Caution Urged for Virtual Care Partnerships in Canada

Provincial governments that partnered with for-profit virtual healthcare companies, and those considering doing so, must be cautious to protect public trust, experts warned in a new analysis.

Marilynn Larkin, Medscape News Canada November 5, 2025

“To address the primary care access crisis, some provincial governments have partnered with virtual care corporations to provide formalized pathways to phone-, video-, and text messaging-based medical care,” wrote Lauren Lapointe-Shaw, MD, associate professor of medicine at the University of Toronto, Canada, and colleagues.

“However, there are risks associated with direct-to-consumer virtual ‘walk-in’ care, related to access, quality of care, and data privacy,” they wrote. “These risks require careful consideration, particularly as formal partnerships could further entrench corporate virtual care within Canadian healthcare systems.”

Lapointe-Shaw noted that corporate partnerships “arose out of provincial governments facing primary care access challenges for their populations. Partnerships offered a way to quickly expand some form of primary care access.

“However, where healthcare budgets are fixed, increasing access to one form of primary care can come at the cost of further investment in other forms of care, such as high-continuity primary care, which has demonstrated benefits across a range of outcomes,” she told Medscape News Canada. “As well, the relatively frictionless nature of corporate virtual care means that there is a greater risk of supply-induced demand, where patients seek more care for minor and self-resolving conditions, such as viral upper respiratory tract infections.”

The analysis was published November 3 in CMAJ.

Partnership Models Varied

Researchers identified current partnerships between corporate care platforms and provincial or territorial governments after doing a structured Web search in November 2024. They defined a corporate virtual care partnership with a provincial government as cases that met the following criteria: Virtual healthcare services were provided by a shareholder-owned corporation, such as Telus or Teladoc Health Canada, not a physician medical professional corporation; they had a formal contract; and they provided services endorsed on the government’s official health services website.

Ongoing corporate virtual care partnerships were identified in the following four Canadian provinces: New Brunswick, Newfoundland and Labrador, Nova Scotia, and Prince Edward Island. Even though the stated reason for establishing corporate virtual care partnerships was to support primary care access, the partnership models varied and had benefits and risks.

For example, although virtual care services were provided free of charge to patients who were not registered on a primary care clinician’s roster (ie, unattached patients), New Brunswick offered two corporate-provided virtual care programs, one of which offered services to both unattached and attached patients. Another program offered virtual and in-person appointments to patients on the primary care wait list. By contrast, in Nova Scotia, the corporate provider had two tiers of care, one of which was available to unattached patients for on-demand virtual visits.

Information on other services and pricing was sparse for all the programs.

‘Implied Endorsement’

The potential benefits of these partnerships, according to the authors, may include increased convenience and access for patients who cannot travel to their nearest primary care clinic or hospital, such as those with mobility issues, those who can’t take time off work, and those who need to arrange childcare.

The authors identified several potential risks, however. One relates to access to and equity of care, since video- and text-based visits benefit those who are confident working digitally, have high internet bandwidth, and have a device that can connect to the internet. Virtual-only walk-in care also can create demand that might not otherwise have existed, which has implications for healthcare system use and costs.

These partnerships also entail risks related to the safety and quality of care, particularly when access to medical records is limited and there is no physical examination or relationship between the patient and physician. Privacy and transparency risks also arise, since virtual care corporations are private, investor-owned third-party companies with an incentive to generate profits. Finally, the partnerships entail higher risks for patients with limited fluency in the clinician’s language, those with disabilities, and those with complex pre-existing conditions.

Governments must be aware that when they partner with corporate care providers, “endorsement of the quality of services they provide is implied,” the authors wrote.

“Corporate virtual partnerships may also further entrench private companies within the broader healthcare system, becoming a permanent fixture even if provinces later improve access to full-service longitudinal primary care,” they continued. “Ongoing checks and balances are necessary to ensure standards are met and rules are not breached.”

Furthermore, Lapointe-Shaw said, “ We do not know how well on-demand virtual care works in comparison to other forms of last-resort care, such as walk-in clinics and going to the emergency department.

“Walk-in clinics and emergency departments have higher operating costs but allow for a physical exam to be completed, which is essential in the assessment of many conditions,” she continued. “Information on the effectiveness and efficiency of last-resort care across these settings for those without a regular source of primary care could inform the development of better care pathways.”

For now, she said, “Most important is improving overall transparency [of these partnerships], including being transparent about the terms of virtual care contracts as well as ensuring independent evaluation of corporate virtual care processes and health outcomes achieved.”

‘Substantial Investment’ Required

Onil Bhattacharyya, MD, PhD, director of the Women’s College Hospital Institute for Health Systems Solutions and Virtual Care and associate professor at the University of Toronto, Canada, commented on the article for Medscape Medical News.

“While there are legitimate risks in partnering with the private sector, particularly regarding data privacy and security, the ability to respond quickly may be advantageous, given staffing constraints and rising demand in many regions,” he said. Bhattacharyya did not participate in drafting the article.

“If the overarching goal in Canada is to increase patient attachment and strengthen capacity for comprehensive primary care, it is essential to ‘right-size’ episodic virtual care programs, corporate or not, so they do not take away human resources from comprehensive primary care delivery,” he said. “For this to happen, these programs need to be flexible and responsive to changing demand, which may make corporate partnerships attractive at certain points in time.”

That said, he added, many of the issues highlighted in the article (ie, limited access, lack of system integration, usability challenges, costs, and concerns around safety and quality) also apply to noncorporate, government-funded virtual care programs. “The main difference is that these programs are not driven by profit or data monetization, though they also tend to move more slowly, which can limit their ability to scale.”

Corporate healthcare partnerships are not limited to virtual care, he noted, pointing to Medavie Health Services New Brunswick, which provides land and ambulance services, home health services, community paramedic programs, 911 services, and telehealth services.

“These models thrive in part because current primary care models are underdesigned and often subscale, because of the ad hoc structure of most clinics,” he said. “Incorporating a range of communication channels such as voice, video, and text, as well as in-person care, with new workflows could increase access, comprehensiveness, and continuity, but it will require substantial investment and ongoing iteration on how care is organized and delivered.”

Lapointe-Shaw reported receiving research funding from the PSI Foundation and a grant from INSPIRE-PHC. She also reported salary support from the PSI Foundation Graham Farquharson Knowledge Translation Fellowship and the Myrna Daniels Seniors’ Emergency Medicine Centre at the University Health Network. Bhattacharyya reported no relevant financial relationships.

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDEdge, The Lancet (where she was a contributing editor), and Reuters Health.

Source Medscape News Canada

References

Government partnerships with corporate virtual primary care, Christine Salahub, Lindsay Hedden, Tara Kiran, M. Ruth Lavergne, Sheryl Spithoff and Lauren Lapointe-Shaw. CMAJ. November 03, 2025 197 (37) E1230-E1234; DOI: https://doi.org/10.1503/cmaj.250639

Characteristics and Health Care Use of Patients Attending Virtual Walk-in Clinics in Ontario, Canada: Cross-sectional Analysis, Lapointe-Shaw L, Salahub C, Bird C, Bhatia RS, Desveaux L, Glazier RH, Hedden L, Ivers NM, Martin D, Na Y, Spithoff S, Tadrous M, Kiran T.  J Med Internet Res. 2023 Jan 12;25:e40267. doi: 10.2196/40267.

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