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Billed as remedy for doctor shortage, virtual medicine in N.S. hits bottleneck

Published

2 years ago

December 7, 2022

Early in the COVID-19 pandemic, virtual medicine offered a novel way for patients to see doctors during a lockdown and hope that technology could alleviate chronic pressure on a strained health system.

For many in Nova Scotia, though, the early promise has proven illusory.

Tim Neufeld, 28, from Dartmouth, N.S., has been on Nova Scotia’s wait-list for a family doctor for five years. He said in a recent interview that he was left frustrated after several unsuccessful attempts at securing a virtual appointment.

“The biggest hurdle is just accessing the system, having to log on between 8:59 a.m. and 9:09 a.m.,” he said, noting that when he tried to sign up for virtual care after 9:10 a.m., all the day’s appointments were already booked.

“Obviously the demand far exceeds the supply, so there’s some pain around that and whether or not you’re able to even get the care you need.”

Sara Wallace, 48, from Dartmouth, compared the experience to “trying to buy concert tickets.” She said she tried unsuccessfully to schedule a medical appointment four times over two weeks before finally succeeding.

Nova Scotia launched its virtual health platform in May 2021, and it now has 67 health professionals — physicians and nurse practitioners — who provide virtual consultations on top of existing general practice commitments.

Brendan Elliot, a spokesman for Nova Scotia Health, said in an email that there are between 150 and 200 virtual visits available on a typical weekday, available to the 120,400 people in the province without a family doctor.

Elliot acknowledged that demand is high and said the province is trying to recruit more doctors and nurses to take part.

Zen Therani, founder and CEO of Vancouver-based digital consulting firm Xenex Consulting Inc., said in an interview that challenges are expected in the early stage of virtual care implementation, but a bottleneck at the booking stage is a problem.

“It really defeats the purpose” of virtual care, which should be increasing access to medical care and improving the patient experience, he said.

Therani, who has worked in digital health for 22 years, said a process like Nova Scotia’s that requires logging in quickly during a short time frame is likely going to be a barrier to those who have poor internet connection or are less comfortable using digital tools.

“We don’t want people to feel left behind,” he said.

Because provinces are implementing different methods of virtual care, access looks a bit different in New Brunswick, where virtual appointments are funded for everyone — not just those without a family doctor.

Kelly Stokes of Saint John N.B. uses virtual health care for herself and her young daughter through the province’s eVisitNB application.

The 27-year-old said in an interview the experience was “hit or miss” when she first tried it a year ago — but she said it has improved as some referrals were outsourced to nurse practitioners and doctors in other provinces. She said a nurse practitioner based out of Ontario provided care for her daughter last month.

New Brunswick’s eVisitNB, which is operated by virtual health company Maple, is staffed mostly by nurse practitioners and a few physicians who may be working remotely from other parts of the country.

Like Nova Scotia, Prince Edward Island reserves provincially funded virtual appointments for residents without a family doctor or primary care provider. In Nova Scotia that represents about 12 per cent of the population, and in P.E.I. it’s more than 15 per cent.

In Newfoundland and Labrador, where the medical association reported in June that about 24 per cent of residents were without primary care, virtual appointments are covered for everyone. The appointments are provided by Springdale, N.L.-based telemedicine company Medicuro, which employs 16 local physicians.

Last month, the medical director of a Medicuro virtual clinic called on the province to raise the cap on the number of daily appointments funded by the province. Dr. Todd Young said in a statement that the province’s limit of 40 virtual appointments a day is far too low given the number of residents without a family doctor and the circulation of influenza, COVID-19 and respiratory syncytial virus.

“The time is now to remove any restrictions to available reliable and professional health care,” Young said. The province’s health department has not said if it is considering funding more appointments.

Therani said it’s very positive to see that provinces are using virtual care to fill in some of the gaps caused by a shortage of primary care providers, and agrees that limits should be removed from virtual care whenever possible.

“Why would you want to put limitations on innovation and accessibility in that way?” he asked.

Therani said that while virtual care does not work for everything, there’s potential to use it strategically to increase efficiency in pre- and post-operative care, emergency medicine and mental health care.

Part of the challenge, Therani said, is that advances in telehealth have happened in a rush as the pandemic dramatically increased the need for virtual medical care.

“It’s difficult because a lot of this is happening in panic, it’s reactive,” he said, adding that there is a need to step back and look critically at the system.

Neufeld and Wallace both said that once their appointments were booked, they enjoyed the experience of using virtual care.

Wallace, who lost her longtime family doctor when he closed the practice in June, said that the virtual appointment she secured on her fifth attempt led to an in-person followup six weeks later.

She said that appointment, in a Halifax clinic reserved for virtual patients, was “the most thorough medical appointment of my adult life.”

It was a complete change from the “packed and overcrowded walk-ins” in the Halifax area she’s had to visit since losing her doctor.

“I think there’s real potential here for this to positively change the way things are done,” Wallace said.

This report by The Canadian Press was first published Dec. 7, 2022.

News

Langford, Heim lead Rangers to wild 13-8 win over Blue Jays

Published

5 hours ago

September 17, 2024

Anne Joseph

ARLINGTON, Texas (AP) — Rookie Wyatt Langford homered, doubled twice and became the first Texas player this season to reach base five times, struggling Jonah Heim delivered a two-run single to break a sixth-inning tie and the Rangers beat the Toronto Blue Jays 13-8 on Tuesday night.

Leody Taveras also had a homer among his three hits for the Rangers.

Langford, who also walked twice, has 12 homers and 25 doubles this season. He is hitting .345 in September.

