Virtual Care Expansion During COVID-19 Did Not Improve Access to Specialists in Rural Canada

Despite significant efforts to expand virtual healthcare services across Ontario amid the COVID-19 pandemic, new research indicates that this did not lead to increased access to specialist physicians for residents in rural regions. Published in the Canadian Medical Association Journal, the study explores whether the widespread adoption of virtual care, supported by new billing codes and technological infrastructure, effectively bridged the gap in specialty healthcare for remote populations.

The research team, led by Dr. Natasha Saunders of The Hospital for Sick Children, analyzed data comparing the driving distances and travel times between patients and specialists during two periods: before the virtual care expansion (January to November 2019) and during the virtual care phase (January to November 2022). The study encompassed over 11,000 specialists and more than 5.3 million patient visits, totaling more than 25 million encounters.

Findings revealed that, apart from minor variations noted in psychiatry, there were no significant reductions in the physical distance between patients and their specialists. This suggests that, although virtual care became more accessible, it did not substantially alter the geographic distribution of specialized services.

Authors suggest that several barriers remain in increasing rural access, such as referral practices that tend to stay within provider networks, limiting patient reach to distant specialists. They highlight the potential role of centralized referral systems that could strategically match rural patients with appropriate specialists. Moreover, considering patient preferences and barriers like transportation and time constraints could enhance the utilization of virtual care modalities.

Ultimately, the study underscores the importance of addressing systemic referral patterns and individual patient needs to leverage virtual care effectively for rural populations. As virtual healthcare continues to evolve, targeted strategies may be necessary to truly expand specialist access beyond urban centers.

For more details, see the full study at CMAJ or visit source.