In response to OHIP changes, one online pediatric health platform reduced its virtual care offerings substantially.Khalil Hamra/The Associated Press
One online pediatric health care platform is severely cutting back its virtual services and another has started charging its users a monthly subscription fee, after the Ontario government began limiting public health insurance payments to doctors for virtual care.
Ontario’s payouts changed on Dec. 1, reducing the amount doctors can bill the government for one-off video consultations to $20, and $15 for one-off telephone consultations. The move is meant to encourage face-to-face interaction. The government and medical experts had become concerned that doctors were leaning too heavily on virtual care in a way that was negatively impacting patients.
Pediatric Telemedicine, a 25-year-old company that offers phone and video consultations, said it is now providing those services on a dramatically reduced schedule, currently two days a week, because of the change. In an e-mailed statement, the company said it was exploring ways of returning to a more frequent schedule. It had previously said it was considering closing altogether.
KixCare, an online pediatric care platform that started operating during the pandemic, has introduced a $29 monthly subscription fee to make up for the reduced payments from the government.
“The option was either closing completely or engaging our active community of families who turned to us when they needed us,” said Daniel Warner, KixCare’s chief executive and co-founder.
Mr. Warner said the change comes at a difficult time. Pediatric emergency departments have been facing a surge of respiratory syncytial virus (RSV) and flu infections in recent months.
Without easy access to doctors on virtual health care platforms, Mr. Warner said, parents end up having no choice but to go to emergency departments to seek care, especially on weekends and late nights.
“It’s certainly concerning to all of us that this defunding came now in the middle of a crisis,” he said.
Mr. Warner added that KixCare’s services resolve patients’ issues in 90 per cent of cases, which he said had significantly alleviated strain on hospitals.
Anna Miller, a spokesperson for Ontario’s Ministry of Health, said in a statement that the provincial government had decided to reduce funding for virtual care in agreement with the Ontario Medical Association.
“Throughout this process, the ministry has taken a patient first approach to ensure that Ontarians will continue to have access to the care they need, when they need it,” she said. “Virtual care is intended to complement in-person care, not replace it.”
Michael Green, a professor at Queen’s University who specializes in family medicine and public health policy, said that while virtual care walk-in options are important, clinics that only provide virtual care have been linked to increased rates of emergency department visits. He said such clinics are likely not aligned with the College of Physicians and Surgeons of Ontario’s guidelines.
He noted that virtual clinics don’t always follow up on things such as lab work, the way a family doctor might. And he said the new funding agreement recognizes the difference, and funds family doctors adequately for virtual care.
Yael Bennaroch, a mother of six, said online platforms such as KixCare were vital when her family needed support after-hours for issues such as her son’s recent ear infection.
She said she finds it frustrating that KixCare now has to charge a monthly subscription fee for a type of health care she believes should be free to users.
“I like going to my pediatrician. I still prefer the in-person meeting for sure, but the KixCare service was invaluable for weeknights and weekends, for things that didn’t need the ER but needed to be addressed soon,” she said.
“We have a public health care system, so I would think that any kind of access that would be needed should be a ‘free’ service, and I say free in quotations because we pay for it with high taxes.”
Douglas Angus, a professor emeritus at the University of Ottawa who studies health policy, agreed that virtual care services are an effective way of reducing the amount of people in hospitals. He said the significant lowering of premiums for online services will prevent them from being an option for some people.
“If I were an average person, I’d be looking at this and thinking the government isn’t concerned about me getting access to health care, they’re more concerned with restricting payments to keep their budgets intact,” he said. Countries in Europe and Australia make better use of technology to provide care, he added.
Mr. Angus said fees for online medical services are further eroding universal health care in Canada. He noted that some clinics have been charging for specialized care for decades and haven’t received enough pushback from governments.
“It puts patients in a bind,” he said. “For those people who may be able to afford those extra fees, it’s okay. But for a lot of people, the way that expenditures have risen with inflation, this puts access to necessary health services in jeopardy.”