Enterprise healthcare physician services in Canada: an environmental scan

Abstract

BackgroundEmployers in Canada are increasingly offering physician services to their employees, often through enterprise virtual care platforms. To date however, little work has been done to understand this method of organizing and delivering care.ObjectiveTo understand the nature, extent and implications of enterprise virtual care in Canada.MethodsWe conducted structured internet and database searches to identify enterprise virtual care platforms and their public websites. To answer our research question, we extracted data from their websites, and linked company documents, including investor reports, and information from Mergent Intellect, a web-based application with business data on Canadian companies.FindingsWe identified nine companies offering enterprise virtual care physician services to employees in Canada on behalf of their employers. According to enterprise virtual care company claims, over four million Canadian employees and their family members have access to enterprise virtual care services. All platforms offer virtual physician services to employees and four also offer in person visits arranged through their platforms. Eight of the platforms provide primary care services and one offers only addiction medicine services. Four of the platforms offer to communicate and share information with an employee’s regular primary care provider. Four state they share aggregate or de-identified health data with employers.ImplicationsEnterprise virtual care companies provide millions of Canadian employees and their families with access to physician services. These services appear to disrupt continuity of care (care by the same provider over time) and pose risks to privacy. As other Canadians do not have access to these services, enterprise virtual care is also introducing two-tiered health care broadly across Canada.

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“…Some services do both, billing public insurance for some services and charging patients privately for text messaging or other services not included in public plans 37. Employers are increasingly offering virtual healthcare and physician services to employees through for-profit virtual ‘enterprise’ platforms that are paid through what is ostensibly private supplemental insurance, but which looks increasingly like duplicative insurance which is banned in six Canadian provinces 39…”

“… 37 Employers are increasingly offering virtual healthcare and physician services to employees through for-profit virtual ‘enterprise’ platforms that are paid through what is ostensibly private supplemental insurance, but which looks increasingly like duplicative insurance which is banned in six Canadian provinces. 39 …”