Virtual care Nova Scotia: An evaluation of a hybrid model of virtual primary care to inform scaling and sustainability considerations

Objective The COVID-19 pandemic accelerated the use of virtual health care in Canada. Nova Scotia launched VirtualCareNS—a hybrid model integrating virtual and in-person primary care—to address access gaps. This rapid evaluation assesses its feasibility, preliminary economic outcomes, and stakeholder experiences. Methods A mixed-methods rapid evaluation design was employed, incorporating utilization and economic analyses. Surveys were completed by key informants, including users (N = 74,159), non-users (N = 3130), and implementation team members (N = 31). Interviews were conducted with providers (N = 8), implementation team members (N = 11), and platform users (N = 28). Results Over 101,000 virtual primary care visits were completed, with 76,054 unique profiles created. The cost per consultation was $123 (95% CI: $99–$149), and the net cost-savings per consultation was $85 (95% CI: $62–$111), primarily driven by reduced travel time and avoidance of emergency department and walk-in clinic visits. Patient satisfaction was high (91%), and providers reported improved access, especially for patients without a regular primary care provider. Conclusion Our rapid evaluation suggests that a hybrid model of virtual and in-person care can effectively address non-urgent care needs, generate cost savings, and improve access for both unattached and attached patients. VirtualCareNS benefits from dedicated leadership structures and integration with Nova Scotia's broader primary care services, positioning it as a scalable and sustainable approach to primary care delivery. Ongoing refinement—guided by user, provider, and implementation feedback—will be critical to realizing its full potential within the publicly funded health system.