Woman questions bolstered primary-care options after eVisitNB hitch

When the province rolled out expanded primary-care options for New Brunswickers last month, Clara Thaysen thought her struggle to get medical care for non-emergencies would be resolved.

The announcement by Health Minister Dorothy Shephard on Jan. 26 included expandedTele-Care 811 non-emergency capacity and Medicare funding for eVisitNB, which uses an online chat platform to connect people with a doctor or nurse practitioner within 30 minutes.

The expanded options are intended to help keep people out of hospital emergency rooms as the Omicron COVID-19 variant drives hospitalizations to record numbers.

But Thaysen said she hita barrier when trying to use the eVisitNB service recently.

The Fredericton resident said shehas a chronic health issue that had flared up at the end of January, to the point where she couldn't work.

She said she wanted to speak to a doctor to see what her next steps could be, but when she signed in to the eVisitNB app, she got a message saying only urgent cases were being seen due to a "high demand" for visits.

"I understood it that this was for, you know, non-urgent cases. But that message implied thatit was only for urgent cases," she said.

"So really, people without primary-care physicians are kind of right back where we started."

'Not a regular occurrence,' eVisitNB co-founder says

The eVisitNB app has up to 600 appointments per day, according to the province.

Service co-founder Dr. Hanif Chatur said the platform is accessible to all New Brunswickers on a first-come, first-served basis, but the province has directed eVisitNB to prioritize patients referred from 811 or hospital emergency rooms, and New Brunswickers with urgent medical and mental health issues.

This means that on some days, too many people could be trying to access care at the same time, or that capacity could be limited. What Thaysen saw doesn't happen often, Chatur said.

"This is the exception to the rule and not a regular occurrence."

Thaysenargues that if cases are being triaged this way, then it's not a primary-care service.

"When I received that message, that didn't sound like a first-come, first-served situation, that sounded like a triage situation," she said.

"To me, that sounds like this is just an online emergency room then, right? Because you don't normally triage cases at a family doctor."

Chatur said since Medicare funding rolled out, there has been an increase in usage.

"The utilization of the platform has increased daily as New Brunswickers become more aware of their options."

When asked for utilization and usage numbers, Chatur said the figures are being submitted to the province and will then be shared with the public.

If users encounter the same situation Thaysen did, they can resubmit their application for care within the same day, Chatur said.

"We are also working closely with all stakeholders to ensure that patients who require laboratory investigations, specialist referrals, and in-person assessments can seamlessly access these services," he said.

Options don't replace in-person care

As part of the recent changes, 811 nurses can refer patients to a primary-care provider within a short period of time.

Previously, they were able to provide health advice, information and referrals to the appropriate service provider. Now, they're connected to a primary-care team in each region, Health Department spokesperson Bruce MacFarlane said.

"The primary-care team will coordinate a virtual appointment and, if required, will coordinate an in-person visit," he said. "The service is supported by providers in community health centres, family physicianoffices and after-hours clinics."

Thaysen said that for her, Tele-Care and online doctor visits are better than nothing, but they can't replace the relationship developed with a primary-care provider andthe availability of regular preventative care.

She said she's still on the primary-care list, but isn't hopeful she'll be matched with a provider in the near future.

Health Minister Dorothy Shephardhas previously said the province is continuing to recruit doctors and nurse practitioners, and reducing the wait list is still a goal.