Guide Summary

Telemedicine - also called telehealth or virtual healthcare - is no longer a new concept.  Its usage has been on the rise globally for several years and the Canadian market is rapidly embracing the new care model as well.  But like the introduction of any new service or model (think: ABMs and online banking), there can be some confusion around what telemedicine is, how it can benefit employees and drive tangible benefits for savvy employers, and what to look for in a provider.

The 2020 Ultimate Guide below will help clarify these questions and more!

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The 2020 Ultimate Guide To Telemedicine for Canadian HR Leaders

Until recently, if you needed to see the doctor, you called them at their office, made an appointment, and went to see them in person, or you might hope for a walk-in appointment or go straight to the ER. But healthcare has changed a lot, especially when it comes to primary care.

More than 31.3 million Canadians—that’s 86%—have a smartphone and that has changed expectations of when and where we access personal information. Today, we expect to access test results on our phones, to be able to email our doctors or live chat with a nurse. Instead of relying only on a GP/family doctor, we connect with multidisciplinary healthcare teams, which research shows achieve better patient outcomes. And new technology has made it possible to safely substitute telemedicine visits for in-person office visits.

But in the midst of all of this change, the Canadian healthcare experience has remained more or less the same. Rising healthcare costs, the increased prevalence of chronic diseases like diabetes, asthma, and heart-disease that require long-term management, and an aging population are putting more and more pressure on traditional models of healthcare. Canadian employers are already a stakeholder in this equation and are seeing their workforce healthcare costs rise as well—and unsustainably. That means many employers are creating health and wellness initiatives to minimize health-related costs, with an eye toward preventative treatment and decreasing absenteeism and disability claims.

We believe telemedicine should be at the core of any company’s health plan. That’s why we built this guide that gives you everything you need to know about:

  • What telemedicine is
  • How it works
  • How it fits in the Canadian healthcare system
  • The benefits it offers to companies and their employees
  • The role of AI in telemedicine
  • Best practices in telemedicine
  • Advice for implementing a telemedicine plan

Read on, and we’ll show you how telemedicine works and how it can help you:

  • Reduce costs for your company
  • Drive employee engagement
  • Encourage work-life balance and work-life integration
  • Build a happier, healthier workforce
  • Attract and retain top talent by standing out as an employer of choice

What Is Telemedicine?

Telemedicine is the remote diagnosis and treatment of patients using telecommunications technology. It’s a form of care that doesn’t require physical presence or a physical exam. (The terms “telemedicine”, “telehealth” and “virtual healthcare” are often used interchangeably.) Remote patient monitoring is another aspect of telehealth, where clinicians track a patient’s health through remote testing or wearables.


A Brief History of Telemedicine

Telemedicine is actually older than you might think. As early as the 1960s, many US and Canadian government agencies were all investing time and money in the development of telemedicine, aiming, among other things, to help rural populations access good healthcare services. In one early effort, clinicians used microwave technology to transmit x-rays, electrocardiographs, and other medical information to and from hospitals to the Papago Reservation in Arizona. For decades, it has been commonplace to transmit patient records, test results, or patient monitoring over long distances to facilitate patient care.


Telemedicine Today

Today, technology has made telemedicine an ever-expanding reality. Physician adoption of telemedicine shot up 340% from 5% to 22% between 2015 and 2018, a recent survey of 800 physicians shows. And the omnipresence of smartphones, mobile capabilities including photos and video, and complete connectivity mean that patients and doctors can be in different places and still communicate effectively about a patient’s health. The increased availability of 4G (and soon 5G) data networks and ever-cheaper smartphones means that the world of telemedicine can now be accessible with any smartphone or laptop, and that a mobile video conference with your primary care provider, rather than an office visit, can deliver equally high-quality care.

How Does Telemedicine Work?

A typical telemedicine journey has these general steps:

1. Intake

A patient connects with a telemedicine app and answers a series of questions to begin the diagnosis

2. Consult

The patient is connected with the right medical resource to further diagnose and provide medical advice

3. Outcome

The patient receives a care plan, prescription and free medication delivery (if needed), and any required referrals or laboratory tests

4. Follow-Up

The patient receives a follow-up from the same medical professional (1-7 days later, depending on the diagnosis)


To bring this to life, below is as an example of how a Dialogue consultation might go.   Imagine a 32-year-old female employee experiencing panic attacks, difficulty sleeping, and constant worrying.  The below illustrates the patient’s care journey with Dialogue: 


dialogue flow


Key components of a strong telemedicine journey include: 



1. Quick initial intake and triage process




 2. In-depth consultation by a nurse, nurse practitioner, or doctor



3. Immediate follow-up notes from the medical professional to ensure clear next steps for the patient 


4. Timely follow-up by the same medical professional to ensure a good patient outcome


At Dialogue, our patients have the option to interact with us through their preferred channel channels.  This gives our patients maximum flexibility to meet their needs throughout their day.  For example, when commuting to work our patients often choose a phone call as it is more convenient when they are driving.  During the workday chat is often preferred as privacy is not always easy to find in the workplace.  Back at home in the evening our patients usually choose video chat.In cases where a physical exam is needed (e.g. for an earache), a care coordinator will assist to help the patient find the nearest clinic or emergency room - and in some cases book the appointment for them.   


