The nature and extent of enterprise virtual care physician services in Canada: an environmental scan

BackgroundEmployers in Canada are increasingly offering physician services to their employees, often through third party workplace "enterprise healthcare" platforms. To date however, little work has been done to understand this method of organizing and delivering care. ObjectiveTo understand the nature, extent and implications of enterprise healthcare physician services in Canada. MethodsWe conducted structured internet and database searches to identify enterprise healthcare platforms that provided physician services and their public websites. To answer our research question, We extracted data from company websites and linked company documents as well as information from Mergent Intellect, a web-based application with business data on Canadian companies. ResultsWe identified nine companies offering enterprise physician services to employees in Canada via 11 enterprise software platforms. According to company claims, over four million Canadian employees and their family members have access to enterprise physician services. All platforms offer virtual physician services and five also facilitate in person visits. Ten of the platforms provide primary care services and one offers only addiction medicine services. Four of the platforms offer to communicate and share information with an employees regular primary care provider. Five state they share aggregate or de-identified health data with employers. ConclusionsEnterprise healthcare companies provide millions of Canadian employees and their families with rapid access to virtual physician services and, in some cases, in person care. These services may disrupt continuity of care (care by the same provider over time) and pose risks to employee privacy. As other Canadians do not have access to these services, enterprise healthcare is also introducing two-tiered healthcare across Canada potentially affecting the sustainability of the public healthcare system.