B.C. 2.0.: Doctors and patients learn that there’s no place like home

Digital health finally hits the mainstream.

Digital health finally hits the mainstream

There’s a good chance that COVID-19 has kept you away from the doctor–physically, at least. And like many other people who turned to virtual medicine during the pandemic, you probably think renewing a prescription by video beats spending hours in a crowded waiting room.

Despite slow progress, the shift toward virtual care was already underway before COVID, says Hamed Shahbazi, founder, chair and CEO of Well Health Technologies Corp. “A lot of people were very frustrated with digital health,” notes Shahbazi, whose Vancouver-based company runs a nationwide telemedicine service and more than 20 brick-and-mortar clinics throughout the Lower Mainland. “But we all knew that it was a clear and unmistakable trend,” he adds. “No business evades digitization and modernization. It’s just a question of when.”

The pandemic forced people to test the limits of virtual engagement, and medical care was no exception, says Shahbazi, who was previously CEO of Vancouver fintech firm Tio Networks Corp., which he sold to PayPal Holdings in 2017 for some $300 million. “These were not whiz-bang technologies,” he explains. “This has been around for a long time. So there are service providers that were able to ramp up very quickly to meet this demand, including us.” On June 26, Well closed at $2.80 on the Toronto Stock Exchange, almost double its share price at the start of the year.

For Shahbazi and other proponents of digital health care, demand has been robust. Roughly 40 percent of Canadians who visited a care provider in June used virtual methods–phone, video, and messaging or email–according to a survey for federal agency Canada Health Infoway. Before the pandemic, just 10 to 20 percent of primary care visits were virtual, Infoway estimates.

Richard Lester, an infectious disease physician with Vancouver Coastal Health, has worked in digital health since 2005. While Lester was doing post-doctoral research in Kenya during the HIV pandemic, he and Gabrielle Serafini set up what he believes was the first use of text messaging and mobile phone communication for patient care. This effort, the subject of a 2010 Lancet paper showing that interactive texting could improve patients’ engagement and health outcomes, became Vancouver-based WelTel, where he serves as chief scientific officer and Serafini as CEO.

In B.C., clinicians have used WelTel’s online platform for everything from remote care to monitoring chronic diseases like asthma. In response to the pandemic, the company quickly redeployed its technology to release an automated virtual tool, now in use in Rwanda and the U.K., that lets physicians monitor COVID-19 patients by text.

Although it’s home to world-leading research and innovation, this province has been slower than some other places to adopt digital health, says Lester, who also notes that the Ministry of Health had aimed to make 50 percent of clinics virtual by 2030. “That all got surpassed within a couple of months because of COVID,” he observes. “If I do want to see a silver lining come out of this, it’s going to be breaking down some of those barriers to innovation that we have in our ecosystem in B.C.”

Provincial health authorities have made a major commitment to invest in digital care, says pediatric anesthesiologist and health informatician Mark Ansermino, a UBC professor who for almost 20 years has run a research lab at the university that works in digital health. “But there wasn’t really buy-in from any of the clinical people until this crisis hit, and now all of a sudden, it’s just accelerated.”

Ansermino also directs the BC Children’s Hospital’s Centre for International Child Health, where his group has launched a research project called Healthy at Home. Socially and from an infection perspective, children are better off at home than at hospital, he says. “You could probably get rid of more than 50 percent of the children who are staying in hospital if you had technology that could enable them at home.” That tech could be a simple camera or a wireless sensor that tracks physical activity and eating habits.

Digital health has long been dismissed as an essential strategy, says Brenda Irwin, managing partner of the Relentless Venture Fund, which invests in technology that optimizes health and access to health care. “Now you have an infectious disease that is putting this profoundly intense spotlight on the inefficiencies of the health-care system that can be addressed with technology.”

The Vancouver-based Relentless fund focuses on heart disease, diabetes, mobility and mental health, the four most common diseases and issues that people face as they age. Because patients with heart disease and diabetes are especially vulnerable to COVID, Irwin sees an opportunity to give them virtual access to a primary caregiver, plus at-home tools to track their own vitals. “Nothing’s going to replace a clinician’s assessment of an individual,” she says. “It’s, how is technology going to enable and mitigate the fear of going to a hospital and acquiring new infections, but also, do you have the ability to manage this at home?”

As of June, 43 percent of Canadians surveyed for Infoway said they would prefer their next health-care visit to be virtual. Looking past the pandemic, Well’s Shahbazi sees a combination of “bricks and clicks”–connecting online, patient and doctor can book an in-person visit if necessary. In his view, COVID got them both on the same page about virtual care. “The patients were always interested,” Shahbazi says. “Everyone wants to do stuff in a more convenient way.”