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Digital Health

Posted by Gordon R. Hart

Aug 7th, 2019

Digital Health

The Canadian healthcare industry is changing rapidly as stakeholders seek to find more efficient ways to deliver access and care. Digital platforms and the prevalence of smartphones has brought the connection of healthcare and technology to a level that is reducing the barriers for care. Instead of having to arrive at walk-in clinic or urgent care and wait your turn (rationing is a cornerstone of the Canadian public health system), patients can now use technology tools to interface with healthcare professionals. Patients can seek care and advice from the comfort of home using live video, audio and instant messaging. Telemedicine, virtual care and telehealth are three different digital tools.

Telemedicine is the treatment of various conditions and the process of healing without being in-person. Doctors often use telehealth platforms like video, audio and/or instant messaging to address the patient’s concerns and diagnose their condition remotely. This care may include giving medical advice, walking them through at-home exercises and remedies, or recommending them seek care via hospital, specialist or face to face with a physician. Telehealth applications extend the care through self-help and guided support. Of course this approach has limitations and as such it typically deals with simple treatments like managing chronic pain, relieving symptoms, and counselling. Those with serious conditions are referred to in-person care.

Virtual Care is the broader term that encompasses all the ways that healthcare providers interact with patients without seeing them in-person. Virtual care includes elements such as scheduling, eligibility, e-prescriptions, image transfer and viewing, payments, remote assessments, research, patient surveys and digital signatures.

What virtual health can do is allow for a better triage of care by using intelligent data gathering to better deploy resources for efficient effective care. There is a growing number of providers delivering some or all of the elements of virtual care and telemedicine. One of the fastest growing providers is Dialogue.

Dialogue has built a comprehensive virtual clinic,

Comprehensive Virtual Clinic steps chart



Dialogue’s primary care scope of practice includes,

• General health (including kids): Congestion, fever, minor aches and pains, allergies, sexual health, etc.

• Healthcare navigation: Assists with appointment scheduling for in-person physicians including specialists as well as tests, radiology, obgyn, etc.

• Skin issues: Rash, eczema, minor bits or cuts, etc.

• Minor injuries or trauma: General advice on injuries and muscular or joint pains, and guidance to seek in-person examination


Dialogue does not treat emergencies or critical situations requiring 911 or some complicated issues including children under 2 years of age, pregnancy follow-up, or psychosis, etc.


The cost of this type of program is approximately $9 per month per employee. This cost is typically offset by reduced absenteeism relating to diagnosis or treatment of uncomplicated health issues. Consider this,

• The average Ontarian wage was $26.83/hr in 2018

CIHI’s 2016 report that only 43% of Canadians reported being able to get a same or next-day appointment)

• The average full time employee is absent for 9.3 days each year due to health issues alone

• The average Canadian takes two to six days off each year solely for medical appointments; those with kids take double

• Each 5-minute doctor’s visit takes approximately two hours of time from the workplace

• 90% of ER visits take 7.8 hours to complete

• Online wait time trackers like Medimap and skipthewaitingroom.com show an average waiting time of 30min to 3.5 hours. More than 40% of clinics were closed to new patients for the day by noon.

Digital Health

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