“I think it’s really important to finish on a strong note,” Langford said. “I’m just going to keep trying to do that.”

Heim was 1-for-34 in September before he lined a single to right field off Tommy Nance (0-2) to score Adolis García and Nathaniel Lowe, giving Texas a 9-7 lead. Heim went to the plate hitting .212 with 53 RBIs after being voted an All-Star starter last season with a career-best 95 RBIs. He added a double in the eighth ahead of Taveras’ homer during a three-run inning.

Texas had 13 hits and left 13 men on. It was the Rangers’ highest-scoring game since a 15-8 win at Oakland on May 7.

Matt Festa (5-1) pitched 1 1/3 scoreless innings to earn the win, giving him a 5-0 record in 13 appearances with the Rangers after being granted free agency by the New York Mets on July 7.

Nathan Eovaldi, a star of Texas’ 2023 run to the franchise’s first World Series championship, had his worst start of the year in what could have been his final home start with the Rangers. Eovaldi, who will be a free agent next season, allowed 11 hits (the most of his two seasons with Texas) and seven runs (tied for the most).

“I felt like early in the game they just had a few hits that found the holes, a few first-pitch base hits,” said Eovaldi, who is vested for a $20 million player option with Texas for 2025. “I think at the end of the day I just need to do a better job of executing my pitches.”

Eovaldi took a 7-3 lead into the fifth inning after the Rangers scored five unearned runs in the fourth. The Jays then scored four runs to knock out Eovaldi after 4 2/3 innings.

Six of the seven runs scored against Toronto starter Chris Bassitt in 3 2/3 innings were unearned. Bassitt had a throwing error during Texas’ two-run third inning.

“We didn’t help ourselves defensively, taking care of the ball to secure some outs,” Blue Jays manager John Schneider said.

The Blue Jays’ Vladimir Guerrero Jr. had a double and two singles, his most hits in a game since having four on Sept. 3. Guerrero is hitting .384 since the All-Star break.

TRAINER’S ROOM

Blue Jays: SS Bo Bichette (calf) was activated and played for the first time since July 19, going 2 for 5 with an RBI. … OF Daulton Varsho (shoulder) was placed on the 10-day injured list and will have rotator cuff surgery … INF Will Wagner (knee inflammation) was placed on the 60-day list.

UP NEXT

Rangers: LHP Chad Bradford (5-3, 3.97 ERA) will pitch Wednesday night’s game on extended five days’ rest after allowing career highs in hits (nine), runs (eight) and home runs (three) in 3 2/3 innings losing at Arizona on Sept. 14.

Blue Jays: RHP Bowden Francis (8-4, 3.50) has had two no-hitters get away in the ninth inning this season, including in his previous start against the New York Mets on Sept. 11. Francis is the first major-leaguer to have that happen since Rangers Hall of Famer Nolan Ryan in 1989.

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Billie Jean King set to earn another honor with the Congressional Gold Medal

Published

6 hours ago

September 17, 2024

Anne Joseph

WASHINGTON (AP) — Billie Jean King will become the first individual female athlete to be awarded the Congressional Gold Medal.

Reps. Brian Fitzpatrick of Pennsylvania and Mikie Sherrill of New Jersey announced Tuesday that their bipartisan legislation had passed the House of Representatives and would be sent to President Joe Biden for his signature.

The bill to honor King, the tennis Hall of Famer and activist, had already passed unanimously in the Senate.

Sherrill, a Democrat, said in a statement that King’s “lifetime of advocacy and hard work changed the landscape for women and girls on the court, in the classroom, and the workplace.”

The bill was introduced last September on the 50th anniversary of King’s victory over Bobby Riggs in the “Battle of the Sexes,” still the most-watched tennis match of all-time. The medal, awarded by Congress for distinguished achievements and contributions to society, has previously been given to athletes including baseball players Jackie Robinson and Roberto Clemente, and golfers Jack Nicklaus, Byron Nelson and Arnold Palmer.

King had already been awarded the Presidential Medal of Freedom in 2009. Fitzpatrick, a Republican, says she has “broken barriers, led uncharted paths, and inspired countless people to stand proudly with courage and conviction in the fight for what is right.”

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Account tweaks for young Instagram users ‘minimum’ expected by B.C., David Eby says

Published

6 hours ago

September 17, 2024

Anne Joseph

SURREY, B.C. – Premier David Eby says new account control measures for young Instagram users introduced Tuesday by social media giant Meta are the “minimum” expected of tech companies to keep kids safe online.

The parent company of Instagram says users in Canada and elsewhere under 18 will have their accounts set to private by default starting Tuesday, restricting who can send messages, among other parental controls and settings.

Speaking at an unrelated event Tuesday, Eby says the province began talks with social media companies after threatening legislation that would put big tech companies on the hook for “significant potential damages” if they were found negligent in failing to keep kids safe from online predators.

Eby says the case of Carson Cleland, a 12-year-old from Prince George, B.C., who took his own life last year after being targeted by a predator on Snapchat, was “horrific and totally preventable.”

He says social media apps are “nothing special,” and should be held to the same child safety standards as anyone who operates a place that invites young people, whether it’s an amusement park, a playground or an online platform.

In a progress report released Tuesday about the province’s engagement with big tech companies including Google, Meta, TikTok, Spapchat and X, formerly known as Twitter, the provincial government says the companies are implementing changes, including a “trusted flagger” option to quickly remove intimate images.

— With files from The Associated Press

This report by The Canadian Press was first published Sept. 17, 2024

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