Family doctor use of various visit types (by billing)

Percentage of family doctors who have billed for at least one phone, home visit, e-mail, or videoconference visit. (see data definition)

What do you see?

  • Is there a change over time in the percentage of family doctors who are using phone or email to communicate with patients?

Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.

*Data courtesy of Alberta Health Services and Alberta Health

Understanding this chart

  • Office visit: Patients interact with their family doctor in the doctor’s office.
  • Home visit: Some family doctors may visit patients in their home (private residence, lodge, group home or supportive living facility). Home visits are used for patients who have specific needs and who are unable to come to the office.
  • Phone, e-mail, or videoconference visit: These types of visits can be used to improve patients’ access to their family doctor. They may also give a family doctor more flexibility in how the doctor meets their patients’ care needs. Phone or e-mail visits can be useful for follow-up, like to review tests after an office visit or for short discussions that do not need an in-person examination. E-mail can be helpful to answer questions a patient wouldn’t normally visit the doctor about. Videoconference may not be used as often because the equipment is not always available and the ability to do an examination by video is limited.

Considerations when reviewing the results

  • Includes only visits that are billed by the family doctor. It does not include communication that the doctor chooses not to bill (e.g., quick follow-up phone call or e-mail). It does not include phone or e-mail communication by another team member such as a nurse.
  • A family doctor may bill for a total of seven phone, e-mail or videoconference visits each week and only once for any given patient in a week.
  • Billing for e-mail and phone communication became available in April 2016.
  • E-mail communication is limited by the types of office computer systems available. The system must be able to support secure e-mail communication between doctors and patients.

 

The percentage of family doctors who use technology such as e-mail or videoconference to interact with their patients is expected to increase over time. This will happen as technology becomes more available, confidence in privacy and security improves, patients and doctors become more comfortable interacting this way, and billing becomes more flexible. The right mix of in-person and technology supported visits is not known.

Some things that might limit uptake of technology visit options are time and payment. These types of doctor-patient interactions can take the same amount of time as an in-person appointment. The amount of time allowed for them must be balanced with all the other demands on a family doctor’s time. In the current fee-for-service system, doctors are paid less for phone and e-mail visits than for in-person visits. This limits the number of these types of visits that will be booked.

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. The information in this chart can be used as input to think and have conversations about primary healthcare in Alberta using the lens of the dimensions of quality shown on the right:

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Dimensions of Quality

  • Acceptability
  • Accessibility
  • Appropriateness
  • Effectiveness
  • Efficiency
  • Safety