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One must thank the authors for taking on a difficult topic. This article replicates criticism of Telehealth Ontario, and its propensity to send people to emergency rooms.
However, as all health professionals work in an interdependent variety of models, particularly in home-based care, at least one critical element is missing - the ability of a nurse to communicate with a primary care NP or physician after hours. In the absence of this element from your analysis, the meaning and significance of your results are diminished.
Does this point to the dearth of physicians who do home visits; who provide active, after hours care? I look forward to the next study wherein this challenge is addressed.
Competing Interests: I and my colleagues provide in-home care and have an active, after hours and weekend support for the patients to whom we provide care.