/visit/ and /portal/
Patient
Confirms location, passes the safety screen, consents, pays or uses a health card, joins the visit, messages the physician, downloads documents and prescriptions.
Cannot: See anyone else’s record or choose an outcome.
Platform blueprint
How it runs.
How it goes live.
Who does what, the routine that keeps the clinic safe and solvent, the real-world options for each component, and a phased path from this demo to a first-province pilot.
Roles
Six roles.
Clear boundaries.
/clinic/
Physician
Works a queue limited to provinces where they are licensed; reviews intake, runs video or phone visits, charts, prescribes, signs documents, enters billing codes, refers or declines.
Cannot: See patients located outside their licences or change fees.
/clinic/ plus policies
Medical director
Owns clinical policies and protocols, reviews a sample of visits, declines and complaints, and approves the fee schedule with the physicians.
Cannot: Override another physician’s clinical decision after the fact.
/admin/
Operations
Runs payments, refunds, hardship waivers, the claims export, physician roster, fees, service switches, webinars and the notification queue.
Cannot: Open charts, notes or clinical messages.
/admin/?tab=audit
Privacy officer
Reviews the audit log, answers record-access and correction requests, leads breach response and the privacy impact assessment.
Cannot: Edit or delete audit entries.
Claims CSV
Billing agent
Submits insured claims to each provincial plan under the physician’s billing number and returns rejections.
Cannot: Access the platform; receives only the claim fields.
Administration
The operating
routine.
Each task opens the Operations tab where it happens. Sign in as operations@demo.doctorsnote.ca to try them.
Daily
- Watch queue ageRequests waiting more than an hour get a nudge to the on-call physician.
- Decide fee-reduction requestsApprove or follow up before the visit; ability to pay never delays clinical review.
- Clear delivery failuresBounced emails, failed SMS or pharmacy faxes are resent or phoned through.
- Answer non-clinical questionsBilling, receipts and access issues. Clinical questions go to the physician thread.
Weekly
- Export insured claimsSend the CSV to the billing agent; chase “needs codes” rows with the physician.
- Reconcile paymentsMatch captured charges and refunds to processor payouts.
- Review the audit logLook for unusual chart access, exports or repeated failed sign-ins.
- Publish educationSchedule webinars and check registrations and reminders.
Monthly
- Re-verify physiciansCheck each licence on the regulator’s public register and liability protection.
- Review feesCompare uninsured fees with provincial association guides and complaints.
- Clinical quality reviewMedical director samples notes, declines, referrals and prescribing.
- Access reviewRemove staff who no longer need access; rotate shared credentials.
When needed
- Open a provinceAdd a physician licensed there. Booking opens automatically.
- Pause a service or visit typeSwitch it off; the intake updates immediately and existing requests continue.
- Record-access requestProvide the record within the statutory time limit (no fee in Québec).
- Privacy breachContain, assess, notify the privacy commissioner and patients where required, document.
Implementation options
Real vendors
for every part.
Indicative Canadian-dollar figures for planning, not quotes. The recommended option is marked. Compare and save your own selection in Operations → Build options.
Hosting and database
Where the app runs and where health records are stored.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Cloudflare Workers + D1 (this demo) | ≈ C$10/mo | Ready now | Outside Canada | Fine for the demo and the public site. D1 cannot be pinned to Canada, so not for real health records. |
| Cloudflare Workers + Canadian Postgres (AWS ca-central-1 or Azure Canada) Recommended | ≈ C$120–250/mo | 2–3 weeks | Canada | Keeps the current app and edge security; records live in a Canadian region with encryption, backups and point-in-time recovery. |
| Fully Canadian-owned cloud (e.g. ThinkOn, OVHcloud Beauharnois) | ≈ C$300–800/mo | 4–6 weeks | Canada | Strongest data-sovereignty story for public-sector or Québec partners; more operations work. |
Clinical record
Where the chart lives long-term and who is the custodian.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Built-in chart (this platform) | Included | Ready now | Follows hosting | Intake, SOAP notes, prescriptions and documents in one place. Needs retention, export and custody procedures. |
| Built-in chart + export to the physician’s EMR Recommended | ≈ C$0–50/mo | 1–2 weeks | Follows hosting | Signed notes exported as PDF or HL7 into the physician’s existing EMR. Least change for physicians. |
| Integrate a certified EMR (e.g. OSCAR Pro, Juno, Accuro, TELUS) | ≈ C$300–600 per physician/mo | 6–12 weeks | Canada | Physicians chart in a familiar EMR; best for a large group; slowest and most expensive. |
Video visits
