The pharmacists’ prescription for Canadian Telehealth: Asynchronous digital health

The Canadian health care system is in a crunch. The population is aging, and there is a lack of both physicians and funding for physician services. Canadian entrepreneurs have to come up with innovative ways to make our current system sustainable. In the past few years, tele-health has been exploding in the US. Many Canadians look at this and think, ‘why can’t we benefit from similar disruptive technology.’ The short answer is we can, but the Canadian healthcare system is not the same as the US healthcare system. For us to make digital health work in Canada, we need a solution tailored to Canadian healthcare.

Many companies have attempted to bring the American brand of tele-health into Canada and have faced slow adoption. The two biggest barriers to tele-health are:

1) a lack of government leadership and

2) a lack of understanding of how physicians in Canada work.

I believe a solution to the dilemma involves two factors. The first is incorporating a model of asynchronous digital health. The second is mobilizing additional first-line primary care providers like pharmacists and nurse practitioners to ease the burden on the primary care system.

What is asynchronous digital health?

Before I answer that question, I want to explain why traditional tele-health as you may know it won’t work in Canada. Canadian physicians are busy.

After spending the last few months practicing in an American healthcare system, you see the stark difference. American physicians are running a business where they are constantly trying to attract new patients that are considered more as customers and revenue generators, a complete departure from the Canadian physician perspective. A Canadian physician is essentially as busy as they want to be, they can see 20 patients a day or they could see 80 patients a day. The limit is merely how hard they want to work and how much time they spend with each patient. The reason that tele-health works within the American system is that there are many physicians who are running at or below 75% capacity, and can use tele-health visits to fill the remainder of that 25%.

For Canadian physicians, taking the time to set up a tele-health conference is something that would only slow down their busy practice and in most cases decrease their earning potential. Compounding this problem, most provinces have not embraced tele-health and have not provided physicians with adequate billing codes to compensate them for time spent digitally interacting with patients. Because of this, any solution that provides the convenience of tele-health in Canada will usually require a co-pay from the patient and often the amount a patient is willing to pay is not enough to offset the time and expenses incurred by the physician. And that’s why traditional video conferencing tele-health will not work in Canada.

So back to the original question, what is asynchronous digital health and why will that work in Canada? Asynchronous communication is the idea that interaction with a healthcare practitioner can occur in a fashion similar to any run-of-the-mill texting conversation. There is not a requirement for the patient and physician to be interacting at the same time. The patient can enter the required information and then the health practitioner can respond to those questions or requests at their convenience. It should go without saying, but this is obviously not a system for medical emergencies. Where it fits in perfectly is treating minor ailments. A perfect example of this came up while discussing this topic with a fellow physician and investor in PopRx. He noted that same day he had a patient who had a cold sore flare up on her lip. A young professional. She had to wait 2 ½ hours in his waiting room for a simple prescription of Valtrex. That two and half hour is not only inconvenient for her but because she bills by the hour is money out of her pocket, and compounded, money out of the economy. Multiply that by thousands of cases every day similar to that and you start to see why this is a problem that needs to be solved.

I had been thinking about this problem for a while when Mark, a pharmacist from Alberta in the PopRx network brought up pharmacist prescribing to me in a conversation. Immediately I saw the opportunity to use our technology to improve Canadians access to digital healthcare. Prescribing Pharmacists proved to be the perfect testing ground for this model of digital health because they are comfortable dealing with minor illnesses, the majority of which can be cured with a simple prescription. We worked with Mark and his pharmacy group to build a platform to bring convenient health care to (Albertans first) Canadians. PopRx health is a platform that allows patients to receive treatment for select minor ailments without leaving home or work through our app or website.

The patient would select one of the preset conditions that we offer.

To start that list will include:

· birth control,

· acid reflux,

· hair loss,

· erectile dysfunction,

· hemorrhoids,

· acne and minor skin rashes,

· UTIs,

· allergic rhinitis,

· cold sores,

· smoking cessation.

They are asked an automated series of questions and prompted to determine diagnosis, suitability for treatment, and any possible risk factors that would warrant additional in-person medical management. In under five minutes, this information is presented to the health practitioner where the decision is made to prescribe treatment or not. If additional information is needed, the practitioner can ask questions via secure text. If a prescription is written the patient can pay for it in the application and have it delivered to their home or office the same day.

PopRx health is looking to roll out its platform in Alberta by early September and across Canada and the following months. In provinces with limited pharmacist prescribing we are working with physician and nurse practitioner partners to provide the service. In the future, we look forward to opportunities to collaborate with employee health programs and benefits to cover the cost of the services.

We believe that PopRx health is not only going to provide great, convenient health care to Canadians but it can provide much-needed relief to the system as a whole. It provides a platform for prescribing pharmacists currently sitting on the sidelines to get off the bench and into the game improving healthcare for Canadians. Our goal is to provide Canadians with convenient access to treatments for minor illnesses so they can live healthier happier lives.

Interested in getting access to PopRx for your pharmacy, contact us at