With the availability of more than 318,000 digital apps, and the development of more than 80,000 new ones each year, it’s a wonder Canada’s workplace health benefits plans haven’t moved more quickly to digital.
This is likely due to the country’s siloed health-care system, with each province and jurisdiction taking its own approach. Streamlining the systems would be far more cost-effective and efficient, says Angela Copeland, board vice-president at Digital Heath Canada, though she notes it can take upwards of almost 10 years to make changes in the health-care sector.
But the outlook for digital health innovations is very positive, says Ryan Weiss, assistant vice-president of market development, group customer experience and marketing at Great-West Life Assurance Co. The industry has seen a lot of changes in the past 10 years, he says, and this is expected to continue over the next decade.
Weiss sees more digital options taking health services to the next level, allowing insurers to target the people who need help the most. “We didn’t have the tools to do that before, we didn’t have the data to do that before,” he says. “And that will allow us to get more resources to the right people earlier on in that curve, which will [mean] better health outcomes.”
It’s a matter of bringing pieces together, whether that’s delivering care virtually, using data and analytics or engaging employees in ways to keep them healthy, says Weiss. As well, it will allow insurers to “do much more at scale for a lower cost to our plan sponsors,” while digital benefits and platforms will “allow a much richer exchange and engagement with members.”
Despite the fact that Canada is lagging behind other countries in embracing digital innovation in benefits plans, it’s definitely on employer and employee radars.
“Canada’s catching up,” says Chris Denys, senior vice-president of possibilities, digital health solutions at Sun Life Financial. “I think the issue is you need to find a way to make these businesses viable by scaling up — and the workplace is one of those areas. There are different companies that have done those pivots. They built something, looked at [the consumer space] and they’re now going into the workplace.”
The main way Canadian employers are embracing digital health is virtual care through an online platform. Among the offerings from the insurance industry are Sun Life’s Lumino and Morneau Shepell Ltd.’s LifeWorks program.
“It has a holistic view of engaging people,” says Barb Vader, vice-president of global clinical services, research lead and chief clinician at Morneau Shepell, referring to the program. “And the premise behind it is it’s a place where you go pretty regularly, like almost every day. It has purpose, it’s not just, ‘I’ve got a problem, I’ve got to go find that one solution available to me.’ So it works more from a total management point of view and has a very strong preventative and educational component.”
Desjardins Insurance has developed three digital options: a sleep disorder screening and treatment program called Haleo; an employee assistance program; and Epsylio, an artificial intelligence-based support service for people struggling with mental-health issues.
The insurer is also piloting a virtual care service with 4,300 plan members in British Columbia, Ontario and Quebec, says Marie Paquet, product manager of online services at Desjardins Insurance. “The service can be used for all sorts of medical issues, like prescription renewals, respiratory issues, skin conditions, mental and nervous problems and even infections and injuries.”
Canadian virtual health-care company Dialogue launched in 2016, building a platform and partnering with the group benefits industry. Sandoz Canada, which is part of pharmaceutical company Novartis, rolled the platform out to nearly 2,000 Canadian employees in 2018. “Novartis has a priority to go digital, so all the stars aligned for us to implement this,” says Marc St. Pierre, Sandoz Canada’s vice-president of human resources.
The company’s staff can use the platform instead of going to a walk-in clinic or visiting their doctor. However, certain health-care services, like physical consultations, still require an in-person appointment. The app also allows members to book appointments and helps them navigate the health-care system.
“These things definitely help ease people’s minds, freeing up their time and removing stress,” says St. Pierre. “So maybe they can just focus on work a bit more, which is obviously the end goal as an organization, and then, from an HR/communication strategy, to give that option of work-life balance to employees.”
Staples Canada, which is looking to provide its employees with more digital health offerings, partnered with Sun Life and Beacon, an online support service aimed at helping Canadians improve their mental and emotional well-being, including internet-based cognitive behavioural therapy.
“We’re very encouraged by the studies that show the success rates of iCBT training,” says Katherine Tilsley, senior director of total health rewards and human resources information service at Staples Canada.
