Maple gets ready for virtual-visit expansion in home care, hospital care

TORONTO – Maple, the provider of virtual visits for patients and physicians, was recently in the news after raising $14.5 million in funding to help fuel its growth. A key part of the program for the near future involves a partnership with SE Health, formerly known as Saint Elizabeth Health, the national provider of home care and community services.

What the two organizations have in mind is to link Maple’s online doctors with home care and community-based patients while they’re being visited by SE Health’s nurses, personal support workers and therapists.

“This will be the first solution of its kind in the world,” said Dr. Brett Belchetz, co-founder and CEO of Maple. “Nobody else has combined home care and primary care the way we’ve done.”

To be sure, nobody has done it on this scale, with a coast-to-coast technological system that connects doctors, nurses, PSWs and patients.

The plan is to make use of Maple’s national platform for telehealth – including video visits and other forms of virtual care – to provide continuous physician services to nurses and PSWs as they’re checking on patients in the community.

That’s expected to dramatically improve the care of these patients, many of whom are too ill or are simply unable to leave the house to see a doctor in person. For example, palliative-care patients or frail patients without enough help to get into a vehicle and to a physician practice.

It will also help keep many patients out of Emergency Departments, and reduce “hallway medicine”, as home care patients are often sent to hospitals when they appear to be sick, and when family doctors are unavailable after hours or in rural regions.

“We’re able to provide national, around the clock coverage,” said Dr. Belchetz.

He commented that Maple and SE Health are natural partners, as in the past, SE Health has lacked the technological infrastructure to provide physician-supervised, virtual home-care visits, while on the other hand, Maple has needed the “boots on the ground”, the nurses and PSWs who are physically present with patients.

The nurses further augment care, taking blood pressure readings or assisting with other medical equipment that virtual physicians may need to use during the encounters. They can even help with the computer equipment for patients who have trouble operating a laptop or smartphone, including patients with dementia.

Virtual visits could be used to examine patients with a host of ailments, including heart failure, COPD, and diabetes. Using the teamwork between online doctor and the physically present nurse or PSW, “We don’t have to automatically send patients to the ER,” said Dr. Belchetz.

Not only can this result in better, faster care for patients, but it also reduces overcrowding in emergency departments and curbs “hallway medicine”.

“When Maple’s virtual physician services are coupled with the care offered by SE Health nurses, personal support workers and therapists, a truly powerful combination is created that ensures patients can be triaged and treated in a responsive and cost-effective manner,” said Michael Peters, senior vice president at SE Health. “Ultimately, we hope patients and their families will receive an exceptional care experience in their own home environment, while avoiding unnecessary hospitalization and emergency department visits.”

Maple and SE Health plan to start pilot projects in the next few months, Dr. Belchetz said. Some of the momentum for moving ahead will depend on government funding for virtual visits.

This seems to be only a matter of time, as many groups have been calling for an expansion of funding for virtual care. British Columbia now offers limited remuneration for doctors doing video visits, and Ontario has been funding some physicians through its Ontario Telemedicine Network (OTN).

Notably, the newly proposed Ontario Health Team strategy has been calling for an expansion of virtual care; Dr. Belchetz expects to see changes in the billing codes, or at least funding of virtual care projects on an ad hoc basis.

Maple also gained international attention this year with its hospital telemedicine project – it provided remote rounding of patients in a PEI hospital that faced a doctors’ shortage. The Western Hospital, in Alberton, PEI, was able to stay open and care for patients by using telemedicine to connect with Maple’s physicians.

Moreover, Dr. Belchetz said, “the outcomes were tremendous,” and hospital performance actually improved when using virtual visits. “Length-of-stay was shorter, and readmission rates were reduced.”

Now, the company is on the verge of expanding the virtual rounding program to other hospitals in Canada. While the hospital in PEI is a small one, very large hospitals have been contacting Maple to augment their delivery of medical services.

“We’re speaking to very large, tertiary care centres,” he said. “We’re taking a gigantic step forward.”