AI-Enabled Urgent Care and Connected Diagnostics Access Model

Problem Statement:
Canada faces a growing primary care access and continuity gap. Many patients are unattached to a family physician, and many who have a provider cannot get timely same-day or after-hours care. The default fallback is a walk-in clinic or an emergency department, which provides access but often produces fragmented records, poor continuity, duplicated work, and avoidable downstream burden on family practices and emergency departments.

The opportunity is not simply to recruit more physicians, which is a slow and costly lever, but to increase the effective capacity of the existing workforce by redesigning the workflow around the encounter. A virtual care platform with embedded AI documentation features (i.e., AI scribe) can reduce administrative burden and one physician can safely cover more appropriate low-to-moderate acuity encounters across a longer effective day. Canada Clinics is seeking a solution that makes this queue-and-alert model operationally practical: patient workup is completed by clinical staff on site, the case is flagged when it is ready, and the on-call physician either reviews and calls the patient back or comes online promptly by secure video or phone to complete the encounter. Decoupling patient workup from physician time is the core efficiency mechanism of this project and the central capability the selected solution must enable.

Objectives:

• Enable a queue-and-alert encounter workflow that separates staff-supported patient workup from physician time, so an on-call physician can cover a longer effective clinic day
• Support dual check-in pathways under one unified numbered queue: optional patient self check-in by QR code, kiosk, or mobile link, running in parallel with a nurse-assisted path
• Capture structured intake and symptom information with AI assistance, including acuity and red-flag routing
• Support nurse-guided connected examination at the point of care, with examination media stored in the encounter record
• Present the on-call physician with a physician-ready review queue with urgent alerting, supporting both deferred callback and real-time completion
• Reduce clinician administrative burden through AI-assisted documentation with clinician review and sign-off
• Route laboratory and point-of-care results into the encounter record and physician review queue, with pending-result and abnormal-result tracking
• Close the loop with patients and family physicians through visit summaries, electronic handoff, and follow-up task tracking
• Operate as one connected encounter workflow rather than a collection of disconnected tools, and interoperate with the site’s existing EMR (TELUS CHR) rather than replace it

Essential (mandatory) outcomes:

• Extended effective access hours beyond current opening hours without continuous physician presence
• Reduced average patient wait time for same-day and urgent care needs
• Increased same-day capacity and throughput per physician hour, without proportional physician headcount increase
• Where incorporated, on-site blood work feeding the physician review queue and reducing separate lab visits
• Reduced clinician administrative burden through AI-documentation features
• Improved documentation quality and more timely communication to patients’ family physicians
• A validated, replicable workflow applicable to other clinics, FHO after-hours settings, employer/campus sites, retirement communities, and rural access points
• Reliable communication back to family physicians via automated visit summaries

Required capabilities:

• Digital front door with dual check-in pathways (optional self check-in by QR code, kiosk, or mobile, plus a parallel nurse-assisted path), a unified numbered queue with patient-flow management, and consent capture
• Staff workup checklist and nurse-guided connected examination capture (digital otoscopy, digital auscultation, throat and skin imaging, vitals), with examination media stored in the encounter record
• Physician-ready review queue with urgent alerting, supporting both deferred callback and real-time completion
• Secure audio and video capability allowing an off-site physician to communicate directly with patients at the access node or at home
• Physician-initiated online waiting room that lines patients up for sequential encounters in the most efficient order
• AI scribe or documentation support with clinician review and sign-off
• Family physician handoff by eFax or electronic summary, and prescription communication by eFax to the patient’s pharmacy of choice
• Ontario privacy and security compliance (PHIPA), Canadian data residency, role-based access controls, and audit logging
• EMR interoperability with TELUS CHR or a practical EMR-adjacent workflow
• Interoperability with connected examination hardware

Complementary / Nice to have features:

• Wait-time estimation and patient status notifications
• Operational reporting dashboard covering throughput, physician time per encounter, and documentation completion
• Patient-facing multilingual support

Out of Scope:

• Autonomous AI diagnosis or treatment, and AI-generated prescriptions without clinician review
• High-acuity emergency care
• Replacement of physician, nursing, or staff judgment
• Pharmacy operations, pharmacist virtual consultation, remote pharmacist supervision, and remote dispensing. These would be treated only as a future optional module subject to regulatory review
• Operation of an independent laboratory by Health Hub
• A purely direct-to-consumer virtual care application with no physical access node
• Full EMR replacement

Canada Clinics operates a single site in Niagara Falls, Ontario, and the commercialization project is designed around that site’s real staffing pattern. Planned physician coverage during the commercialization project is 24 to 36 hours per week of in-person encounter blocks, subject to locum availability, supplemented by up to 20 hours per week of on-call remote review through an alert-driven queue. Nursing and clinical support staff are on site throughout operating hours to handle intake support, vitals, connected examination capture, and specimen coordination. Baseline patient volumes and throughput will be documented during project initiation and will serve as the commercialization project baseline.

This local pattern reflects a broader national challenge. A substantial share of Canadians do not have a regular family physician, and many of those who do cannot reliably access same-day or after-hours care. Emergency departments and walk-in clinics absorb a significant volume of visits for conditions that a redesigned access model could manage more efficiently. Communities across Ontario and the rest of Canada report the same pattern of unattached patients, long waits for same-day appointments, and reliance on episodic care settings, which indicates a shared rather than isolated problem.

This gap exists largely because physician time, not clinic capacity, is the binding constraint, and most clinic workflows still assume the physician is present for every step of the encounter. Recruiting additional physicians is a slow and costly lever. At the same time, the available technology tends to sit at one of two extremes: EMR and booking tools built for scheduled in-person visits, or direct-to-consumer virtual care applications with no physical access node and no staff-supported workup. Neither supports the middle model this project targets, where trained staff prepare the encounter at a physical site and an on-call physician reviews, calls back, or joins by video to complete it.

Without a connected workflow built for staff-supported workup and off-site physician review, Canada Clinics and clinics like it will continue to leave usable capacity unused, patients will continue to wait or default to emergency departments, and family physicians will continue to receive incomplete or delayed information about care their patients received elsewhere. A validated workflow would be replicable well beyond one site, including FHO after-hours settings, additional clinic locations, employer and campus sites, retirement communities, and rural access points. Canada Clinics estimates 3 to 10 additional deployment sites within 12 to 24 months of a successful commercialization project, and is willing to act as a reference site and champion the solution to peer organizations.