Virtual nursing project in Nunavut shows improved outcomes

BY ALYA NIANG

In response to the pandemic, health systems across Canada quickly pivoted to launch or expand virtual care options. Since then, health systems have been recognizing how virtual care can address the diverse needs of patients and healthcare providers to deliver safe, timely and equitable care.

In 2020–2021, the Government of Canada provided funding to the provinces and territories to enhance technology and infrastructure that would facilitate the delivery of virtual care, to evaluate the impacts of virtual care or to establish policy supports for virtual care. As a result, provinces and territories implemented a wide range of initiatives.

To share the successes and challenges of these initiatives and to inform future virtual care policy and delivery, the Canadian Institute for Health Information (CIHI) conducted interviews across the provinces and territories.

This included Nunavut, where we found high patient satisfaction with the Virtual Nurse Practitioner Chronic Disease Program.

While Nunavut has deployed telehealth services to its 25 communities for more than a decade, with equipment provided in every health centre to facilitate patient–provider communication, a strong foundation in primary care has been difficult to achieve due to challenges such as recruiting and retaining staff.

To address gaps, the new Virtual Nurse Practitioner (NP) Chronic Disease Program has been piloted to support patients at home, offering an adaptable model of care delivery that leverages NPs.

The program has a dedicated NP workforce providing chronic disease management in nine communities, where they meet patients virtually at minimum every three months and can have virtual specialist consults to support patient care. The program provides an opportunity for patients to be screened for chronic diseases and cancer, including cervical and colorectal cancer, hypertension and diabetes.

Program results/successes from data collected between October 2021 and October 2022

• 358 new referrals were registered in October 2022, compared with 121 in December 2021. Nearly half of patients program enrolment. Patients at higher risk (e.g., uncontrolled diabetes, significantly overweight) saw the greatest benefit, with a larger average decrease in their biomarkers.

• 96 percent of patients were satisfied with their overall experience; 93 percent of patients indicated that they had received the same quality of care with the NP virtually as with an in-person visit; and 94 percent felt that their cultural values had been respected during their appointment.

(45 percent) had three chronic diseases addressed per visit.

• Between 27 percent and 42 percent of newly referred patients were not up to date with screening for chronic diseases or cancer. Of these patients, more than 90 percent became up to date after their first intake appointment.

• Chronic disease biomarkers showed a statistically significant decrease following

• 97 percent of patients felt that there was a positive change to their quality of life, and 94 percent felt that their chronic disease was better managed since seeing the NP virtually.

Overall, the program’s success highlights the value of integrating NPs in virtual care to improve access to primary healthcare, and it provides an adaptable model for other jurisdictions across Canada that deliver care to rural and remote populations.

While virtual care has long been a

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