Virtual care in ontario community health centres: A Cross-Sectional study to understand changes in care delivery

Background Virtual delivery of primary care has seen a massive adoption as a result of the COVID-19 pandemic.

Aim In this descriptive study, we use an equity lens to explore the impact of transitioning to greater use of virtual care in community health centres (CHCs) across Ontario, Canada.

Design & setting We administered a cross-sectional survey and extracted electronic medical record (EMR) data from thirty-six CHCs.

Method The survey captured CHC’s experience with the increased adoption of virtual care. A longitudinal analysis of the EMR data was conducted to evaluate changes in health service delivery. EMR data was extracted monthly for a period of time prior to the pandemic (April 2019 - February 2020) and during (April 2020 – February 2021).

Results In comparison to the pre-pandemic period, CHCs experienced a moderate decline in visits made (11%), patients seen (9%), issues addressed (9%), and services provided (15%). During the pandemic period, an average of 54% of visits were conducted virtually with phone as the leading virtual modality (96%). Drops in service types ranged from 82% to 28%. The distribution of virtual modalities varied according to the provider type. Access to in-person and virtual care did not vary across patient characteristics.

Conclusion Our results demonstrate a large shift towards virtual delivery while maintaining in-person care. We found no meaningful differences in virtual versus in-person care related to patient characteristics or rurality of centres. Future studies are needed to explore how to best select the appropriate modality for patients and service types.