JMIR Publications

ABSTRACT

Background:

Canada has been slow to implement virtual care relative to other countries. In recent years, however, the availability of on-demand, “walk-in” style virtual clinics has increased, with the COVID-19 pandemic contributing to both increased demand and provision of virtual care nationwide. Such care facilitates access to physicians while maintaining physical distancing, yet there are concerns regarding continuity and quality of care as well as equitable access. There is a paucity of research documenting the availability of virtual care in Canada, hampering efforts to evaluate the impacts of its relatively rapid emergence on the broader healthcare system and on individual health.

Objective:

We conducted a national environmental scan to determine the availability and scope of virtual “walk-in” clinics, cataloguing the services they offer and whether they are operating through public or private payment.

Methods:

We developed a power term and implemented a structured google search to identify relevant clinics. From each clinic meeting our inclusion criteria, we abstracted data on remuneration model, region of operation, services offered, and continuity of care. We compared clinics operating under different remuneration models using Fischer’s Exact Tests. Complementary analysis of Google trends examines changes in public demand.

Results:

We identified 18 virtual walk-in clinics. Most provide some services under provincial public insurance, though 8 (44%) operate on a fully private-pay model while an additional 7 (39%) charge patients out of pocket for some services. The most common supplemental services offered included dermatology (83%), mental health services (78%), and sexual health (61%). Four clinics (22.2%) mentioned continuity, information sharing, or communication with consumer’s existing primary care provider.

Conclusions:

Virtual walk-in clinics have proliferated, along with interest in virtual care. However, concerns about equity in access, continuity of care, and diversion of physician workforce within these models call attention to the importance of supporting virtual options within the context of longitudinal primary care. More research is needed to support quality virtual care and to understand its effects on patient and provider experiences and overall health system utilization and costs.