And since the beginning of 2018, L’Oréal Canada has offered employees a digital health service called EQ Care, which provides online access to family doctors, nurses and specialists through a computer, tablet or smartphone.
Undeniable growth trend
As many employers add online and virtual platforms to their benefits offerings, the move into digital health isn’t slowing down. The global market, which was US$80 billion in 2015, is expected to reach US$206 billion by 2020, driven by mobile and wireless health, according to a report by Statistica.com.
Digital health is growing significantly as people want more, and easier, access to medical health professionals. While 67 per cent of Canadian employees said they’d use virtual health care if it was available, just nine per cent of employers said they offer it, according to a 2018 survey by Medisys Health Group Inc.
Another survey, published by Accenture in February 2019, found 88 per cent of Canadian workers are open to employers collecting their personal data if it provides them with enhancements to performance, well-being or some other personal benefit. The survey found 70 per cent of organizations use new technologies to collect data on their employees and their work so they can gain insights that can then be actioned to increase safety, well-being and quality of work. However, just 24 per cent said they’re very confident the data is being used responsibly.
Jeff Dutton, an employment lawyer at Dutton Employment Law in Toronto, says the rise in digital health benefits is an interesting angle for privacy law. Since digital health is relatively new, it’s important employers keep the records and documents sealed, he adds.
Some employers, especially in the U.S., are using their insurance companies to provide incentives for employees to focus on better health, like quitting smoking, says Dutton, “so maybe then they get access to records.”
But employers can’t discriminate based on these new electronic markets. “From an employment law standpoint, nothing should change.”
Impact on the benefits industry
For the insurance industry, a lot of traditional digital engagement has been around claims, says Denys. “That’s where a lot of your touchpoints are and that’s at the end of the whole journey. You weren’t there to help them find the resources, to help them save money, learn more about their health conditions. The relationships we had in the past have been anchored just at the claims point.”
While the claims relationship isn’t a deep one, he says, this is where digital health opportunities abound — they’ll foster deeper relationships between insurers, employers and employees. “There’s a lot of opportunity to drive a deeper relationship, meet more needs, more members over time,” says Denys.
Great-West Life’s plan sponsors are asking about digital health services, says Weiss, but they’re also interested in return on investment. “So it’s a good, neat service, but I want to make sure it’s providing value for my members. There’s usually a calculation done, which is if you’re staying in the workspace and getting the same outcome and care in 20 minutes versus potentially half a day. It’s an evolving product and market.”
Of course, cost continues to be a leading concern for plan sponsors trying to stretch their benefits dollars. “You can actually get more care and service in many cases through these digital benefits, and help our plan sponsors . . . ,” says Weiss. “A good example is, most people recognize that more mental-health coverage would be great for their members. But it’s balancing that against, ‘Well, am I going to cough up more money for that?’ Digital health and benefits allow people to get, usually, a lower cost and more coverage for the same dollar.”
Shane Saunderson, a doctoral candidate in the faculty of applied science and engineering at the University of Toronto, has been looking at the rise of digital health, including artificial intelligence, from a dual perspective. “The fun thing is being able to do all this research while having an MBA so that, whenever I do something, my brain naturally starts thinking through ‘How is this going to impact insurers?’ and ‘How is it going to impact pharmaceutical companies and the health system?’”
He still can’t get his head around the answer. “I don’t think we quite know yet. I’m always wary of being hyperbolic because I hate overhyping things,” he says. But the potential, even if it’s a false potential, could be significant, he adds.
However, Saunderson acknowledges there are challenges. “It’s a reality that the health system is slow and for good reason, because you don’t want to introduce things too quickly and deal with people’s health and lives. But that’s probably what’s standing in the way of a lot of this technology. And it’s not perfect but, in a lot of cases, it’s already better than people.
“Part of the problem is that we hold technology to an even higher standard than ourselves,” he adds. “So it may still take some time before this starts to really roll out. But in many cases, it’s ready. It’s coming, and it’s just a matter of somebody stepping up and saying, ‘OK, let’s give this a shot.’ Because now they can think in the future.”
Alethea Spiridon is managing editor at Benefits Canada.
Download a PDF of the 2019 Group Benefits Providers Report.