What conditions can telemedicine diagnose and treat?

A telemedicine provider with a multidisciplinary team (like Dialogue) can typically evaluate a growing number of primary care medical conditions, including (but not limited to):

  • Nasal congestion
  • Sore throat
  • Allergies
  • Urinary infections
  • Sexually transmitted infections
  • Dermatological issues such as eczema, rashes, etc
  • Muscular and joint pain
  • Anxiety
  • Depression
  • Insomnia
  • Travel and nutritional health

Take a closer look at what telemedicine has to offer Chevron-Right-Small-1

How Telemedicine Fits in the Canadian Healthcare System

The use of telemedicine is spreading rapidly across the world. According to research from HIMSS Analytics, as of 2017, 71% of healthcare providers use telemedicine tools to connect with patients.

Although Canada has been slower to adopt telemedicine than other countries like the United States, Canadians want telemedicine. According to a study by the Canadian Medical Association:

checkmark-1  7 in 10 Canadians say they would take advantage of virtual physician visits
checkmark-1  6 in 10 Canadians are excited about artificial intelligence’s potential in healthcare, especially in preventative care
checkmark-1  70% of Canadians believe that incorporating more technology into personal health care can help prevent illnesses
checkmark-1  Most Canadians see virtual visits as leading to faster, more convenient, and higher-quality care—a “doctor on demand.”


Gaps in Canadian Healthcare

Two huge factors in the growth of telemedicine have been the problem of accessing primary care quickly and efficiently, or finding the right specialist. The potential benefits of online physician visits are particularly high in rural or remote areas where reliable healthcare services are harder to come by.

Here are some sobering facts:

  • More than half of Canadians cannot schedule a same-day or next-day doctor’s appointment
  • 1 in 3 Canadians report having to wait six or more days to be seen by a family doctor.
  • 2 in 3 Canadians’ only option for medical care outside regular hours is the emergency department.
  • Mental health treatment is hard to access, and as a result, 500,000 Canadians miss work due to their mental health in any given week.

The growing strain on the healthcare system places an increased burden on patients in the form of delayed and lower-quality of care. The consequences of delayed access are big: Delayed care has been shown to increase future hospital visits and increase costs for employers.

Learn more about telemedicine's evolving role in the Canadian healthcare system Chevron-Right-Small-1

Why Use Telemedicine?


Improving Health Outcomes

Why is telemedicine important? Because it makes healthcare simpler. It provides convenient, on-demand access to online physicians and nurses and can refer patients to a network of online doctors, medical specialists and other health professionals. In Dialogue’s approach, every video consult is followed with a care plan, navigation support, follow-ups, and self-management resources. Patients can choose their preferred communication method (chat, calls, or video), and employer-sponsored unlimited primary care means that medical consultations happen when and how they need to, at no cost to the patient. It’s like having a doctor on demand.

Telemedicine and remote patient monitoring have been shown to benefit patients by:

  • Engaging them to better manage their own health
  • Decreasing wait and travel time
  • Improving patient experience, knowledge, satisfaction, and clinical outcomes
  • Reducing hospitalizations and healthcare costs
  • Enabling better management of chronic diseases
  • Increasing access to healthcare tools and expertise
  • Reducing emergency room visits, severe illnesses, and deaths
  • Decreasing embarrassment, discomfort, or fear associated with in-person medical consultations


Improving your employee wellness program

Employers and private insurers are driving the telemedicine trend. That’s because employers have a lot to gain from offering telemedicine to their employees. US adoption of telemedicine is already significant: In 2017, over 75% of Fortune 1000 corporations included telemedicine as part of their comprehensive benefits package. A study by the National Business Group on Health in 2017 found that nearly all companies offering group health care plans will offer telemedicine by 2020. Canadian adoption is likewise on the rise, though it still has a way to go to catch up to the United States: only 9% of employers said they offered telemedicine benefits as of late 2018, whereas 67% of employees said they would use telemedicine if it were available.

