Horizon ‘exploring options’ to extend Teladoc contract

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Horizon Health Network is “exploring options” to extend its contract with Toronto-based Teladoc Health Canada, citing recent success with a virtual care pilot project despite a bumpy start.

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Earlier this year, Horizon pulled the plug on the project at the Sussex Health Centre – one of two rural hospitals selected for the initiative launched under the former Higgs Progressive Conservative government.

Horizon moved the virtual care technology over to Grand Manan Hospital, while maintaining the service at Charlotte County Hospital in St. Stephen, for the rest of the one-year pilot project, which was set to run until the end of October.

Horizon is now finalizing its “comprehensive evaluation” of the virtual emergency department (ED) pilot project, but so far, the initial results are promising, according to Greg Doiron, vice-president of clinical operations for Horizon Health Network.

“Over the past year, Teladoc has shown positive results in improving wait times for lower-acuity medical needs, the rate of patients leaving the ED without being seen and ED length of stay, with very high patient satisfaction results,” Doiron said in a statement.

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One hundred per cent of Grand Manan Hospital patients, for example, were assessed by a physician after-hours thanks to virtual coverage compared to 60 per cent when there wasn’t virtual coverage, according to Horizon Health Network.

Ninety-eight per cent of 134 Grand Manan patients who presented during Teladoc shifts between June and September “reported that they were fully treated by the virtual physician, with no in-person backup required,” Horizon noted.

Patient transfers were also about 32 per cent faster at Grand Manan Hospital during Teladoc shifts, Horizon added, while patient satisfaction averaged 9.7 out of 10 for the pilot project.

Grand Manan Mayor Bonnie Morse couldn’t speak highly enough of the difference the virtual care service is making for her residents.

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While the Grand Manan emergency department is open 24/7, Morse said it relies on just an on-call physician after hours. Oftentimes, she said, that physician, who has already worked all day, may not be called in to treat a patient presenting with a minor ailment.

But those minor ailments can now be treated with the help of Teladoc, which connects patients with a physician by video. That physician can diagnose and prescribe by performing assessments with the help of on-site nurses using electronic stethoscopes and handheld cameras.

“I think (virtual care) has provided an extra level of service without burning out the doctors who are on call covering the ER and outpatients for a week at a time,” Morse said.

“You’re not overtaxing them, but you’re also still getting that level of treatment.”

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Grand Manan has three doctors for its 2,600 residents, Morse said. These doctors work in family practice, staff the island’s ER and care for outpatients.

Grand Manan council recently authorized a letter to be sent on behalf of the island to Health Minister John Dornan to show support for the Teladoc project.

“My understanding is (Teladoc) was designed for remote communities in Newfoundland,” Morse said. “Certainly there are some similarities between Grand Manan and some of the remote places of Newfoundland as well, so it’s a system that I think has really done what it was designed to do on Grand Manan.

“We’ve had really good feedback on it.”

Virtual care an option for Stella Maris

Earlier this year, when Teladoc was pulled out of the Sussex hospital, Dornan told reporters that the technology hadn’t added “one minute” to the hospital’s ER hours.

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He explained that Teladoc Health Canada – the company contracted to provide the service – requires a local physician to be on call in case of major emergencies.

However, Dornan, who is also a doctor, hasn’t ruled out virtual care as an option for some rural hospitals in New Brunswick despite pushback from fellow doctors.

Earlier this year, the New Brunswick Medical Society came out strongly against the virtual care pilot project, arguing it was a waste of government money and has lured some doctors already working in New Brunswick away to Teladoc.

The medical society, which represents the province’s doctors, went so far as taking Horizon to court in an attempt to get an unredacted copy of the contract signed with Teladoc. That court action was discontinued last month.

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According to documents in that court case, the Higgs cabinet approved $865,595 in the 2024-25 fiscal year for the pilot project.

Last month, Horizon told Brunswick News that the project continues at Grand Manan and Charlotte County hospitals using “existing funds.”

Vitalité Health Network recently indicated that virtual care is an option to restore ER hours at Stella-Maris-de-Kent Hospital.

“Sometimes Teladoc works well in a community that is able to give in-community physician support for the Teladoc doctor that works in the ER and sometimes they’re not so it’s less valuable, so yes, that is one of the options that is being considered (for Stella Maris),” Dornan recently told reporters.

In the legislature Tuesday, interim Progressive Conservative Leader Glen Savoie asked Dornan to restore Teladoc service to the Sussex region given his comments about its effectiveness in other areas.

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“With Teladoc, we experimented with this in Sussex,” Dornan said. “It increased the number of care during daytime hours. It didn’t give one minute for overnight hours.

“We looked at another riding, which is interestingly enough a Tory riding – Grand Manan – and we put Teladoc there where it’s increased the access to 24/7 care in that community because there was physicians that were working with the Teladoc staff, so a solution for one area sometimes works better in other areas.”

Dornan didn’t promise to restore the service in Sussex, but said his government is “committed to helping the people” in that riding.

Vitalité previously told Brunswick News that it had “initiated discussions with our colleagues at Horizon Health Network to assess opportunities and potential collaborations” to address the ER staffing issue at Stella Maris.

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The New Brunswick Medical Society remains unconvinced about the place of virtual care in emergency departments.

“A true virtual emergency department solution simply does not exist,” Dr. Lise Babin, president of the New Brunswick Medical Society, said in a statement. “In the absence of a qualified in-person physician, emergency departments become episodic care clinics. They cannot offer equivalent emergency services.

“The experience with Horizon Health Network has clearly demonstrated, as the minister indicated earlier this year, that these private virtual services, which present themselves as emergency services, simply increase costs without adding a single minute of clinical services equivalent to in-person emergency care.”

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