O3198: Virtual Urgent Care - Lessons Learned for Patients, Providers and Administrators

Background: Virtual care usage has exploded since the pandemic. Our hospital went live with a digital front door virtual urgent care platform staffed by paediatric emergency medicine specialists in April 2021. Using an initial symptom checker, patients were referred to one of three outcomes – direct to the emergency department (ED) for in-person care, back to their primary care provider, or to be seen virtually by our clinicians in a virtual video visit. In this abstract, we will present data from patient and provider surveys, gauge satisfaction and discuss lessons learned and next steps for other virtual urgent care platforms.

Methods: After working with a third party vendor, we customized our symptom checker to assure appropriateness of virtual visits, ED and primary care referrals. Patients in our catchment area who qualified for virtual visits would then be placed in a queue and seen in a first-come-first serve manner by our virtual physician. Families have access to the symptom checker at all hours of the day year round, and have access to virtual visits year round from 10 AM until 10 PM. Feedback from families is elicited at the end of each visit, with basic patient related outcome measures recorded. Providers were surveyed for their perspective on the system in September 2022.

Results: Since launching in April 2021, over 30,000 unique families have accessed the symptom checker, and over 6200 families have completed a virtual visit. Of those accessing the symptom checker, 36% of patients were referred to the ED, 25% were referred to their primary care provider and 24% received a virtual visit. The most common chief complaints were fever (24%), Cough/Cold (10%) and vomiting/diarrhea (6%). Most encounters occurred between 6 and 8 PM. Two-thirds of users reached out to their primary care provider before accessing our service. Overall, 64% of patients would have gone to the ED in person if the offering was not available and 90% of patients felt at ease after using the on-demand service. Providers were generally satisfied with the service, but questioned whether or not PEM specialists were most suited to providing it. Ongoing requests to refine what complaints were eligible for virtual visits are also described.

Conclusion: Virtual care in the pediatric emergency department is in its infancy but is growing and innovating at a significant speed. As virtual offerings become standard, guiding principles will help build the most robust and appropriate care model required for each community. The principle of “the right patient to be seen at the right time by the right provider and using the right technology” communicates the idea of maintaining close links with patient populations, advocating to build systems and remove barriers and connect with community health providers.