As healthcare costs grow at dramatic rates, outpacing GDP growth, more and more healthcare costs are shifting to employers. A study by Mercer estimates that employer healthcare costs will climb by 130% between 2015 and 2025. Telemedicine benefits can help reduce those costs by addressing issues before they become chronic or debilitating. In turn, employees stay productive and engaged because health and well-being are closely linked: Healthy employees are more productive than peers with health issues.


Reducing Absenteeism and Presenteeism

Absenteeism is a prime contributor to lost revenue and productivity for Canadian organizations and the economy as a whole. Employee absenteeism costs employers $16.6 billion each year, at an average of $2,000 per employee annually in Canada. Although not as widely measured, presenteeism (employees who come to work sick, or who suffer from conditions that prevent them from working productively) can also have a significant impact on productivity losses. With 60% of employees not engaged at work, it’s as important as ever for organizations to decrease engagement-related productivity loss.

That’s where telemedicine can help: Virtual care can not only reduce time spent away from work, but can also minimize the personal and travel time needed for an in-person medical consultation. Telemedicine enhances employees’ work-life balance and contributes to greater productivity while at work.


Improving Access to Mental Health Care

One of the major causes of short- and long-term disability claims, absenteeism, and presenteeism is mental health. 1 in 5 Canadians experience a mental health issue in a given year, and half a million Canadians miss work due to their mental health. And 27% of Canadian workers report experiencing high to extreme levels of stress on a daily basis—the kind of unmanaged stress that can lead to mental illness issues such as anxiety and depression. According to the Mental Health Commission of Canada, $51 billion is lost each year in the Canadian economy due to mental health related issues. Employers incur approximately 25% of those costs.

But 1 in 4 people with a mental health issue never consult a health professional. Stigma, limited access, high costs, and patients ignoring treatment recommendations all make mental health difficult to manage effectively. Telemedicine offers new, more promising avenues for treating mental health. Greater accessibility, a multidisciplinary approach, and regular follow-ups mean that telemedicine can offer comprehensive, convenient, and cost-effective mental health care. Research by McMaster University shows that virtual mental health care is clinically effective and reduces costs and waiting times.


Attracting Top Talent

employee engagement
All of this benefits employers. In a recent survey, the majority of Canadian HR leaders say their top priorities are to improve:
  • employee engagement
  • employee recruitment and retention
  • employees’ mental and physical health

Telemedicine can help on all three counts.

Plus, companies offering telemedicine stand out as employers of choice in a competitive market. Nearly two-thirds of respondents to a survey said they would likely leave their job for a comparable position at a company with better work-life benefits. Employees who are happy with their benefits are most likely to rate their company as a great place to work. Research shows that healthier employees have increased job satisfaction—a top factor in retaining employees.

At a time when health benefits are often being cut, or their costs are shifted to the employee, adding modern and convenient healthcare benefits for employees can be a win for human resources leadership.


Achieving Work-Life Balance

Over 90% of millennials worldwide consider work-life balance a crucial requirement of where they work. Telemedicine improves employees’ ability to achieve that work-life balance. Employees using telemedicine services like Dialogue can have prescriptions sent to their pharmacy or delivered to their home or workplace, allowing them more control over their daily schedules. They can seek care outside of work hours or when traveling. With so many employees telecommuting, the ability to offer standardized healthcare to all employees, no matter where they are, is a huge bonus. That can be especially valuable to teleworkers in remote areas, who may not otherwise have access to the same quality of care. Finally, research shows that 95% of users are satisfied with tele-consults—which makes for happier, healthier employees.

Learn more about how telemedicine benefits employees and employers Chevron

Best Practices in Telemedicine

Evidence suggests that team care, centered on the patient’s needs, leads to the best outcomes. Who makes up that team? A combination of care coordinators, nurse clinicians, nurse practitioners, physicians, and a range of allied health professionals working together as an integrated unit. This multidisciplinary approach allows a telemedicine provider to route each problem to the right place and to offer continuous care. A group of providers communicating closely means the team can treat more patients efficiently, making a multidisciplinary approach cost-efficient and scalable. Finally, including different types of providers means that any regulatory changes—like whether a nurse practitioner can participate in telemedicine consults, for example—won’t be disruptive to the overall team.

Telemedicine also means that a top-notch team can be built from experts all over the country. A doctor in Ottawa, a nurse in Montreal, a psychologist in Toronto, and a dietician in Calgary can use secure electronic records and communication to collaborate on meeting a single patient’s needs.


Data Privacy and Security

Because Telemedicine involves transmission of sensitive personal health information, it’s important to reassure users that their data is safe and secure. The best telemedicine providers have earned certification of their SOC2 security compliance, meet all regulatory requirements in the jurisdictions where your company operates, and ensure that all third-party vendors are safely managing and storing your data.

