Virtual care

Virtual care

The way health care is delivered in Nova Scotia is evolving. Virtual care has the potential to increase access to health care for all Nova Scotians. 

This includes synchronous virtual care tools, from telephone to electronic medical record-integrated solutions, as well as the fee codes being used to provide safe and effective health care to Nova Scotians.


Virtual Care Policy in Nova Scotia

The Nova Scotia Department of Health and wellness has developed the ‘provision of Publicly Funded Virtual Health Services” Policy.  The policy is to ensure that publicly funded health care services that are delivered virtually are delivered in ways that are safe, of high quality, and compliment in patient care. The policy outlines roles and responsibilities, standards of care and policy guidelines. In Appendix 1 the policy also lists the virtual care tools that have undergone oversight privacy and oversight security assessments for use in Nova Scotia.

The Provision of Publicly Funded virtual Health services can be found here.

Virtual care fee codes

Most physicians can bill for all non-procedural services that are delivered virtually. You can bill what you normally would for an in-person visit, regardless of whether the care you deliver is done in-person or via the telephone, telehealth or any virtual care tool listed above. Simply include the following text on your claim to denote the mode of synchronous care delivery:

  • If service was provided via phone call, use “Pandemic telephone”
  • If service was provided over the telehealth network, use “Pandemic telehealth”
  • If service was provided over a virtual care platform, use “Pandemic virtual care”

The fee codes for opioid agonist therapy, psychotherapy, consultations and counselling, geriatric and nursing home visits are all covered by virtual care. See March 4 MSI Physicians' Bulletin.

These codes have been extended to March 31, 2023. Effective March 4, 2022, physicians providing care in a walk-in setting will also be able to claim for virtual care.

Additional details can be found in the March 24 MSI Physicians’ Bulletin.

All premium fees are also applicable. This is not stated directly in the MSI Physicians’ Bulletin, but Doctors Nova Scotia has assurances from the Department of Health and Wellness that premiums do apply.

A new health service code (03.03X) is also available to facilitate the provision of synchronous clinical care using technology that supports non-face-to-face encounters, such as care delivered using the telephone, the hospital-based telehealth network, Zoom for Healthcare, and other PHIA-compliant virtual care tools. This code is paid at the same rate as ME=CARE modifier for comprehensive primary care fee codes.

For physicians for whom the 03.03x code is more remunerative than the applicable in-person fee code, you can bill the 03.03x consistent with the terms as outlined in the March 18, 2020 MSI Physicians’ Bulletin.

Virtual care compensation review

The four Atlantic Provincial and Territorial Medical Associations (PTMAs) retained Deloitte to develop recommendations for virtual care compensation models in the region. The report, called Virtual Care Physician Compensation Review was delivered to the PTMAs in March 2021 and discusses best practices for virtual visits, remote consults, secure patient messaging, remote patient monitoring and e-consults for each key virtual care modality.

The report includes jurisdictional insights from across Canada and internationally, an overview and assessment of applicable compensation models, evaluation of recommended models, issues and considerations, a series of recommendations and a summary of health system and patient benefits.

Click here to read Virtual Care Physician Compensation Review.

New report makes recommendations for Nova Scotia

In October 2021, Doctors Nova Scotia (DNS) and the Department of Health and Wellness (DHW) commissioned Deloitte to make recommendations on how physicians can expand the use of virtual care in Nova Scotia. The final report was completed in March 2022. It is one of many factors DHW will consider as it makes decisions on a permanent approach to compensating synchronous and asynchronous virtual care and provider-to-provider e-consults.

The project included an analysis of leading compensation practices for synchronous provider-to-patient visits. This will help determine whether evidence supports deviating from Nova Scotia’s current practice of payment parity between in-person and virtual visits. A key priority for this project was to engage physicians to understand their preferred compensation framework. Engagement methods included a physician survey, workshops with the DNS e-Health Committee and the Section Forum, a webinar and a case study discussion on the association’s Doctors Lounge.

Click here to read Advancing a Permanent Virtual Care Compensation Framework in Nova Scotia.

Virtual care playbook

The Canadian Medical Association, in collaboration with the Royal College of Physician and Surgeons of Canada and the College of Physician and Surgeons of Canada updated a Virtual Care Playbook in 2021 to help Canadian physicians introduce virtual patient encounters (aka telemedicine) into their daily practices.

While not exhaustive, the playbook covers all key considerations to succeed at providing safe, effective and efficient care:

  • Fitting virtual care into your practice workflow
  • Technology requirements
  • Scope of practice – what problems can be safely assessed and treated
  • “Webside” manner
  • The virtual visit from beginning to end

Click here to download Virtual Care Playbook

Virtual care solution options

Zoom for Healthcare (“Stand-Alone” - i.e. not integrated with the two provincial EMRs) 

The Nova Scotia government has secured an agreement with Zoom, a company specializing in videoconferencing, to license any physician in Nova Scotia (as well as a member of their staff) to use Zoom for Healthcare at no charge. This initiative has been extended to March 2023.

Zoom for Healthcare: 

  • Delivers consistent, reliable, clinical experiences through reliable videoconferencing services
  • Provides high quality video and audio
  • Uses resources and hardware that physicians most likely already have in their practices
  • Uses straightforward user management processes
  • Meets Nova Scotia privacy and security standards 

There are limited licenses available. Click here to register for Zoom for Healthcare.

EMR-Integrated Virtual Care Solutions for Telus Med Access

Telus Virtual visits is a add on solution that providers physicians using Telus Medaccess the ability  to engage in virtual care. It allows for video visits, patients file sharing, and save notes and information to a patients chart without changing platforms.   There is also a patient portal called Pomelo.

For more information, visit https://www.telus.com/en/health/ . For product information, pricing and availability information, contact

Shawn Bellefleur, Atlantic Regional Manager, Business Enablement by Cell at 506-866-7591

EMR-Integrated Virtual Care Solutions for QHR Accuro

Accuro Engage is a add on that gives providers using the Accuro EMR the ability to integrate Video Visits, secure Patient Messaging, Online Booking, and Appointment Notifications into their existing EMR. There is also a free patient portal called Medeo for patients to be able to access services.

For more information, visit Accuro Engage - Accuro EMR. For product information, pricing and availability information, contact David.Krish@QHRtech.com.

Contact

Brent Andrews
E-health advisor
902-225-8577 (cell)
Jyllian Cress
E-health policy advisor
902-481-4905
1-800-563-3427 ext. 4905