Canadian HR Reporter

CANADIAN HR REPORTER MAY 2019 FEATURES 23 BENEFITS Putting health first with virtual care Benefits for employees, employers include improved access, lower costs By Lewis Levy I t 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 com- pared to other Organisation for Economic Cooperation and De- velopment (OECD) countries — with one-third of health-care expenditures actually com- ing from private sector fund- ing, 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. is is most evident when it comes to loss in productivity and related costs from absenteeism in- cluding 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 produc- tivity 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 physi- cians alike is virtual care. In its own right, virtual care has wit- nessed a major transformation in terms of the diversity of services readily available to patients. Virtual care is no longer re- garded as simple telemedicine or an adjunct to face-to-face encounter. Increasingly, patients, providers and health plans in both Canada and the United States rec- ognize that virtual care represents a critical component of health- care delivery. Virtual care allows for a more comprehensive information ex- change between physicians and patients. at'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 organiza- tions recognize the need to adopt more widespread and appropriate virtual care. In March, the Canadian Medi- cal 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 ad- ministrative 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 move- ment for widespread adoption of virtual care, health care remains one of two industries late to arrive to the "virtual first" party (educa- tion being the other). Most indus- tries, such as travel, embraced vir- tual services years, if not decades, ago. Like these other service indus- tries, virtual care is progressing through what Kevin Kelly, author of e Inevitable: Understanding the 12 Technological Forces at Will Shape our Future has char- acterized 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" strat- egy — making virtual care a pri- mary front door for receiving care. e virtual first approach deliv- ers critical value to address three of the most significant concerns challenging health care today: Access: Rural areas in both Can- ada and the U.S. are experiencing a health-care crisis (many urban areas are also woefully under- served). Too few doctors — es- pecially a variety of specialists — choose to establish their practices outside of urban or suburban ar- eas, leaving many people without the care they need. In rural areas, for instance, very few Canadian physicians are re- ported to be practising, with the majority located in and around ur- ban hubs. Furthermore, about five million Canadians over the age of 12 do not have a regular care pro- vider, according to 2016 stats from Statistics Canada, and for those who do, same- or next-day ap- pointments 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 pro- viders and health plans to improve quality — according to both clini- cal and service metrics. Platforms like Teladoc Health, which support a virtual-care in- frastructure, enable the highly scalable collection, analysis and reporting of quality data to pro- mote 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 ex- penditures in Canada in 2018 expected to reach $253.5 billion or $6,839 per person (represent- ing 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 ob- vious and less apparent. As mentioned, workplace ab- senteeism has a significant finan- cial impact, costing the Canadian economy $16.6 billion dollars an- nually. One of the drivers of ab- senteeism, 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 ben- efit plans, and executives aiming to establish their companies as employers of choice, a virtual-first strategy provides an immediate solution to help tackle productiv- ity-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. Credit: Wright Studio/Shutterstock Virtual care has witnessed a major transformation in terms of the diversity of services readily available to patients.

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