TeleTest’s goal is to improve access, convenience and standardization of the healthcare experience. Over 1 million Ontarians and an additional 500,000 Canadians are without a family physician, and many do not have reliable access to acute or chronic medical care. In every other sector of our society, there has been a digital transformation enabling improved access and improved quality of services. Healthcare has been slow to evolve. At TeleTest, we believe we can help provide a transformative care experience for acute conditions and many chronic diseases - done safely and with the goal of improved health outcomes. We believe convenience doesn’t have to sacrifice quality of care, where it can. Importantly, we understand there is a need to leverage digital tools where they can be leveraged.
We hope we can reduce the number of unnecessary visits to walk-in clinics, and emergency rooms, when they can be safely done so. We also understand that much of healthcare delivery requires a nuanced understanding of a physician assessment in a traditional clinical setting. There is no replacement for that. We are not here to replace your family doctor (if you have one) or the emergency room but help those who have fallen through the cracks by a system that is struggling to bear the load of providing basic medical care. We have access to powerful tools in software, yet no one is delivering on promises that were made decades ago. We think we can make a difference.
We believe the heart of a great medical experience is the knowledge of a physician guiding patients through both simple and complex medical needs. In our experience treating thousands of patients every year, many common themes have emerged:
- Patients with recurrent acute, non-complex medical needs routinely present to our emergency room and walk-in clinics, where intervention earlier in their journey would have improved the timeliness of treatment, improved outcomes and reduced the negative externalities that come with having to interact with the healthcare system (i.e. time lost at work, financial impact).
- Patients with complex medical needs, like diabetes and hypertension, are undiagnosed because the medical experience is challenging and can be unfamiliar. Many patients we see have gone without routine screening bloodwork or mammograms, do not have family doctors, and didn’t seek those tests because they are not aware walk-in clinics arrange them or, in some unfortunate cases, have been turned away because it was a ‘1 issue per visit’ experience.
- Parents and family members struggle to find a family physician when they move to a new city. They worry about losing a family doctor 3 hours away because it is impossible to find one where they live. So they miss appointments and scheduled screenings for fear of losing access to a service they underutilize.
- Patients in rural communities only have access to a local emergency room for assessment of their medical needs.
- Patients who cannot access their family physician in a timely fashion are directed to emergency rooms or local walk-in clinics. In many emotionally trying experiences as physicians, we can often hear frantic patients in our waiting room at the end of the day when our clinic is at capacity stating they’ve already been to 2 or 3 other clinics, and their young child needs an assessment for a respiratory infection or they need medication for a urinary tract infection they’ve experienced before. These patients end up being referred to the emergency room.
- Patients in communities where physician turnover is high constantly live in fear their next family doctor will move to another city or province, worrying about their next diabetic medication renewal or routine bloodwork.
- There is an over-utilization of publicly funded healthcare resources, particularly lab testing. Many patients have their thyroid levels, or B12 levels checked far more frequently using publicly funded lab test resources than is medically necessary because care is fragmented and access to previous lab result data is poor. In its current construction, the current healthcare experience doesn’t always afford healthcare providers a way to provide guideline-based, “Choosing Wisely” medicine. The patient care experience is not standardized and often doesn’t follow guideline recommendations. Many tests are under-ordered, and many are over-ordered. Patients struggle with accessing uninsured testing, and obtain it as an insured test through a walk-in-clinic when it is not guideline indicated.
- A data-driven approach to laboratory testing can identify medical trends that can prompt early intervention. For example, declines in kidney function of 20% represent ‘red flags’ but are routinely missed in the acute care experience because of how the system exists in its current iteration.
- We understand patients bear responsibility for accessing their own medical care. But we also know that many socio-economic and psychological factors play a role in individuals not seeking out the basic healthcare services they ought to do. Reducing friction with the healthcare experience will save lives.
These shortcomings are not meant to ascribe blame to any single individual or institution. We know physicians, nurses and allied healthcare providers are working their hardest to deliver care with the resources they have. We work alongside them every day and see the struggles they experience. We also know patients struggle with access issues on a daily basis and can be empowered to better manage their own care.
Recurrent Urinary Tract Infections
I get recurrent urinary tract infections, usually once every year or two. Each time I head into a walk-in clinic, I usually wait 2 hours to see a physician for a prescription. The last time, I went to 3 walk-in clinics in my neighborhood that were all at capacity. I thought I could deal with it on my own and ended up a week later waiting in the emergency room for 8 hours needing IV antibiotics. With TeleTest, I was tested for a UTI, grew a positive culture and within 24 hours received antibiotics. I didn’t miss work, I didn’t struggle to find someone to pick up my daughter from daycare, and I didn’t have to race around the city looking for an open clinic.
Overactive bladder or Urinary Tract Infection
I have been told I have a diagnosis of overactive bladder, so I get symptoms of a urinary tract infection that doesn’t get better with antibiotics. I also do not have a family doctor and I want to avoid antibiotics at all costs. Getting tested to ensure I don’t have a urinary tract infection saves me a 2-hour visit to a doctor to provide a sample and have someone follow up on the results. I used TeleTest, realized I didn’t have a urinary tract infection and managed my symptoms under physician guidance until they resolved.
STI Testing in a Small Town
I live in a small town where there aren’t too many physicians, and the physicians I know are colleagues and friends. I struggled for many years with getting access to testing. In fact, I avoided STI testing for many years until I discovered TeleTest. I know my physician is a professional, but this is my experience.
I have multiple regular sexual partners, and I want to test routinely. When I lived in an urban center, even with a local health unit and STI clinic, it was a hassle to get tested. Many walk-in clinics I visited were unfamiliar with rectal or throat gonorrhea/chlamydia testing, so these tests were not done. With TeleTest, swabs arrive at my home within 2 days and I drop them off at the lab for testing. I could view my results online and share them with my sexual partners.
I want to get tested more frequently for STIs. Each time the physician asks me the same questions, and in the end, tells me to use condoms. I know that already, I just need to make sure I don’t have chlamydia. It’s hard to wait in a walk-in-clinic ten times a year for a requisition and medical advice that’s been delivered repeatedly. In the past, I just would delay testing until I had several partners.
Visitors to Canada/Working in Canada
I do not have healthcare insurance and don’t quality for OHIP. Accessing basic blood tests like monitoring of my diabetes, or my INR levels while in Canada has been a struggle. Each walk-in clinic visit I visit charges $100 for an assessment, where all I need is a requisition to monitor my INR levels and some guidance about how to change my medication dosages. I have to make monthly visits to walk-in clinics for a new requisition on each occasion and am already struggling financially. In the past, I would just skip testing which I know is unsafe.