Seven times out of ten, Clic Santé offers a private clinic

Around 70% of the services offered on Clic Santé are offered in a private clinic, shows a survey by The Press. And more than half of the services offered on the platform in which Quebec has invested 77 million are paid.

Created in 2013, the Clic Santé online reservation portal took off in the midst of the COVID-19 crisis to support the Legault government’s screening and vaccination campaign. With some 75 million reservations to date, it has become the main health appointment platform in Quebec.

However, the paid services offered on the site now exceed those covered by the Régie de l’assurance santé du Québec, without regard to availability, shows an exhaustive analysis of The Press.

“We have been sounding the alarm several times,” recalls Xavier Gauvreau, vice-president of Médecins québécois for the public system.

Check a print

Does Clic Santé offer as much visibility to the private sector as D patients report?^r Gauvreau, resident in psychiatry? To check it, The Press has performed thousands of automated searches on the platform. We obtained 1.3 million appointment proposals. In more than half (52%) of cases, these were paid options, while seven in ten (70%) results pointed to private clinics.

To our knowledge, this is the first measurement of the place of the private sector in the largest health appointment booking platform in Quebec.

The ratio of offers where you have to take out your wallet increased to 88% in the case of a consultation for a child. More than seven out of ten options were “with fees” when it came to consulting a doctor (70.3%) or making an appointment with a mental health professional (75.2%).

Reservations or offers?

Trimoz Technologies, the Saguenay–Lac-Saint-Jean company behind Clic Santé, explains that there is a difference between the appointment offers on Clic Santé and the reservations that users actually make to make an appointment you in a clinic, pharmacy or public establishment.

If we first examine the offers, Trimoz spokesperson Maxime Couture states by email that “92% of the appointments offered on Clic Santé are for free services.” Our analysis of the offers shows instead 48% of free services for our 50 virtual patients, during three days of testing.

Trimoz explains in these terms the difference between his methodology and that of The Press : “Consider a one-hour time slot offering 10 different services, only one of which is free. In our methodology, we consider this niche as “free availability” because it offers at least one free option accessible to citizens. […] Your approach, on the other hand, counts this same slot as 90% with fees (9 services) and 10% without fees (1 service). »

The methodology of The Press reflects what was indeed offered to the population on Clic Santé over the course of three different days in recent weeks.

Regarding reservations made by users, the Trimoz spokesperson writes: “Across the entire Clic Santé platform, in the last week, we observed 92.63% of appointments free of charge. » He adds that this statistic is in line with the annual average for 2024.

However, it is impossible for us to analyze confirmed appointments. Trimoz refuses to transmit its data “for commercial reasons”.

The D^r Xavier Gauvreau also denounces the opacity of Clic Santé: “It’s extremely problematic,” he says.

“Our priority is to ensure the availability of a sufficient number of appointments for vaccination and screening, in order to adequately meet the needs of the population,” indicates Santé Québec, the new state corporation responsible for coordinating operations. from the health network, in an email.

The agency emphasizes that it does not have a target ratio between public and private services.

Distance first

Trimoz also explains that the order in which results are displayed is based solely on “proximity to the patient,” which is consistent with our experience. A pharmacy or private clinic, he notes, “cannot pay to appear higher in search results,” as retailers can do on Amazon, for example.

The health organizations and companies that use Clic Santé all have special agreements with Trimoz, which has around fifty employees. These are flat-rate contracts in the public network, while private clinics and pharmacies generally pay per use, depending on the company.

The owner of a telehealth platform told us a cost per reservation of $0.85, but the rate varies considerably depending on the volume of customers, Trimoz nuance. In the public network, the fees included in the contracts are 75 cents, indicates Santé Québec.

This amount allows users to make an appointment, receive reminders, modify the date and location of an appointment, or cancel it if necessary. “This flexibility offered by the platform represents a considerable advantage, particularly in a context of labor shortage, by significantly reducing the pressure on establishment staff,” says the agency.

Trimoz also argues that Clic Santé allows establishments to reduce their costs of managing appointments internally. This element represents the largest portion of the system developed by Trimoz, a bit like the part of an iceberg that is underwater.

The platform “helps generate annual savings of fifty million dollars for the Quebec health network,” says Maxime Couture.

“Although it may seem high,” the amount invested by Quebec “has made it possible to generate significant savings, both financially and in terms of time savings,” is also the opinion of Santé Québec.

Methodology

We simulated 50 patients living near a hospital or a CLSC (the first three characters of their postal code were the same).

Using a script in Python language, each of our fictitious patients requested each of the 230 services offered by Clic Santé. We have recorded all the appointment offers proposed by the platform and all the details associated with them (name and address of the establishment, type of establishment, price of the service, minutes of availability, etc.). More than 1.3 million offers have been registered.

We made three waves of requests (November 25, November 26 and December 3): the first for an appointment within two weeks; the second for an appointment within 48 hours, the third for an appointment without time limits.

Our approach complies with Clic Santé’s conditions of use.