again later.

With hospitals strained, walk-ins stretched and more than 125,000 people without a doctor or nurse practitioner, more Nova Scotians are turning to virtual care.

Since August, Nova Scotia Health has partnered with Maple to cover appointments for anyone on the Need a Family Practice Registry – a wait list for patients without a doctor or nurse practitioner. The doctors and nurse practitioners helping patients online are drawn from the same pool as those helping patients in-person.

However, many Nova Scotians have chosen to turn to and pay for other providers because patients are either struggling to access Virtual Care NS due to long wait times, or they’re not eligible for the free service because they have a doctor, but also can’t wait for an appointment weeks away.

“When we talk about privatization, this isn’t an abstract conversation. If someone needs to see a doctor, they need to see a doctor. And if they have $20, they’re going to pay,” said Claudia Chender, Nova Scotia’s NDP leader.

Amy Lemoine has found herself using her credit card instead of her health card to pay for care lately.

Lemoine, a home daycare operator, has a family doctor but couldn’t wait for an appointment. She also couldn’t afford to go to a walk-in clinic and shut her daycare down.

Instead, she’s paid for Maple a few times.

“So, that one is free for people who do not have a family doctor but where I do have one, it’s $70,” said Lemoine.

Lemoine said she’s also discovered another platform called Your Doctors Online -- a group that’s based in Mississauga, Ont., but on its website said it connects patients with doctors in a variety of places, including Nova Scotia.

Lemoine said Your Doctors Online was free when she used it before but when she needed it this week, it cost her.

“I’m just going to pay the $20, otherwise I’m just going to be sitting in the ER all night probably,” she said.

Your Doctors Online’s website said due to the ministry no longer supporting virtual care, MSI will no longer be accepted. CTV News reached out to the platform but did not hear back.

According to Nova Scotia's Department of Health and Wellness, virtual care services that are not publicly funded are excluded under the reciprocal billing agreement.

“In situations where we discover that a company or provider has or is trying to bill reciprocally for a virtual care service, we reach out to educate them about our policy in Nova Scotia,” said Tony Kiritsis, a communications advisor with the Department of Health and Wellness.

As Nova Scotia Health looks to recruit more practitioners, extend hours and improve Virtual Care NS, the president of Doctors Nova Scotia points out that other provinces rely on out-of-province providers.

“For example, in New Brunswick they recruited physicians and nurse practitioners out-of-province. Nova Scotia, through Virtual Care NS is only using Nova Scotia physicians,” said Dr. Leisha Hawker, the president of Doctors Nova Scotia.

Hawker sees pros and cons to expanding the pool outside of Nova Scotia.

“The downside to having physicians that aren’t local is they don’t know the local resources and pathways in care. But the upside to expanding your pool of physicians is you would have more physicians working,” Hawker said.

Nova Scotia’s Department of Health and Wellness said its current policy requires physicians or other providers who provide virtual care to be licensed, credentialed and based in Nova Scotia.

“Providers must either be able to see patients in-person or refer them to a clinic in situations when a proper assessment cannot be done online or by phone,” said Kiritsis. “Diagnostic imaging, lab tests and results can only be ordered and received by a physician who is licensed and has credentials in Nova Scotia.”

Hawker also questions if Virtual Care NS should offer pre-planned appointments as well, rather than only offering same-day appointments.

Brendan EIliott, a spokesperson for Nova Scotia Health, said they continue to look at appointments as an option but their evaluation has shown the program is more efficient and effective when working on a non-scheduled basis.

“We continue to evaluate the benefits and drawbacks of scheduled appointments and will keep that option open if the data supports an adjustment,” Elliott said.