National Post (National Edition)
WHERE THE DOCTOR IS ALWAYS IN
Maple Corp. takes telehealth into the mainstream
The telehealth market is booming as we become more and more likely to connect with our doctors via computer screen or smartphone, and one Canadian telemedicine provider is blooming right along with it.
With so many companies struggling to pivot their operations during these pandemic times, Toronto-based Maple Corp. has found its sweet spot: providing a telehealth/virtual-care service especially fitting for an era of safety vigilance and overtaxed health-care resources.
Open 24 hours a day, seven days a week, the Maple platform promises to connect patients with a pre-vetted general practitioner or specialist by video, instant message or phone call in two minutes or less. The platform currently has more than two million users, along with some 1,500 physicians who work as much or as little as they choose (they’re paid a fee for service per consultation).
Maple chief executive Dr. Brett Belchetz said a half-dozen doctors across the country reach out to join the network on any given day, with another 600 GPs on the wait list to be added as need builds.
“We’ve seen phenomenal rates of patient satisfaction in virtual-care visits … and it’s a no-brainer as to why,” he said. “They don’t have to travel across town or miss half a day of work, and can comfortably see a doctor from the comfort of home or work with none of the risks of infection you’d have in the waiting room.”
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Heading into the pandemic, Maple was growing at 10 to 15 per cent month over month in terms of revenue and usage. But between February and April this year, revenues tripled as physician offices and medical centres were forced to shut down.
“Since then, we've returned back to a more sustainable pace of growth, but we're still meeting sales and usage targets in 2020 that we weren't expecting to reach for several years,” said Belchetz, who started the company in 2015 with co-founders Stuart Starr and Roxana Zaman, after working as a consultant and ER doctor (he can still be seen in the ER sometimes). “We've seen massive adoption of virtual care and I'd be shocked if things went back.”
The C.D. Howe Institute agrees, noting in a new report, Canada's Virtual Care Revolution: A Framework for Success, that the pandemic has forced mass adoption of virtual care years ahead of schedule. The authors of the report released in December expect virtual care will be “a mainstay of clinical care in the future,” provided the financial and regulatory support is there from providers and government.
Duncan Stewart, director of Technology, Media & Telecommunications research at Deloitte Canada, shares a similar sentiment, noting that “the pandemic absolutely was a tipping point for telehealth and you can't fit that genie back into the bottle.”
He points to data from Ohio State University's Wexner Medical Center showing that 92.5 per cent of patient visits conducted during a four-week period ending in April this year were done via video or telephone, compared to 0.1 per cent pre-pandemic in March.
In Canada, there was initially some criticism about how the service fit into the public health-care system, but there are now an increasing number of publicly funded billing codes for virtual services. Prior to the pandemic, only British Columbia had such codes.
After COVID-19 arrived, 60 per cent of health-care visits with primary care physicians and specialists were conducted virtually, before plateauing around 30 per cent, according to a September 2020 survey by Canada Health Infoway, a federally funded not-for-profit that promotes digital health solutions.
Stewart said the necessity of providing health care during COVID-19 has pushed aside multiple prior barriers to telehealth, namely consumer and provider apprehension, and a lack of support from insurers and government.
“There used to be a technology gap for older people, but that's gone away, too,” he said. “If grandparents can connect with their families via video now, they can do it with a doctor.”
Maple has helped those trends along for a while, working with governments and insurers to get them used to the idea and to implement programs.
For example, the company in 2018 helped save a rural hospital in Prince Edward Island by building a platform that has kept the facility running using virtual staff. In Ontario, Maple is collaborating with some long-term care homes to help residents virtually access specialists.
Partnerships with major benefits providers such as Green Shield Canada and Medavie Blue Cross are also enabling widespread access to Maple services, with Belchetz hinting at alliances with other large providers coming soon.
But perhaps the most notable ally of late is Shoppers Drug Mart Inc., which invested $75 million into Maple this fall in exchange for a minority stake in the company.
Belchetz said working with the country's largest pharmacy chain on two previous initiatives — providing virtual physician visits for Shoppers' customers in B.C. where the service is publicly funded, and then expanding that service to other provinces for several weeks as COVID-19 hit — helped demonstrate that Maple's platform can handle the kind of business scale that Shoppers can drive.
“I think their eyes were open to the fact this could be a very fruitful relationship for the long term, especially as public coverage is becoming more and more common for virtual-care visits,” he said.
This influx of funds will be used to scale up Maple's technology infrastructure and staff, along with its provider network. Belchetz said early discussions are also underway around how to integrate Maple with Shoppers'
COVID WAS A TIPPING POINT FOR TELEHEALTH AND YOU CAN'T FIT THAT GENIE BACK IN THE BOTTLE.
existing health-care provider networks.
“What we're trying to build is an omnichannel health experience that patients can access all in one place,” he said. “The idea would be that we would eventually figure out a way to get all these providers into one platform, but we haven't made any firm decisions on how or when this will happen.”
As the virtual-care wave entices new entrants into the market, Belchetz believes Maple's already existing presence in all aspects of health care (that is, the employer/insurer, direct-to-consumer and hospital spaces) will be its greatest advantage.
“Over time, what's happening is that we own a large chunk of the patient's healthcare experience,” he said. “We're the platform that has their hospital records, plus the one they get middle-ofthe-night care in and they won't want to switch.”
Gaining a strong foothold in Canada also provides Maple with the perfect springboard for expansion into other markets.
“As we get to the point where we've captured a very good percentage of Canadians, we are going to have an incredibly scaled example of how virtual care can operate across multiple environments,” Belchetz said. “That's a really good opportunity to then take our system and start to build that same platform in other countries.”