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Digital Health Services Survey: What We Heard from Canadians

February 24, 2021

Table of contents

What we heard – At a glance

425

We heard from 425 Canadians about their experience with digital health services.

The top 3 ways respondents say they use digital health services:

  • 72% receive medical advice from a health care provider by telephone
  • 58% have made an appointment electronically
  • 42% access websites, mobile applications, or interactive online tools and services designed to help support monitor their health

72% of respondents say they receive digital health services through their family doctor.

What respondents value as very important when using digital health services:

What respondents value as very important when using digital health services.

What respondents value as very important when using digital health services

The top 3 barriers to digital health services, according to respondents:

  • 23% say they don't have enough information about digital health services available to them
  • 21% say that their other health care provider (e.g. physiotherapist, dentist, optometrist, chiropractor, etc.) does not offer digital health services
  • 20% say that their family doctor does not offer digital health services

The top 3 things that would help respondents increase their use of digital health services:

47%
say their family doctor offering digital health services

47%
say more options or choices for digital health services

40%
say their specialist offering digital health services

Introduction

In December 2020, the Competition Bureau (Bureau) released a survey to hear from Canadians about their experience accessing and using digital health services. The Bureau heard from 425 Canadians,Footnote 1 and the results of the survey will help inform the Bureau's market study of Canada's health care sector, which is examining how to support digital health care through policies that promote competition.

Pro-competitive policies in the health care sector can encourage innovation by health care providers and businesses, and lead to more choice, improved quality, and greater access to products and services for Canadians.

What digital health services do respondents use?

Table 1: Which of the following digital health services have you used?
Response % of respondents
Receiving medical advice from a health care provider by telephone 72%
Making an appointment electronically 58%
Accessing websites, mobile applications or interactive online tools and services designed to help support or monitor your health 42%
Accessing medical records electronically 41%
Providing health records to insurance companies for assessment (medical, dental) against claims or eligibility for coverage 34%
Consulting with a health care provider by e-mail or electronic text message 32%
Requesting or submitting a referral for a prescription electronically 29%
Visiting a health care provider virtually by video 28%
Viewing an electronic version of your referral to a specialist or other health care provider 16%
I have never used or received digital health services 7%
Other 6%
Using medical devices at home that electronically transmit results to a health care provider 5%

Of the respondents who have used digital health services, more than two thirds say that they have done so by telephone. Making appointments electronically and accessing websites, mobile applications, or interactive online tools and services designed to support or monitor health are also commonly-used digital health services.

Respondents also expressed satisfaction with digital health care services and support expanding the availability of such services. Many respondents say that accessing health care services digitally is more convenient and saves time (e.g. less time spent in waiting rooms, less time needed off work). Respondents say that digital health care services are especially useful for routine care and that digital health care empowers them to take control of their own health.

What Canadians have to say…

"Love the idea of expanding. So much easier to book and manage [medical] appointments online and receive things like requisitions through online [portals]."
"Overall, I like virtual care especially for routine things like prescription renewals, discussing treatment options, looking up test results etc. I don't believe that I have access to my medical history/charts in Ontario - that would be nice."
"Having access to one's own medical records, including test results and trajectory of care is critical. As someone with a chronic illness, not having access to all of the information on my medical history is a problem."

How do respondents receive digital health services?

Table 2: How did you receive the digital health services identified in your previous response?
Response % of respondents
From a family doctor 72%
From a specialist (e.g. cardiologist, neurologist, oncologist, dermatologist, etc.) 39%
From another health care provider (e.g. physiotherapist, dentist, optometrist, chiropractor, etc.) 30%
From a pharmacist 23%
From an insurance provider 23%
From a nurse practitioner 15%
Other 14%
From a walk-in clinic 12%
From a hospital or emergency room 11%
From a private service provider (e.g. Maple, Akira, Babylon, etc.) 7%
Don't know / Unsure 2%

Overwhelmingly, respondents indicated that their family doctor is the main way they received digital health services. Respondents also receive digital health services through specialists, such as cardiologists, neurologists, and oncologists, or from other health care providers, such as physiotherapists or dentists. Less than 1 in 10 respondents who have used digital health services did so through a private service provider.

Respondents said that virtual visits with their doctors and/or specialists, when appropriate, can be more efficient and allow them to save time and money by avoiding travel. However, many respondents raised that, in some instances, in-person visits may be preferable to digital services. Some respondents pointed to inconsistences between the types of digital services offered by different health care providers, with some providers able to offer virtual visits over video and others only able to offer visits over the phone.

What Canadians have to say…

"I love phone call appointments with my doctor/specialists. I was able to take a picture and email it and avoid driving, parking, sitting in a waiting room. One [of my health care providers] works 40 km away and overbooks so there is always an hour wait."
"Digital health care is an excellent option for patients, but there should always be the option for in-person care. Awareness [and] education needs to be much higher to ensure this format is more broadly adopted. [It] offers significant cost savings/travel times for patients."
"Access to digital health services is mixed; I have one doctor who launched right into having Zoom meetings, and another, in hospital, who says they are not allowed to use Zoom because it  had problems…"
"For people to use it, it must first be offered! Why is it that platforms such as Well Health Technologies or CloudMD are not available in Québec? There is so much inefficiency in the current system. This is what we need, telemedicine is win-win-win (patients/practitioners/governments)." [translation]

What do respondents value when using digital health services?

