A virtual outpatient program that saved Manitoba millions in avoided COVID-19 hospital admission costs is winding down.
As of Wednesday, new patients were no longer accepted into the Virtual COVID Outpatient Program, which will suspend operations at the end of June. There are currently only five patients in the program, but it could have kept going with permanent funding, physicians say.
Three doctors who have been part of the team that kept the program running since it began in late 2020, said they had universally positive feedback from patients who participated in it and they are disappointed it is shutting down. The program allowed certain patients to be monitored at home via video conferencing or phone calls while they were on oxygen and slowly recovering from COVID-19, rather than remaining in hospital. More than 500 patients used the virtual program over the past 18 months. The province had been looking into expanding it for use with other chronic conditions, such as lung disease and heart failure. Doctors found that patients did better when they were at home, surrounded by their loved ones and pets.
"It’s been probably the most fun thing and innovative thing in my 15-year career here in Manitoba," said gastroenterologist Dr. Dana Moffatt.
Moffatt, and internal medicine physician Dr. Jonathan Laxton, associate and assistant directors of the program, respectively, helped start the program with Dr. Ken Kasper at HSC. But the program was running without definitive funding and required administrative volunteer work from doctors.
Shared Health confirmed the program stopped taking new patients Wednesday, describing intake as "temporarily paused" until the fall.
It’s uncertain whether the program will resume in the fall under its current structure, Moffatt said.
"This is a pause in the sense that there’s no one that wants to run this program anymore, because there’s been no funding for it," Moffatt said.
He said doctors have been asking, for the past 18 months, for continuous funding to pay for nursing and clerk positions, which had been staffed via "piecemeal" contracts. Doctors get paid to see patients in the program, but they aren’t paid for the work involved in designing and operating it.
"The problem will be if there is another big wave, and all of a sudden they need this sort of clinic," Moffatt said. "How quickly can they restart this (and) find people who want to work in this position again, knowing it’s only been piecemeal funding?"
The number of patients referred to the program has dropped significantly. At its peak, during the height of the third wave, more than 50 patients were enrolled. The five that are still enrolled will continue to receive care in other respiratory hospital programs after the end of this month, said Laxton.
The decline in patients, the doctors said, is partly because fewer COVID-19 patients are admitted to hospital, and after the Omicron variant dominated, most patients had other worsening chronic conditions, not strictly COVID-19.
Another reason, Moffatt said, is that centralized COVID units have been disbanded, causing "a bit of an outreach issue."
Dr. Clare Ramsey, a respirologist and critical care physician who worked with patients on the take-home oxygen, said it was one of the more rewarding parts of her job, and patients were so thankful for it.
"This program was a pleasure to be part of because it was well-organized," she said. "And just the gratitude from patients was kind of the complete opposite of everything else going on in the pandemic. It worked well and saved hospital time."
Laxton said he has hope the virtual model can be used to monitor patients in the future, and could be particularly useful for certain patients in remote and northern communities.
In total, 547 Manitobans from 45 communities enrolled in the program, all of whom either avoided hospital or stayed in one for less time because of the program.
Shared Health stated 4,178 hospital days were saved.
Moffatt said those hospital days add up to more than $4 million saved. Shared Health stated the savings are around $2.8 million.
"The cost of running VCOP is approximately $500,000 over the course of a year, not including physician fees. Program costs fluctuate with demand for the service," a Shared Health spokesman stated, saying the program is "paused" because of the lower number of COVID-19 patients being admitted to hospital.
"If you think bigger, this could revolutionize the way health care works in every province, and some provinces are doing that," including B.C., Moffatt continued.
"But I don’t think there’s going to be the willingness on physicians’ parts to volunteer. The same way that at the beginning of the pandemic, everybody was pulling on the same rope together to get things done… there’s an element of burnout and fatigue with two years of going above and beyond the call of duty and working your hardest all the time. I don’t know that people will be willing to do that anymore."
Last week, 58 Manitobans had to be admitted to hospital with COVID-19 and eight required intensive care, the provincial government announced in an epidemiological report Thursday.
Katie May is a general-assignment reporter for the Free Press.