Auditor General Demands Action Toward Virtual Care Expansion, Transparency Issues and Long-Term Care

Bonnie Lysyk

Today, Bonnie Lysyk issued 13 value-for-money audits in her annual report, which also looked at consumer protection in the bereavement sector, the review and implementation of school curricula, and other issues.

Lysyk’s report highlights concern over the slow expansion of virtual health-care services, Ontario’s retirement homes having increased numbers of residents who should be in long-term care, and its gaming, alcohol and cannabis regulator lacking transparency.

Lysyk found Ontario has been slow to integrate virtual care services with its health-care system, and while the government relaxed rules around billing for remote care this year to accommodate the surge in demand, that work will need to accelerate after the pandemic.

The auditor found the Ontario Telemedicine Network, which offers remote care, and the Ministry of Health “do not have effective systems and procedures in place to offer virtual care services more long term in a cost-efficient manner to meet Ontarians’ needs.”

What’s more, she said, the audit found “numerous cases” where physicians had “significantly high” billings for virtual care, including one where a doctor billed $1.7 million for remote services in 2019-2020 and another $1.9 million for in-person services. That doctor reported seeing as many as 321 patients virtually in one day, the report said.

Lysyk also raised concerns about the proliferation of private, for-pay virtual care services, saying they have “created risk of unequal access to health care, as well as oversight risk” since they are not under provincial purview.

The report also delves into the management and operation of Ontario’s 770 retirement homes and found an increasing number of people in those facilities require a higher level of care that could more suitably be provided in a long-term care facility.

More than 4,000 patients who no longer needed acute care in hospitals were discharged to retirement homes in 2019-2020, the auditor found. “Many of those people had health profiles similar to residents in long-term-care homes,” Lysyk said.