Table 3: Please rate the importance of the following items when using digital technology to access health services.
  Not all important Somewhat important Important Very important No opinion
Quality of care 0% 2% 11% 86% 1%
Data privacy 1% 6% 20% 72% 1%
Data security 1% 4% 17% 77% 1%
Easy to access 0% 3% 22% 74% 1%
Easy to navigate 0% 4% 22% 73% 1%
Cost 1% 11% 31% 52% 5%
Timeliness 0% 4% 24% 70% 1%
Convenience 1% 5% 25% 68% 1%

Quality of care, data privacy, data security, ease of access and navigation, timeliness, and convenience are all described as very important by at least two thirds of respondents who use digital health services. In contrast, only 52% of respondents described cost as very important.

Although respondents say that they enjoy the convenience and time savings associated with digital health services, they stressed the importance of data security and privacy. Respondents also expressed that they would like control of their own health information, so that they have confidence in who it is shared with.

What Canadians have to say…

"Security of information and privacy are my top concerns. There should be standardization across the healthcare sector in terms of what services are offered digitally and the processes involved."
"It is more convenient and safe for myself as a disabled person to use the phone. I do not want to go back to in person care."
"I think increasing digital care for those who prefer that decreases barriers to care. I no longer have to take my kids along and sit in a waiting room for over 30-60 min for a 5 minute doctor's visit! I also don't have the physical barrier of finding the location, finding parking, paying for parking etc. It is really much better for me! I feel like my doctors are able to take care of more patients this way."
"My hesitation to use digital health services is the protection of my information, how it will be used and who has access to it. It's my health records and data and I should have control and consent for how it is used by others - power needs to be transferred to the consumer."

What prevents respondents from using digital health services?

Table 4: Has anything prevented you from using digital health services?
Response % of respondents
Nothing has prevented me from using digital health services 29%
I don't have enough information about the digital health services that are available to me 23%
I prefer accessing health services in-person 22%
My other health care provider (e.g. physiotherapist, dentist, optometrist, chiropractor, etc.) does not offer digital health services 21%
My family doctor does not offer digital health services 20%
I need care that cannot be provided through digital health services 20%
My specialist (e.g. cardiologist, neurologist, oncologist, dermatologist, etc.) does not offer digital health services 16%
Other 15%
I have concerns about data security 12%
I have concerns about privacy 12%
I have experienced connectivity and technology issues where I live 10%
I find digital technologies difficult to use 7%
Digital health services are not covered by my provincial/territorial or other health insurance plans 5%
Don't know / Unsure 1%

29% of respondents say that nothing prevents them from using digital health services. However, the top barriers to using digital health services identified by respondents include a lack of information, a preference to access services in-person, and their other health care provider, such as physiotherapist, dentist, or optometrist, not offering digital health services.

Respondents expressed issues related to the accessibility of digital health services, particularly for older Canadians, Canadians with disabilities and those without adequate access to technology and telecommunications services.

What Canadians have to say…

"My experience having access to my record was incredibly positive, but required significant health literacy to be a support to me. I would like to see consistency across digital health services so that a single record can be accessed, or at a minimum that providers can easily share information."
"I'm sure that digital health care has an important role to play, but I prefer face to face meetings with doctors."
"I welcome the introduction of digital health care but lack the knowledge of the technology to feel comfortable using it regularly."
"Access to adequate internet and telephone services is the greatest barrier to digital access in my rural area. Because of this my physician offers telephone consultation however to access this service I need to drive 50km for decent cell phone signal."
"At my age we need support to use technology. Given the pandemic, it is important to be able to discuss electronically with our Family Physician and other health professionals (nurses, pharmacists)." [translation]

What would help respondents increase their use of digital health services?

Table 5: Which of the following would increase your use of digital health services?
Response % of respondents
More options and/or choices for digital health services 47%
My family doctor offering digital health services 47%
My specialist (e.g. cardiologist, neurologist, oncologist, dermatologist, etc.) offering digital health services 40%
My other health care provider (e.g. physiotherapist, dentist, optometrist, chiropractor, etc.) offering digital health services 38%
More information on digital health services 33%
Better technology 29%
Better security for digital health services 24%
Better privacy for digital health services 22%
Greater comfort using digital technologies 16%
Better internet in my area 16%
Other 12%
Nothing would increase my use of digital health services 8%
Don't know / Unsure 6%

Nearly half of respondents say that more options and/or choices for digital health services as well as their family doctor offering digital health services would increase their use of digital health services. And, 40% of respondents say that their specialist offering digital health services would increase their use of digital health services.

Many respondents say that having a family doctor that offers digital health services encourages their use of these services. Respondents also say that there needs to be more information on what digital health services are available and how to use them. 

What Canadians have to say…

"More support needed to navigate online health information - what is reputable? How can it support my decision making, and when I need to see a physician?"
"Everyone I talk to doesn't realize that digital health care is an option. They're now learning it is only because of the pandemic forcing more advertising of digital services. Elders especially aren't aware of these options."
"The scope of the digital health services is very limited, largely for managing minor illnesses, prescription renewals and mental health counselling. There is a much greater potential, but currently digital health services are disjointed and disconnected from each other. Without standardized personal health records it is impossible to share my medical profile with digital health providers."
"Some computer equipment (tablets, cellular, etc.) is not always designed to use these health services. Many people have outdated equipment. Costs associated with equipment and Internet service. Public places are not confidential. Assistance to seniors and people with disabilities for equipment that is not suitable for them. Is the choice to use the video up to the doctor, patient or both?" [translation]

Conclusion

This summary report highlights the results of the Bureau's four-week long Digital Health Services Survey. The feedback received from this survey will help inform the Bureau's market study, which is examining how to support digital health care in Canada through policies that promote competition. For information on the study, please visit the Bureau's market study portal.

For questions or comments pertaining to this report, or the Bureau's health care market study more broadly, please contact the market study team.

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