It’s a familiar situation: An employee is feeling ill at work but is too busy to leave for a medical appointment. Or perhaps the employee’s child wakes up with a sore throat and needs to see a doctor.
New apps and services are emerging to aid in those situations. Video health conferencing and telemedicine allow patients and health-care practitioners to link up with each other, often right on a smartphone.
The options include Dialogue, a service that Great-West Life Assurance Co. recently began offering to employers in Ontario and Quebec. Employees at participating companies can download an app to use the service.
Employers using the service include Quebec-based technology company Coveo Solutions Inc. Coveo, which has used the service since May 2016, says about 70 per cent of its 200 employees have enrolled in Dialogue.
“In a matter of minutes, you talk to a nurse over a chat and, in a maximum of an hour to 90 minutes, you have access to a doctor via video conference on your cellphone, which makes it . . . extremely simple,” says Claude-Antoine Tremblay, director of human resources at Coveo.
The service is available to employees, as well as their families, and there’s no limit on the number of times they can use it.
Tremblay says that, aside from the occasional unexpectedly long wait time to access a doctor, the majority of Coveo employees have been happy with the service. The cost to Coveo, he notes, is about $15 each month per employee.
A growing area
Wendy Poirier, Canada growth leader for health and benefits at Willis Towers Watson, notes the time savings from video-based health services have been a key benefit to employers.
“I think their primary initiative, and one that would seem to resonate with employers, is . . . those half days they give you off for medical appointments, and could they save money from a productivity perspective while also meeting a need of an employee to get immediate help, information?” says Poirier.
Poirier notes more providers are introducing video-based health services in Canada as employers consider a wider variety of wellness options for their workers. But so far, very few employers are using video services, she adds, noting she expects more Canadian companies will take them up as they become more comfortable with them.
But are such services worth the money? Poirier believes they can be, if they provide convenience via an at-home experience and offer timely and accurate diagnosis. Another factor, she adds, is the reduced stress for employees needing to leave for appointments during work hours.
Dr. Jason Abrams, associate medical director at Toronto-based Medcan, says that while he had his reservations at first, video services have been a source of convenience for his patients. Medcan offers video-based appointments for some of its services.
“If I may say so, initially I was skeptical because I wasn’t sure how patients and clients would react to that [medical] direction based on an initial video consult. But a lot of times, they’ve really been pleased that they’ve had the opportunity to check before making their way to a medical facility and spending that extra time that it requires them to do so,” says Abrams.
Common issues he deals with via video include triaging medical concerns, referral requests to other doctors, prescription refills, consultations about lab tests and diagnostic imaging reports and mental-health assessments.
“I would say it’s most appropriate for any type of medical question or medical condition that wouldn’t require a physical examination in the form of a hands-on examination by a doctor,” says Abrams.
Developments on the public side
While new services are emerging on the private side, some provinces are making them available through public coverage as well. For Dr. Eric Cadesky, a family physician in Vancouver who often uses publicly funded video services with his patients, it’s about improving access and adding a different dimension to traditional face-to-face care.
“In terms of replacing an in-person visit, think of it more like complementing,” says Cadesky, who adds that in some cases, such as assessing dermatological issues, video consultations can be more appropriate.
“If we’re doing it digitally, instead of me just looking with my eye at something that’s three millimetres, now I can look at it and put it on to a 60-inch screen . . .. So it can actually go beyond the capabilities of the human eye. So it’s a tool that complements the in-person visits; it’s a tool that improves access . . . to an existing relationship or creates access to start a new relationship.”
In Ontario, the government-funded Ontario Telemedicine Network usually relies on patients visiting a health-care facility close to them in order to connect with a medical professional via video. However, a pilot program launched in September has allowed patients to access their primary care providers directly via their smartphones, tablets or desktop computers. Dr. Ed Brown, chief executive officer of the service, says the provincial government is working to increase access to virtual visits in Ontario.
“We’re working really hard right now to scale up access for virtual visits, so when you talk about those other companies, the challenge they have is that it’s not insured through the public system. Kind of what we’re doing is we’re working with government and talking to providers and looking at how we can provide advice and support on how to make these things part of the publicly funded health-care system,” he says.
When it comes to the relationship between private services and coverage through provincial programs such as the Ontario Health Insurance Plan, Natalie Mehra, executive director of the Ontario Health Coalition, says the issue of video consultations is on the group’s radar.
“We are worried about it, for sure,” she says, suggesting coverage shouldn’t depend on the technology people use to access health care.
“As life changes and that technology changes, OHIP needs to modernize the coverage. Because if every new technology that comes in that changes the way that physicians consult with their patients means that they don’t, any longer, have to apply to the Canada Health Act, then the wealthy get care and those that are not [wealthy], don’t. And we’re already seeing that emerge with this. And we’re extremely concerned about it.”
Ryan Murphy is an associate editor at Benefits Canada