Addressing Emergency Department Overcrowding by Strengthening Primary Care

Emergency departments across Canada are under immense strain, with many visits stemming from conditions that could be managed in primary care settings. According to the Canadian Institute for Health Information (CIHI), between April 2023 and March 2024, 15% of all ER visits were for conditions that could have been handled by a primary care provider¹. In British Columbia, the figure sits at 12.2%, though it is likely underestimated, as the province’s data excludes patients who left the ER before being seen².

This trend signals deep-rooted gaps in access to primary care. Patients in rural and remote communities, as well as children under nine, are particularly affected, with their reliance on emergency departments for primary care nearly double that of other groups¹.

Why Are Patients Turning to the ER for Primary Care?

A major contributor to this issue is Canada’s shortage of family doctors. While efforts have been made to recruit and retain primary care providers, such as B.C.'s addition of 800 new family physicians following the introduction of a new payment model, many Canadians still struggle to find consistent primary care². The challenge isn’t just about physician numbers; over 60% of family doctors report that excessive paperwork and administrative burdens negatively impact their mental health, further limiting the time available for direct patient care³.

Beyond the physician shortage, accessing primary care remains difficult due to long wait times for appointments, lack of digital integration, and a growing burden on existing healthcare providers⁴.

Emergency Departments at a Breaking Point

ER overcrowding has become one of the most urgent challenges in Canadian healthcare. The Canadian Agency for Drugs and Technologies in Health (CADTH) highlights that emergency departments are often the safety net when primary care access fails. However, misalignment between health system capacity and patient needs results in overcrowding, longer wait times, and poorer health outcomes⁵.

Patients presenting with non-urgent conditions often face the longest delays in emergency rooms. The Canadian Institute for Health Information found that while the average wait time to see a doctor in a B.C. ER is 3.4 hours, patients with non-urgent concerns tend to wait significantly longer than others². These delays impact not only those with non-urgent concerns but also patients experiencing serious medical emergencies who require immediate attention.

Potential Solutions to Reduce ER Overcrowding

To alleviate pressure on emergency departments and improve patient care, healthcare leaders must focus on strengthening primary care infrastructure and streamlining access to timely medical advice. Key strategies include:

1. Expanding Primary Care Access

Increasing the number of family physicians and nurse practitioners is critical. B.C.’s new family doctor payment model, the Longitudinal Family Physician (LFP) Payment Model, has successfully recruited hundreds of new physicians, but more investments in primary care are needed nationwide².

2. Reducing Administrative Burdens

Simplifying paperwork and decreasing administrative demands on primary care providers would allow them to see more patients and improve care efficiency³.

3. Leveraging Virtual Care

The CIHI report found that 9% of ER visits could have been managed through virtual care, highlighting a massive opportunity to expand digital health solutions¹. Virtual consultations can provide quicker access to specialists, reduce unnecessary ER visits, and ensure patients receive timely medical advice.

How Alethea Helps Improve Primary Care Access

At Alethea, we recognize the urgent need for better access to timely medical expertise, which is why we’ve built a secure, easy-to-use eConsult platform that connects primary care providers with specialists across Canada. Through Alethea, family physicians, nurse practitioners, and other PCPs can consult with specialists in over 43 specialties, often receiving expert advice within 24 hours.

By integrating eConsults into routine primary care, we can:

• Reduce unnecessary ER visits by ensuring PCPs have rapid access to specialist support.
• Improve patient outcomes by enabling faster, more informed decision-making.
• Decrease referral wait times by helping PCPs manage more cases at the primary care level.
• Support rural and underserved communities by providing remote access to specialist care.

With Canada’s healthcare system at a critical turning point, solutions like Alethea’s eConsult platform can play a pivotal role in improving primary care access and alleviating strain on emergency departments.

Are you a primary care provider looking to improve patient care and reduce unnecessary specialist referrals? Sign up for Alethea today and experience how eConsults can enhance your practice while supporting better healthcare access for all Canadians.

Get Started with Alethea

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References

1. https://secure.cihi.ca/free_products/ED_Report_ForWeb_EN_Final.pdf
2. https://globalnews.ca/news/10903844/er-visit-data/
3. https://www.cmaj.ca/content/195/24/E851
4. https://www.cma.ca/healthcare-for-real/why-are-er-times-so-long-canada
5. https://www.cda-amc.ca/sites/default/files/hta-he/OP0553GUI-HTERP-Guidance-ED-Overcrowding.pdf

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