It might come as a surprise to some Canadians that public sector health-care spending (as a percentage of total health spending) is on the low end compared to other Organisation for Economic Cooperation and Development (OECD) countries — with one-third of health-care expenditures actually coming from private sector funding, according to a 2015 report from the Canadian Institute for Health Information.
When you then consider longer wait times to see a physician and an aging Canadian workforce, the health of employees can add up to a significant cost for employers.
This is most evident when it comes to loss in productivity and related costs from absenteeism including delays, replacement costs for absent workers, administrative expenses, or negative effects on other workers or customers.
One estimate sees absenteeism costing the Canadian economy $16.6 billion annually in productivity per year, according to a 2012 report from Statistics Canada.
To help reduce absenteeism and improve patient access to health care, one strategy that is gaining widespread acceptance among governments and physicians alike is virtual care. In its own right, virtual care has witnessed a major transformation in terms of the diversity of services readily available to patients.
Virtual care is no longer regarded as simple telemedicine or an adjunct to face-to-face encounter. Increasingly, patients, providers and health plans in both Canada and the United States recognize that virtual care represents a critical component of health-care delivery.
Virtual care allows for a more comprehensive information exchange between physicians and patients. That’s evident from a recent survey by Canada Health Infoway that found 91 per cent of British Columbia patients who used a virtual-care service felt their health issue was addressed appropriately during their virtual visit, and 87 per cent avoided a work absence.
Canadian physician organizations recognize the need to adopt more widespread and appropriate virtual care.
In March, the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada announced the formation of a task force to “identify the regulatory and administrative changes needed to support virtual care in Canada, and to allow physicians to deliver care to patients within and across provincial/territorial boundaries.”
Despite this growing movement for widespread adoption of virtual care, health care remains one of two industries late to arrive to the “virtual first” party (education being the other). Most industries, such as travel, embraced virtual services years, if not decades, ago.
Like these other service industries, virtual care is progressing through what Kevin Kelly, author of The Inevitable: Understanding the 12 Technological Forces That Will Shape our Future has characterized the four stages of natural history for a new idea:
1. This new idea is simply unrealistic. Deliver care without seeing the patient? How is that possible?
2. This idea is odd and unproven — and, therefore, probably dangerous.
3. OK, there might be potential with this idea — but its value is trivial. We need much more proof before we can seriously consider making a change.
4. The benefits are obvious, I can’t believe we ever did it any other way.
Health care has finally arrived at stage 4. In this stage, many people are moving to a “virtual first” strategy — making virtual care a primary front door for receiving care.
The virtual first approach delivers critical value to address three of the most significant concerns challenging health care today:
Access: Rural areas in both Canada and the U.S. are experiencing a health-care crisis (many urban areas are also woefully underserved). Too few doctors — especially a variety of specialists — choose to establish their practices outside of urban or suburban areas, leaving many people without the care they need.
In rural areas, for instance, very few Canadian physicians are reported to be practising, with the majority located in and around urban hubs. Furthermore, about five million Canadians over the age of 12 do not have a regular care provider, according to 2016 stats from Statistics Canada, and for those who do, same- or next-day appointments are difficult to obtain.
Virtual care can overcome many of these barriers, meeting the needs both of individuals who live in remote areas and providers in populated areas.
Quality: Not only does virtual care provide a much-needed channel for care delivery, but it also facilitates the ability for providers and health plans to improve quality — according to both clinical and service metrics.
Platforms like Teladoc Health, which support a virtual-care infrastructure, enable the highly scalable collection, analysis and reporting of quality data to promote best practices in a myriad of areas such as prescribing patterns around antibiotics and steroids among providers in the network.
Cost: With total health-care expenditures in Canada in 2018 expected to reach $253.5 billion or $6,839 per person (representing 11.3 per cent of Canadian GDP), according to the Canadian Institute for Health Information, strategies to address spiraling cost concerns are critical. Virtual care offers a solution in ways both obvious and less apparent.
As mentioned, workplace absenteeism has a significant financial impact, costing the Canadian economy $16.6 billion dollars annually. One of the drivers of absenteeism, limited access to care, not only affects patients who must choose between skipping care or seeking it via the emergency room, but also their employers.
Virtual care is not a trend but a fundamental component of a high-quality health-care delivery system.
For managers of employee benefit plans, and executives aiming to establish their companies as employers of choice, a virtual-first strategy provides an immediate solution to help tackle productivity-related costs and provide the services employees of all ages seek.
Lewis Levy is a chief medical officer at Teladoc Health in Boston, Mass. For more information, visit www.teladoc.com.
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