A Toronto startup touting itself as Uber for healthcare says its new 24/7 virtual doctor’s office is the first of its kind in Canada.

Ontario residents can register for Maple online, type in a description of their symptoms and click to request a consultation with a doctor. Patients select a video chat or text chat appointment and can also share photos with the physician.

The doctors are practicing physicians who work for Maple “in their off hours to provide care to patients after hours,” said co-founder and CEO Dr. Brett Belchetz.

As listed on Maple’s website, illnesses suitable for remote treatment include colds, influenza, allergic reactions, rashes and other skin conditions, eye, ear and urinary tract infections, vomiting, diarrhea, sexual health issues and mental health concerns.

Belchetz: “There’s no doubt Canada is behind.”

After viewing details of the patient’s request, a Maple doctor conducts a virtual appointment with the patient, usually within minutes of the original online request, according to Belchetz.

Although there are other virtual health services in Canada – such as the Ontario government’s Telehealth phone line staffed by nurses – Belchetz said the Maple model is different.

“This is an around-the-clock Uber model where there are physicians staffing a digital (service) and a physician can see you in minutes,” he said. “This is a brand new type of technology for Canada and Ontario to be able to request on-demand service from a physician anywhere in the world.”

Belchetz said two other features make Maple unique from existing virtual healthcare services: Maple’s doctors write prescriptions and sick notes, and there’s also a virtual pharmacy. Patients within certain Ontario postal codes can have their prescriptions filled and delivered by Maple’s partner pharmacy PopRx. It’s all done without patients leaving their home or office.

“In Canada almost 100 per cent of our patients have to go (see a doctor) in person,” Belchetz said. “We can introduce so much more efficiency into the system and greatly impact the patient’s experience.”

Fee-based, for-profit

Although Maple’s prescription deliveries are free, its healthcare services are not. Since only in-person doctor visits are covered by the Ontario Health Insurance Plan (OHIP), patients must pay for Maple’s virtual doctor visits.

Initial registration is free but treatment costs $49 per virtual visit from 8 a.m. to midnight on weekdays, $79 per visit from 8 a.m. to midnight on weekends and $99 per overnight visit between midnight and 8 a.m. every day of the week. Unlimited visit memberships cost $359 per year for an individual or $579 for an annual family membership.

Belchetz didn’t disclose exact patient registration figures but said Maple’s “patient numbers are in the thousands already.” So far over 50 doctors have signed on with Maple and five to 10 new doctors are expressing interest in the service every day, he added.

A legal option

Maple is only available to Ontario residents for now but Belchetz said the company plans to expand to other provinces. He said Maple’s fee-based for-profit model is perfectly legal under federal and provincial healthcare legislation.

“We’re not double-charging patients. It’s very well established in Canadian law that anything that isn’t an insured service covered by the government is legal to charge for,” said Belchetz, who’s also a practicing emergency room physician in Toronto.

He said Maple is just as legal as elective health procedures like laser eye surgery or dentistry. They are aren’t covered by OHIP but people can opt to pay for them out of pocket or through their workplace benefit plans.

“This isn’t meant to be a replacement for our healthcare system. It’s meant to be a complement to it,” Belchetz said.

Maple offers its own corporate healthcare plans for businesses. Employers can cover all or part of Maple patient costs for their staff, which can be billed directly to the employer so workers don’t have to pay up front. Belchetz said companies can contact Maple directly to set up corporate benefit plans.

Businesses using Maple’s corporate plan say it decreases employee absenteeism and boosts productivity by allowing staff to seek healthcare without missing work, he said. He noted that while 60 per cent of all U.S. companies include telemedicine in their benefit packages, the corresponding percentage in Canada “is almost zero.”

Canada lags behind

That’s just one of many figures suggesting Canada lags other countries in digital healthcare. Teladoc, the first publicly traded telemedicine company in the U.S., treats almost one million patients per year. Kaiser Permanente, the largest not-for-profit managed care organization in the U.S., provided more treatment through video or instant messaging than via office visits for the first time ever last year.

The British government just launched a six-month trial that could see Babylon Health, a startup which uses artificial intelligence chatbots in its virtual treatment model, replace the National Health Service’s telemedicine phone line.

Progress is being made in Canada, too. Toronto’s Humber River Hospital opened its doors in 2015 as North America’s first fully digital hospital. It’s equipped with robots that mix and administer medication, electronic medical records and bedside touchscreens patients use to access their charts, make calls and control the temperature in their room.

This bedside touchscreen at Humber River Hospital is for patient communications, electronic medical charts and controlling the room temperature. (Photo: Humber River Hospital)

With the new Toronto-based mobile app HouseCallsNow, patients can book a housecall from a doctor and track their estimated arrival time with GPS. The visits are covered by OHIP because the physicians visit patients in person.

Nova Scotia is now rolling out MyHealthNS. Patients can use the secure online portal to view or add to their own health records, message doctors directly and download test results. During a three-year pilot project, doctors said the portal freed up 22 per cent more time for them to see additional patients.

That’s not the only Canadian data pointing to the benefits of digital healthcare. According to surveys by the federal agency Canada Health Infoway (CHI), 80 per cent of Canadians say they would take advantage of digital health solutions – if they were easily available – to make appointments, renew prescriptions and access their lab tests, immunization records and medication histories.

“Struggling to do the right thing”

Other CHI research estimates that digital technology has already generated $16 billion in cost savings and efficiencies for the Canadian health system between 2007 and 2016. Despite those kinds of figures, Belchetz said Canada remains a global laggard in digital health.

“There’s no doubt Canada is behind. We’re really, in some respects, living in a different century here in terms of healthcare.”

When asked why, he said federal and provincial governments are “struggling to do the right thing” but “because they’re overburdened and busy with taking care of the population as it gets older and sicker, it’s hard to get off that treadmill and think of doing new and different things.”

“Great innovations that change the way we do things, I don’t think they come from governments or huge organizations with a lot of inertia,” he said. “They come from small, innovative groups.”

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