P.E.I. releases telehealth contract as Opposition raises new concerns about private health care

The P.E.I. government provided media with copies of its contract with a private telehealth service provider Thursday, as the Official Opposition opened a new front in an ongoing battle over the private delivery of health care.

Greens raise billing, privacy concerns, accusing government of offering two-tier health care

Through the Maple virtual care program, Islanders are able to consult with a doctor via text, phone, or video conference. (Carolyn Ryan/CBC)

The P.E.I. government provided media with copies of its contract with a private telehealth service provider Thursday, as the Official Opposition opened a new front in an ongoing battle over the private delivery of health care.

That contract is a software services agreement with Maple Corporation to provide the platform for virtual appointments with family doctors as part of a pilot program that began in August.

Under the pilot, the thousands of Islanders on the provincial patient registry waiting to be assigned a family doctor have been invited to set up an account to be able to access a doctor online.

During question period Green MLAs raised concerns about the program, and said the party had tried to obtain a copy of the contract through a freedom of information request but had been denied.

"Why are you refusing to be open and transparent about the details of the contract with Maple?" Opposition health critic Trish Altass asked the health minister during question period.

"One of the many dangerous things with contracting private companies to deliver public services in health care, or anywhere else, is that it ends up putting a barrier to transparency," Altass said. 

There was no rationale provided as to why the opposition's request would have been denied, and the contract itself includes a clause explaining how it can be released through freedom of information.

The contract, dated Aug. 15, 2020 but signed on Nov. 30, details set-up fees for the service totalling $30,000 plus a software licensing fee of $5,000 per month, in addition to a flat fee of $36 for each weekday medical consultation using the service and $57 per weekend consultation.

The province said there were nearly 1,400 consultations between Island patients and doctors employed by Health PEI using the software in the 2020-21 fiscal year.

Opposition health critic Trish Altass asked why the province didn't release a telehealth contract the Opposition requested through freedom-of-information. Government promptly provided copies to the media, and the minister promised to table the contract Friday. (Legislative Assembly of P.E.I.)

Altass said she hadn't been provided with a copy of the contract, but had been advised by the minister that he would table a copy in the legislature Friday.

Among the concerns raised by the Opposition Thursday, MLA Lynne Lund raised questions about wait times to use the service, and whether the health care system was being double-billed when people using the service were directed to an in-person medical appointment.

"I've heard from some constituents in Summerside who have tried to use Maple to access health services and found the experience disappointing," said Lund. 

"It seems like a lot of people spend a lengthy amount of time in the wait queue, only to be told to go to the ER or to the clinic.... Does Maple bill government for providing a get care recommendation? If so, wouldn't that essentially be double charging the system?"

Wait times up to two hours

Health and Wellness Minister Ernie Hudson did not have an answer to that question.

A statement provided to media later in the day said wait times range from a few minutes to two hours.

The province said there is a fee if a patient is directed to seek further medical attention after a virtual consult with a physician.

But the province said the software also provides screening questions to patients who log in for an appointment which can direct them to seek in-person medical aide, in which case there is no charge.

The Greens also raised concerns during question period about privacy, saying people who use Maple are targeted afterwards with ads on social media, and questioning how the platform uses confidential patient information.

In its statement, the province responded "The platform is secure and patient privacy and confidentiality are utmost priorities. The contract does not permit Maple to share data or information with any third parties."

It's not the first time during this sitting of the legislature that government has been criticized over private sector involvement in the delivery of health care services. Both opposition parties have been critical of the role Medavie Health Services could play in the eventual deployment of mobile mental health response units in P.E.I.

Premier Dennis King said his government views the issue differently from the opposition.

"I think it's a service we're trying to provide," he said. "I think that it's the evolution of many different aspects of health that we have to talk about … we have to look at new ways to do things in an ever-changing environment, in an ever-changing world."

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