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Is There a Distinctly “Vancouver” Watch?
When Darren Entwistle, president of Vancouver-based Telus Inc., took the microphone at a press conference in Thornton Park in the Downtown Eastside last fall, onlookers could easily have confused him for a politician.
Entwistle, who speaks with the intensity of an embattled platoon commander, has long called for a revolution in Canadian health care. Under his leadership, Telus—which has 55,000 employees and is B.C.’s biggest company—has invested $2.5 billion in a widening array of health-related businesses. These investments have given the company a pivotal presence serving more than 20,000 doctor’s offices across Canada. Meanwhile, to further cement the company’s role within Canada’s $250-billion health-care industry, Telus has been tasked by the federal government with building a long-overdue national electronic network for drug prescriptions that Ottawa says will dramatically improve control over prescription opioids and other hard-to-handle pills. In short, this is not your grandma’s phone company. (Although it may now be one of her health-care providers.)
At Thornton Park, Entwistle was talking about Telus’s Health for Good initiative, a $5-million program that’s deploying mobile “clinics on wheels” for the homeless and other vulnerable people in downtown Calgary, Montreal, Vancouver and Victoria. “Working in collaboration with community partners and organizations,” Entwistle boomed to an audience that included Dr. Patricia Daly, chief medical health officer for Vancouver Coastal Health, “we’re bringing health care directly to the community and helping a traditionally underserved group.”
Seen in isolation, Telus’s generosity in paying for all this might be viewed simply as a typical bit of philanthropy aimed at building public goodwill for a company with an already impressive charitable record. With 13.4 million customer connections, annual revenues above $14 billion, assets worth more than $20 billion, and profits of well over a billion dollars last year, it’s safe to say Telus can afford it.
But extending a helping hand with local health care is not a community relations issue for Entwistle: this is a man who is, in his own words, “complexly obsessed” with the need for a bottom-to-top transformation of every aspect of Canadian health care. And Telus—which, until 20 years ago, was a stodgy government-owned phone company that also managed a lot of government health records—is Entwistle’s vehicle to achieve that transformation. As he said in Thornton Park, “The cornerstone of our passionate social purpose is our heartfelt commitment to enabling better health outcomes for our fellow Canadians.”
And you thought Telus was just a phone company?
Juggy Sihota, who serves as vice president of Telus Health, was also on hand with Entwistle in Thornton Park last September. In an interview afterward, she echoed Entwistle’s passion: “We’re trying to revolutionize access to health care,” she averred.
Unlike sports and media-obsessed Bell and Rogers (Telus’s main competitors in the big leagues of the Canadian telecom industry), said Sihota, “Telus is not buying sports teams and we’re not spending a lot of money on broadcast rights.” Instead, like Vodafone in Europe and AT&T in the U.S., Telus is going after data-rich health-care services as a highly lucrative “content area” that will help keep its internet infrastructure humming and growing, while expanding into delivering clinical services both as a contractor to governments and as a vendor to private patients.
In an era when Canadian governments begrudge the resources to bring health care into the information age, Telus has pounced on the opportunity. “We’re already the largest health informatics provider,” Sihota explained about her company’s expansive role selling data services to public health systems across the country, “and now we’re starting to offer health-care services.”
“We’re already the largest health informatics provider,” Sihota explained about her company’s expansive role selling data services to public health systems across the country, “and now we’re starting to offer health-care services.”
A 2012 video produced by Telus noted that “the top five issues where health information and communications technology can make a huge difference” are chronic disease management, medication management, access to health care, illness prevention and health-care system performance improvements. Telus’s subsequent big-ticket investments have followed this road map. In 2013, Telus purchased Practice Solutions, a suite of electronic medical records technologies now used by many Canadian doctors.
In 2017 it won the federal contract for a national prescription drug management system. In 2017, Telus launched a national system that allows doctors to communicate electronically with each other about their patients. Last year, Telus broke into the business of directly delivering clinical services to patients by purchasing Medisys, which operates 24 private clinics. Then, last September, Telus partnered with Babylon, a company that connects patients with clinicians using “virtual medical appointments.”
In an environment where talk of private, profit-oriented delivery of health-care services remains a nationwide taboo, causing electoral shipwrecks for governments that even nod toward privatization, Sihota speaks with refreshing candour about the imperatives propelling Telus’s quest. “Health care is bursting at the seams,” she warns, “and the private sector has to get involved to ameliorate the problems.”
Terry Lake, who served as B.C.’s health minister between 2013 and 2017 and now works as vice president of a Gatineau-based cannabis corporation, sees Telus’s health-care push as a “shrewd strategy” that has “huge national scope.” As health minister, Lake partnered with Telus to deliver virtualized home health-care monitoring services for B.C. seniors. “It was a sound strategy,” Lake explained on the phone from his home in Kamloops recently. “We’ve got a baby boomer generation that needs home health care, so home health monitoring makes perfect sense.” Telus’s strategy of opening up virtualized health-care services is also sound, Lake believes. “For many seniors, that’s super-convenient. We have difficulty getting to see physicians—so virtualized access, when appropriate, makes perfect sense.”
But David Chan, a software engineer and professor emeritus of family medicine at McMaster University, in Hamilton, Ontario, is also watching Telus’s health-care strategy with acute interest. “They’ve been extremely adept at carving out a huge market share by acquiring electronic medical records systems,” he observes.
As the inventor of a highly successful non-proprietary publicly owned medical records system that competes with Telus’s products, Chan knows what he’s talking about. The federal contract to build a national electronic prescription system offers Telus the chance to earn “micropayments” from billions of transactions between doctors, patients, pharmacists and drug companies, he muses. But as Telus takes control over a growing swath of Canadian health care, Chan worries that our dependency on the company, and its highly proprietary technologies, deepens by the day. “The day may come,” he warns, “when we find ourselves wishing we’d stuck with a public ownership model for our health-care system.”