David George-Cosh

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In the early days of the COVID-19 pandemic, Maple Corp.'s chief executive officer had a career-making decision to make: Do I hit the button or not? 

Dr. Brett Belchetz knew the pandemic would lead to a surge of interest in his telehealth firm as internal statistics showed client visits quadrupled to over 3,000 per day in early March, requiring an extra set of computer servers equipped to handle the influx of demand. 

After spending the day helping onboard dozens of new doctors to the company's digital health platform, Belchetz put his stethoscope down and briefly took his company offline to switch its back-end to a more robust server around midnight when usage was low. If the plan failed, it risked causing significant outages that could derail Maple’s momentum.

"It was one of the longest minutes of my life," said Belchetz, who founded the company five years ago after friends frequently solicited his medical advice during his time as an emergency room physician.

As COVID-19 rages on and people stay home amid fears of contracting or spreading the coronavirus, it's fostered a societal shift that is changing how people work, live, and interact with one another – including virtual visits with the doctor. Furthermore, this technology can assist with simple diagnostics and prescribing medication while patients avoid unnecessary visits to the emergency room in a secure, private environment. 

That's led to a booming interest in Canadian telehealth providers such as Maple, Dialogue Technologies Inc., Telus Corp.'s Akira app, WELL Health Technologies Corp., and CloudMD Software & Services Inc. - each providing a service that helps facilitate a video chat between a doctor and their patient using a phone or computer. It could also disrupt an industry where $264 billion was spent on health care in Canada last year, which works out to roughly $7,068 for every Canadian, according to the Canadian Institute for Health Information. 

While most of these virtual visits are not fully covered by provincial health care plans, some insurers will compensate patients for accessing telehealth services or provide it directly to them. 

"The one silver lining from the pandemic is that it forced governments to recognize the value of virtual [health] care and start funding this kind of care," Belchetz said. "Now there's billing codes we can take care of, and my understanding is that's going to get more comprehensive …over the next six to eight months."

Despite signs of growing adoption, Canada is still in the early days of telehealth services, according to a recent report by Infor Financial Inc. principal Kenrick Sylvestre. Canada's digital health space is vastly underpenetrated relative to other developed countries as doctors remain well behind in providing technology-driven offerings to patients, he said. 

"We are still in the early innings, but as adoption and usage increases, health data will become a greater focus for all participants and that could lead to some interesting market developments," he said in the report. 

Some investors have already noticed. CloudMD's shares have more than doubled since the company went public on the TSX Venture Exchange in early June, while WELL Health has soared more than 300 per cent since the beginning of the year. Last month, Maple received $75 million in venture financing from Loblaw Co. Ltd. along with a deal to provide telehealth services for Shoppers Drug Mart customers. 

The federal government is also paying attention to this growing industry, earmarking $13.4 million earlier this month to fund three Toronto-based companies and an innovation hub aimed at helping support digital health treatments, including telehealth services. 

CloudMD, which helps connect patients and their digital medical records to more than 3,000 doctors and practitioners across the country, has seen a fivefold increase in customers since COVID-19 emerged as a global health crisis, according to the company's chief executive officer, Essam Hamza. And his team was prepared - the company quickly created a plan to shift its resources online once it became clear to Hamza that the coronavirus would likely cause massive shutdowns. 

"When COVID hit, it just moved our timeline ahead by about ten years and helped us expand on what we want to do [with telemedicine] a lot quicker," Hamza said during a phone interview. "Our company is set up for a pandemic." 

While most of these telemedicine services tout an emphasis on patient privacy with all records encrypted to protect from hackers, there still remains a risk of breaches. Last month, The Canadian Press reported that two Telus Health medical service providers paid an undisclosed ransom to hackers who obtained 60,000 patient records, while Toronto-based LifeLabs said last November a data breach exposed the personal information of up to 15 million customers.

Barry Billings, senior advisor of digital health at the MaRS Discovery District, expects telehealth services to become even more ubiquitous once diagnostic tools like blood pressure monitors or biometric devices become cheaper and more commonplace. 

That would give doctors more real-time patient data to work with, resulting in more efficient and reliable care, he said. It can also be predictive and help to identify potential health issues before it's too late, he added. 

"Telemedicine is just a new delivery channel for medicine," Billings said. "In 10 years from now, they're not going to call it 'telemedicine' anymore. They're just going to call it 'medicine'."