Increasingly popular Ontario virtual clinics find space in legislative gap

Currently not covered under the Canada Health Act, telemedicine practices have a unique window for growth

Increasingly popular Ontario virtual clinics find space in legislative gap
Maple, a recently launched 24/7 virtual walk-in clinic, is allowing workers in Ontario to get around long wait times and the unavailability of doctors after-hours by offering remote consultations. Billed as the Uber for healthcare, the industry-changing service is able to operate by working around existing healthcare legislation.

“We are not a healthcare provider,” Maple CEO Brett Belchetz told TVO. “We’re a technology platform.”

While it is not the first virtual walk-in clinic, it is the first to provide round-the-clock access to family physicians. Patients can book a single appointment on the platform for $49 on weekdays, $79 on weekends, and $99 from midnight until 8 AM. Physicians on call can answer questions, offer diagnoses, and issue prescriptions and doctors’ notes. So far, 3,000 Ontarians have signed up for the service, and the company plans to expand nationally by year’s end.

Around 30% of healthcare in Canada — mostly non-critical items like prescription drugs and dental care — is private. Medically necessary care, which includes most hospital visits and doctors’ appointments, is covered by the provinces and territories under the Canada Health Act.

Current legislation essentially prevents physicians from accepting private payment for consultations since they’re already covered in the public system. However, virtual consultations are a special case. “There’s a very clear requirement in provincial health plans that for [the province] to reimburse a medical visit, the patient and the doctor have to be physically in the same place,” said Belchetz.

Virtual consultations, therefore, can only be availed by those who can afford to pay for them privately. Still, Belchetz said, many patients who’ve signed up on the Maple platform are low-income earners; this is because hourly wage earners can come out ahead financially by using the service instead of taking a half-day off work.

Canada has lagged peers like the US, Europe, and Australia in virtual care because of factors including an absence of integration in electronic health record-keeping, the fee-for-service model, and outdated privacy laws that hamper the adoption of new technologies.

Despite this, Ontario currently has one of the largest telemedicine programs in the world: the provincially funded Ontario Telemedicine Network delivers more critical care services than those provided by Maple and other virtual walk-in clinics, such as consultations for patients in far-flung communities.

The Ontario government’s next steps to dealing with the blossoming virtual clinic business are still unclear. “At this time, the Ministry is exploring options related to the funding of virtual physician consultations and assessments,” said Ontario Ministry of Health and Long-Term Care representative David Jensen in an email to TVO.

Healthcare professionals have also raised concerns that since virtual clinics can’t access patients’ medical records, request specific doctors, or see the same expert every appointment, they might not have the quality of service that comes with continuity of care.

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