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Examining experiences and system impacts of publicly funded episodic virtual care

Funded by:



Health systems are under pressure as one in five Canadians has no regular place for primary care and people face substantial travel time and delays accessing care. Virtual platforms have responded to urgent needs offering virtual services that mirror “walk-in” style clinics, in that they offer immediate access, but more limited longitudinal continuity or coordination. We refer to these services as episodic virtual care (EVC), to distinguish them from virtual services offered in longitudinal primary care. Nova Scotia (NS) and New Brunswick (NB) offer a unique opportunity to study the deployment of publicly-funded EVC. In NS, patients on the Need a Family Practice Registry can access care via Virtual Care Nova Scotia (VCNS). In NB, all residents eligible for provincial health insurance can access eVisitNB, including people who have a regular place of care. Differences in how these services have been deployed, staffed (nurse practitioners and family physicians), and connected to other parts of the health system make these highly informative policy examples.

This project explores: 1) patient perceptions and experiences, and how these may differ depending on the type of care needed, age, gender, residence (urban or rural), immigration, and language preference; and 2) clinicians' experiences, including how this may differ depending on the type of care needed, type of clinician (nurse practitioner or family physician), gender, remuneration model, and years of experience. Also, the project uses linked administrative data and quasi-experimental difference-in-differences analysis to assess impacts on visits to community-based primary care (including in-person walk-in clinics), emergency department visits, and referrals for other health services like prescriptions, imaging, and other specialist physicians.



The overarching goal of this work is to learn from the implementation of EVC in Nova Scotia and New Brunswick and understand experiences and system impacts, including:

  1. What are patient perceptions and experiences of EVC and how do these differ by patient characteristics?

  2. What are clinician experiences of EVC and how do these differ by patient and clinician characteristics?

  3. What are the characteristics of patients who use EVC and of clinicians who deliver it?

  4. What are the system impacts of EVC?

Findings will be important to identifying impacts and trade-offs in the deployment of EVC, and to plan effectively for primary care capacity. This study will provide helpful information to decision makers across multiple jurisdictions as they contend with the challenge of meeting patients’ immediate needs for access, while seeking to improve coordination and integration of systems as a whole.

Team Members

Nominated Principal Investigator: Ruth Lavergne

Co-Principal Investigators: Agnes Grudniewicz, Julie Easley, Ted McDonald

Co-Investigators and Collaborators: Lindsay Hedden, Nichole Austin, Tara Kiran, lauren Lapointe-Shaw, Emilie Marshall, Ruth Martin- Misener.  

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