Opinion: Virtual healthcare is just what the doctor ordered for Canada’s ailing public health system
As a Canadian, one of the things that makes me swell with pride is our beloved healthcare system. It’s a testament to the character of our nation that we look after our neighbors, from cradle to grave.
Written by Brett Belchetz
When Lester B. Pearson’s Liberal government passed the Medical Care Act in 1966, he described a system where people can access healthcare services according to their needs, and “irrespective of their ability to pay.”
This is a noble vision, but for it to remain viable, we need to avoid loving our healthcare system to death. This means speaking frankly about its limitations, and figuring out innovative ways of addressing them.
Canada lags painfully behind other industrialized nations when it comes to the timely access to healthcare. This is particularly true of frontline services, with many Canadians struggling to obtain same-day or next-day appointments with their family doctors.
In Canada, 99.75 percent of all medical visits take place in-person, according to 2017 statistics from the Organisation for Economic Co-operation and Development (OECD) and the Ontario Telemedicine Network.
Around four percent of Ontario’s health budget is used on capital projects, much of which is used to build the infrastructure required to facilitate these visits — from surgeries to parking lots. Ontario alone plans on spending $20 billion on hospital infrastructure between 2017 and 2027.
When you consider that a large proportion of these visits (particularly for routine visits, prescription refills, and complaints that don’t require a physical examination) can be done virtually, through a patient’s smartphone or computer, these statistics are puzzling, and are indicative of potential savings in Canada’s health system.
There are huge benefits to both patients and healthcare providers by shifting primary care from the clinic to the smartphone, and it’s crucial that we embrace them. For Canada’s system of universal healthcare to survive into the 21st century and beyond, it must embrace this new digital paradigm of medicine.
For healthcare providers, virtual medicine could mean less of the precious healthcare budget needs to be spent on infrastructure (and the ongoing costs of operating said infrastructure), and instead on doctors and nurses.
For patients, it means they can access medical services without disrupting their day, or taking time from work. It could also mean that they don’t become one of the thousands of Canadians each year who become infected with a virus from sitting in a waiting room.
Virtual care could also result in better healthcare outcomes.
A major cause of hospital overcrowding in Canada is that our readmission rates are extremely high —meaning that many people return to the hospital a few days after being discharged.
This is primarily because patients can experience complications after discharge. These usually can be dealt with in an outpatient setting if caught early, but when discharged patients don’t have access to timely physician attention, they often end up getting much worse by the time they are seen by a doctor, and require a repeat hospital stay.
There’s evidence proving that access to ongoing virtual care can drastically lower readmission rates. A 2015 study from the Milken Institute of Public Health at George Washington University showed that home-based access to medical advice can reduce readmission rates by as much as 75 percent.
Given that an overnight stay in an acute care hospital bed costs roughly $1,500, and a virtual doctor visit costs $49, it makes no sense that there’s little support for virtual healthcare on a federal or provincial level.
For Canada’s system of universal healthcare to survive through the 21st century and beyond, we must re-evaluate how care is delivered. This can be a painful process, but we can take comfort in knowing that other countries are asking the same questions, too.
Take, for example, US hospital system Kaiser Permanente, which is one of the largest in the world with over 10 million patients. It already conducts more than half of its visits virtually through video and instant messaging. Last year, almost 13 million were conducted in this way.
So, too, is the UK’s National Health Service (NHS), which is the closest analog to Canada’s healthcare system. NHS England has offered round-the-clock virtual GP consultations since 2017 with a service called GP At Hand.
These other countries have embraced virtual care, leading to lower costs, increased patient satisfaction, and better health care access. It’s time Canada did too.
Brett Belchetz is a practicing ER physician in Toronto. He is also the CEO and Co-founder at Maple, a national telemedicine provider connecting Canadian patients and doctors for online medical visits. He is a Senior Fellow at the Fraser Institute and works as an on-air medical expert for CTV and Global News. Brett previously worked as a management consultant with McKinsey & Company.