VIRTUAL HEALTH CARE VISITS CODE

Some early studies examined virtual care during the first months of the pandemic, including one from the US by Ferguson et al. Īs a result of the pandemic, the adoption of virtual care for health services was both accelerated and widespread. In late March of 2020, the province of Manitoba introduced virtual care tariffs, with retroactive implementation to March 14, 2020, for use during the pandemic to reduce in-person clinical visits and support virtual care visits. In an attempt to facilitate safe access to health care for patients, while also curbing viral transmission associated with in-person clinical care, many primary care services quickly implemented virtual care. The COVID-19 pandemic has resulted in abrupt disruptions to conventional (in-person) clinical care and highlighted the need for other models of care such as virtual care to meet patient needs. Within primary care, there was very limited integration of virtual care in clinical practice, and it was considered more of a complement to existing modes of care. Prior to the COVID-19 pandemic, only three Canadian provinces – British Columbia, Alberta and Ontario – offered reimbursement for select virtual care services. Alternate funded (salaried) physicians and nurse practitioners are also required to submit tariff and ICD-9 codes in an identical manner for administrative purposes although they are not directly tied to payment.

VIRTUAL HEALTH CARE VISITS CODE

In Manitoba, primary care providers submit tariff (procedure) codes and a single International Classification of Disease, ninth revision, clinical modification (ICD-9) code following each patient visit to the provincial health insurance system for remuneration. In Canada, the delivery of universal health care is a provincial/territorial responsibility and primary care is delivered through independently operated community-based clinics that typically represent the first point of contact with the health system. A 2018 survey for the Canadian Medical Association reported that less than 8% of health care delivery in Canada was delivered virtually and only 4% of primary care physicians offered virtual care services. Virtual care has been used in Canada for delivery of primary care since the 1970s, although utilization was relatively low. Virtual care is defined as any interaction between patients and members of their circle of care, occurring remotely, using any form of communication or information technologies, to facilitate or maximize patient care. Ongoing provision of virtual care can enhance quality, patient-centered care moving forward.

Virtual care as a primary care visit type continues to evolve. Virtual care was utilized by patients with more comorbidities and prescriptions, suggesting that patients with chronic disease requiring ongoing care utilized virtual care. ConclusionĮarly in the pandemic restrictions, approximately one-third of visits were virtual. There was no significant difference between the number of follow-up visits that were provided as a clinic visit compared to a virtual care visit (8.7% vs. Female patients (OR 1.16, CI 1.09–1.22), patients with ≥ 3 comorbidities (OR 1.71, CI 1.44–2.02), and patients with ≥ 10 prescriptions (OR 2.71, 2.2–1.53) had higher odds of receiving at least one virtual care visit compared to male patients, patients with no comorbidities and patients with no prescriptions. There were 146,372 visits provided by 154 primary care providers between 03/14/20 and 06/30/20, of which 33.6% were virtual care. Generalized estimating equation models describe factors associated with virtual care. Patient (sex, age, comorbidities, visit frequency, prescriptions) and provider (sex, age, clinic location, provider type, remuneration, country of graduation, return visit rate) characteristics describe the study population by visit type. Between 03/14/20, and 06/30/20, we assessed each visit for a follow-up visit between the same patient and provider for the same diagnosis code. Tariff codes from billing records determined the visit type (clinic visit, virtual care). Retrospective cohort study of primary care providers in Manitoba, Canada that participate in the Manitoba Primary Care Research Network (MaPCReN) and offered ≥ 1 virtual care visit between 03/14/20 and 06/30/20 representing 142,616 patients. This study examined the nature of virtual visits, characterizing the use and users of virtual care in primary care settings from March 14/20 to June 30/20 of the COVID-19 pandemic. To retain continuity of care the delivery of primary care services shifted to virtual care. In March 2020, Canada implemented restrictions to curb viral transmission of COVID-19, which resulted in abrupt disruptions to conventional (in-person) clinical care.

Virtual health care visits