Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond

Based on the results from the Living with the Impact of a Neurological Condition (LINC) project, those with chronic neurological conditions use more health care services across the continuum compared to other chronic health conditions.2 In a study from British Columbia, physician service utilization is 1.4–5.6 times higher in people with chronic neurological conditions, as are the total direct health costs and out-of-pocket expenses for people affected by chronic neurological conditions.1 There are also limitations in health care services for this population with the physical environment cited as one of the significant barriers to the provision of adequate services. [...]the burden of neurological diseases is not only shared by the individuals and families affected by it but also by the health care system. Digital health solutions are also adopted by the federal and provincial authorities as a key priority area of innovation to reduce health care costs.8,9 There is also growing demand by patients to have access to such services, as seen in a 2018 nationally representative survey of Canadians’ opinions on health care access.10 Our experience with virtual care in neurology We have successfully implemented eVisit pilot project in 2018 in the stroke clinic. The results of our pilot study demonstrated a very high degree of patient satisfaction, reduction in per capita health care costs, out of pocket expenses [mean(SD): $74.92(57.99) CND; median(IQR): $52.83(31.26–94.53) CND], health system costs (range between $23,832 to $28,584 dollars, just from the pilot), and statistically significant reduction in wait times for an eVisit follow-up compared to in-person follow-up.11 Physicians were able to assess patients more quickly via eVisit than via an in-person encounter, thus increasing the timely availability of health care.12 Adopting virtual care solutions can also result in a significant reduction in costs.13 The cost saving is a conservative estimate, and the actual figures are likely higher if other factors and social determinants like childcare, income status, other personal factors, and visit characteristics were accounted for. Physicians and other health care providers benefit from eVisit’s flexible scheduling, which allows being more productive with their time, enabling them to distribute their clinical activity to accommodate other commitments, including teaching, research, and administration.20 In addition to increased productivity, eVisits have the pote