Artificial Intelligence (AI) and Telemedicine

Machine learning and AI technologies have recently been popping up in almost every area of healthcare, from improving medical assistant chatbots to service delivery to new drug discovery. Clinicians now regularly use machine learning algorithms to diagnose and treat patients. A recent survey of 56 leading healthcare organizations found that 86% of them have already adopted AI—and plan to spend an average of $54 million on it by 2020.

AI telemedicine drives down the cost of providing quality care at scale. That’s because:

  • AI software can sift through the mountains of data faster than humans and quickly identify health problems before they become catastrophic.
  • Machine learning algorithms can recommend a diagnosis based on symptoms and patient health data.
  • AI tools help automate how clinicians triage patients and record clinical notes.
  • AI can be used for virtual consultations—where providers use machine learning to help analyze a patient’s record—to provide care recommendations. 

Overall, AI telemedicine offers a faster, more convenient patient experience.

AI tools offer lots of opportunities to patients in the world of telehealth:

  • AI-enabled chatbots ensure always-on medical assistants, collecting any necessary information from the patient and connecting the patient directly to the right medical resource
  • AI allows evidence-based medicine to be practiced at scale: AI algorithms would never forget to ask a question to rule out a rare condition or feel rushed to wrap up a consultation. The result is a systematic, comprehensive approach to every patient, every time.
  • Concierge and assistant services: Many of the interactions between patients and telemedicine services aren’t about a medical opinion, but about navigating a complex healthcare system. With AI, personalized recommendation systems identify the nearest clinic, lab, or pharmacy, without requiring medical experts to be on call.
  • AI can help improve patient’s safety by authenticating patients using face recognition and government issued document

Finally, best-in-class telemedicine providers use a “human-in-the-loop” approach. Human empathy and connection are an essential part of quality care and will not be replaced by machines any time soon.  At the end of the day, it’s a synergistic approach that yields the best results.




Telemedicine Implementation in the Workplace

As an HR professional, you already know how much work it takes to drive organizational change. Because healthcare is such a sensitive, personal experience, you need to put lots of thought into how to implement a successful rollout.

Remember that you’re inviting a wide range of patients, with varying degrees of tech savvy, to use telemedicine. You want to ensure that the patient journey is easy to navigate.

Once you make the decision to offer telemedicine, it’s important to make sure employees know about it, understand how to access it, and appreciate how it can help them save time, money, and paid time off.

Here’s some advice to bring telemedicine to your workers.


Demonstrate the Value of Your Telemedicine Program

It can be a genuine challenge to get employees to embrace new health benefits. The key is to create new habits: when patients have a health concern, they come to rely on telemedicine and their doctor app. Good account management can help drive position patient outcomes.


Keep the Rollout Rolling

How can HR professionals effectively communicate a new benefit? A good telemedicine service provider is one who will work with you long-term to build trust in your new telemedicine system. Beyond the initial rollout, your provider should offer a comprehensive awareness campaign, including onboarding, ongoing education, and follow-ups and evaluations to reinforce adoption.

Dialogue, for example, offers a comprehensive implementation toolkit:

  • Email communications to announce the service facilitates maximum employee registration. For example, Dialogue provides email templates and works closely with communications to answer any questions they may have;
  • Tech-enabled initiatives such as user videos and IT intervention to “push” the telemedicine benefit app on all employer-administered mobile devices (if applicable);
  • Webinars, including an overview on how to use Dialogue and training sessions for managers and employees; and
  • Pamphlets, posters, kiosks, and banners.

Here are a few tools you can use to encourage adoption of your telemedicine services:

  • Testimonials: Amplify real-life examples of how coworkers have already benefited from the service.
  • AMAs: Offer regular online or in-person events where employees can ask an expert anything they want to know about their telemedicine benefits.
  • Schedule time-specific notifications about how the service can be used throughout the year—for example, during flu season or allergy season.

Key Takeaways

In all, telemedicine offers so many opportunities for employers to bring better care to their employees. Here are some key takeaways:

  • New technology has made it possible to safely substitute telemedicine visits for in-person office visits.
  • Employees want telemedicine. That’s because telemedicine fills gaps in our existing healthcare systems, making it easier to access care quickly.
  • A healthy workforce leads to lower disability costs in the long-run: Improved patient satisfaction means improved employee health and happiness, and increased employee engagement.
  • An effective implementation strategy, with support from the telemedicine provider, amplifies user adoption.
  • Telemedicine helps create a better work-life balance, which helps attract and retain top talent.