How patients and physicians see each other.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Built-in video + TURN relay (e.g. Cloudflare Realtime) Recommended | Usage-based, ≈ C$20–60/mo | Days | Peer-to-peer; relay outside Canada | What the demo uses, plus a relay for hospital and corporate networks. Media is encrypted end to end between the two browsers. |
| Zoom for Healthcare | ≈ C$30 per physician/mo | Days | Canadian data centre available | Familiar to physicians; launch links from the console. |
| Canadian telehealth video vendor | Quote | 2–4 weeks | Canada | Some provinces publish verified virtual-visit vendor lists, which can matter for public funding. |
Payments
Card holds at booking, capture on completion, refunds.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Stripe (manual capture) Recommended | 2.9% + C$0.30 per charge | Days | Configurable | Adapter already written; needs a Canadian account, Elements card entry and webhooks. |
| Moneris | Quote (interchange-plus) | 2–3 weeks | Canada | Canadian bank-owned processor; more integration work. |
| Helcim | Interchange-plus, no monthly fee | 1–2 weeks | Canada | Calgary-based; transparent pricing for small volumes. |
Prescription transmission
How prescriptions reach the patient’s pharmacy.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Secure e-fax gateway (e.g. SRFax, Canadian servers) Recommended | ≈ C$15–40/mo | Days | Canada | Works with every pharmacy in Canada today. |
| Provincial e-prescribing where available | Varies | Months | Canada | Confirm per province; national PrescribeIT was reported shut down in May 2026. |
Insured claims submission
Getting paid by provincial plans.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Accredited billing agent Recommended | ≈ 3–5% of billings | Days | Canada | Takes the CSV export; handles rejections. Fastest way to start in each province. |
| Direct submission (e.g. Ontario MC EDT, Alberta H-Link, BC Teleplan) | ≈ C$50–150/mo | 2–4 months | Canada | Lower ongoing cost; requires accreditation and maintenance per province. |
Email and SMS
Sign-in codes, reminders and status updates with no health details.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Transactional email (e.g. Resend) + SMS (e.g. Twilio) Recommended | ≈ C$30–80/mo | Days | Outside Canada (no health data sent) | Messages carry no clinical content, which keeps cross-border delivery low-risk. |
| Canadian messaging provider | Quote | 1–2 weeks | Canada | For partners that require Canadian residency for all patient contact data. |
Identity checks
Making sure the patient is who they say they are.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Physician checks photo ID on video Recommended | Included | Ready now | Not stored | Standard for virtual care; recorded as a checkbox in the note. |
| Digital identity verification service | ≈ C$1–3 per check | 1–2 weeks | Configurable | Useful for message-only renewals and higher-risk documents. |
Webinars
Paid and free physician-led education.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Zoom Webinars + platform ticketing Recommended | ≈ C$110/mo for 500 attendees | Days | Configurable | Registration and payment stay in this platform; Zoom only hosts the session. |
| Recorded courses on a video host | ≈ C$20–60/mo | 1 week | Configurable | Evergreen paid content for employers and patients. |
AI scribe (optional)
Drafts the visit note for the physician to review.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Not at launch Recommended | — | — | — | Add after the privacy assessment and physician feedback. |
| Canadian-hosted AI scribe | ≈ C$100–300 per physician/mo | 2–4 weeks | Canada | Needs patient consent each visit and physician review of every note. |
Privacy and security assurance
What a regulator, insurer or hospital partner will ask for.
| Option | Cost | Set-up time | Data location | Notes |
|---|---|---|---|---|
| Privacy impact assessment + penetration test Recommended | ≈ C$15–40k one-time | 4–8 weeks | — | Minimum before real patients. |
| Add SOC 2 / ISO 27001 programme | ≈ C$30–80k first year | 6–12 months | — | For employer, insurer and health-authority contracts at scale. |
Recommended pilot stack
About C$895 a month to run
and C$33,800 to set up.
Indicative. Excludes physician compensation, card-processing percentages, legal fees and insurance. Billing-agent fees scale with insured volume.
Roadmap
From demo
to first patients.
Demo
Now
- Every workflow working on synthetic data
- Present to physicians and advisers
- Collect fee, scope and policy feedback
Foundations
Weeks 1–4
- Operating company, medical director and privacy officer named
- Physician agreements, licences and liability protection verified
- Canadian database, live Stripe, e-fax and billing agent connected
- Privacy impact assessment and counsel review of policies started
Pilot
Weeks 5–10
- One province, two or three physicians, set hours
- Insured visits plus uninsured documents
- Weekly quality and complaints review
- Penetration test before opening publicly
Expand
Month 3 onward
- Add provinces as physicians are licensed
- Employer and insurer accounts, webinars
- EMR export or integration, optional AI scribe
- French-language service before Québec