Telus virtual health-care app touted by Alberta government sparks outcry from physicians

Some family doctors are voicing their concerns about a new Telus Health app being introduced by the province that allows Albertans online access to a doctor.

Babylon is a free downloadable app developed by Telus Health that lets Albertans meet with licensed physicians in one-on-one video consultations through their smartphone.

The app can be also be used to check symptoms — including those of COVID-19 — book appointments and get prescriptions and referrals, all covered under Alberta's public health-care insurance.

Health Minister Tyler Shandro said Thursday the joint initiative with Telus Health comes at a time when the health system is asking people to self-isolate as a result of the COVID-19 pandemic.

But the announcement prompted many Alberta physicians to complain that the service is deeply flawed.
    
Katherine Bisby, a family physician in Calgary, said she's not opposed to adding this tool to the mix — especially to keep patients and doctors safe during the pandemic.
    
But she said it appears to undermine family doctors who already offer a virtual service by phone — and who have been asking the government to increase their virtual billing rate, which is just $20 per call.
    
Calgary family physician Dr. Jennie Herd told CBC News in an email that the $20 per call billing rate is unfair, especially given that Babylon doctors are paid more.

"Clinic overheads remain the same at an average of $60-80 per hour per doctor. So, at four patients per hour at our current rate of seeing them we are just covering clinic costs and providing this service for free," she said.

"I am very upset as a physician in practice for over 20 years that the government is promoting and funding a service for my patients to call an unknown physician, with no access to my patients' charts, when I am available for the same service," wrote Edmonton general practitioner Dr. Alice Bedard.

According to Alberta government spokesperson Steve Buick, doctors with Babylon are paid under an Alternative Relationship Plan based on the fee for a basic office visit of $38.

Continuity of care

Some doctors also said the app won't give patients the continuity of care they would receive with their own family doctor.

Dr. Ruoh-Yeng Chang said Babylon seems like the equivalent of a walk-in clinic where whoever answers the call will not know a patient's history.

"This is an undermining of existing family practices and the relationship between family doctors and their patients," she said.

"We are the medical home. Patients can call us with concerns and we will talk to them. Now they are being told to call someone else instead."

Other doctors raised similar objections.

Community pediatrician Dr. Natalie Forbes said the introduction of Babylon undermines the important goal of ensuring all Albertans have a "medical home" to receive care.

"Babylon is substandard private health care, funded by our government, putting money into the pockets of Telus," she wrote. 

Appropriate compensation

Dr. Kimberly Dary, a child and adolescent psychiatrist at Edmonton's Stollery Children's Hospital, said it's going to be increasingly important that the doctors in her field are able to continue to treat patients as the health crisis evolves.

"Right now, families are experiencing heightened anxiety, significant panic, children are not in school. There's going to be an escalation of psychiatric emergencies," she said.

But the emergency room is the not right place to see those patients during a pandemic, she said.

Dary said it's vital that the government quickly find a means of appropriately compensating physicians as they are forced to move to virtual delivery of health care.

"This is not a 10-minute phone call. Our assessments and followups are very in depth," she said. "Right now, there's no support from the government to moving us to doing this."

Buick said in an email to CBC News that the Babylon platform is not intended to replace the traditional family practice.

"It provides a new and convenient option for publicly funded virtual physician visits to supplement existing services," he said.
    
Health Minister Shandro promoted the new app on Twitter, where there were also several posts critical of the service.