Meet your new receptionist: How AI is answering the call in Canadian clinics

The telephone never stops ringing. Your admin assistants are burned out and harassed by irate patients. Turnover is rampant and replacements are not only difficult to recruit but take time to train. On the other side of the equation, patients are fed up with busy signals and waiting on hold. If all this sounds familiar, you’re not alone . . . but help is on the way.Dr. Mohamed Alarakhia, CEO of Amplify Care, formerly the eHealth Centre of Excellence, had his epiphany when he needed the services of a glass company to replace a broken windowpane.“I called a random company in the area that had good reviews, and I spoke with Sarah,” he recalled. “She was lovely and empathetic about my broken windowpane. Sarah was an agentic AI agent, but I didn’t know that until the very end of the conversation when I noticed some subtle repetitions and thought, ‘This is a little off.’ It was phenomenal, so if a glass company can use this technology, I thought, why can’t we use it in healthcare?”Turns out, we are or are starting to. At least two companies—Phelix.ai and Strello Health—have together several dozen clinics across the country using the technology and a startup, Medini Inc., poised to join them.Read: Backers behind Evidence2Practice tools wonder why most Ont. FPs aren’t using these EMR toolsHassaan Ahmed, founder and CEO of Phelix.ai, was aware of the need for a better way of handling incoming calls in a medical clinic from his own experience as a medical assistant at the Appletree Medical Group while working on his BSc in biopharmaceutical science at the University of Ottawa. Ahmed went on to earn an MSc and PhD in medical biophysics from Western University.Phelix.ai began using interactive voice response technology requiring patients to press numbers on their phone’s keypad to respond to questions, but as AI took off, the company introduced its current agentic AI application and is in the process of replacing the older IVR or interactive voice response installations. Ahmed claims a total of 30 clinics using its technology across the country.Strello Health was co-founded by Dr. Reza Mirza, a rheumatologist practising at St. Jospeh’s Healthcare in Hamilton, Ont., Dr. Ali Qamar, a family physician in Thorold, Ont. and software engineer Ali Sharif of Toronto. The company soft-launched its agentic AI solution in June 2024 and is currently live in five clinics with another five or six scheduled to go live in the next two months. On top of that, said Dr. Mirza: “We have a chain of 20 clinics in British Columbia that wants to start right away and 50 or so clinics on a wait list.”Medini Inc., a startup launched by Dr. Fayyaz Rizvi, a second-year resident physician, and Dr. Michael Zon, who is also working on a PhD in biomedical engineering, is in the process of developing a solution, but looking for funding assistance for a pilot.Phelix.ai is currently integrated with two EMRs—Oscar Pro and Accuro—and is under evaluation by Telus Practice Solutions. The virtual agent greets patients, asks for their name and date of birth and the reason for their call. A knowledge base provided by the clinic lists 30 to 50 reasons for a call and how the agent is expected to handle them. It triages medical complaints, so a patient complaining about chest pains, for example, would be instructed to hang up and call 911. The agent asks callers when they would like to make an appointment, assesses the urgency of the complaint and links to the EMR calendar to find an open slot.The virtual admin assistant can also respond to queries about parking or whether the clinic is accepting new patients. It can access a fax server to respond to a caller inquiring about the status of a referral. It can access the patient chart to tell a caller if their lab results have been received and can book an appointment or even send the patient the report if that’s what the clinic prefers. Phelix.ai is also working on a way to fill cancelled appointments and handling requests for prescription refills by creating a task for the doctor to complete.Phelix.ai has its own PBX or private branch exchange telephone system to which a clinic routes its calls and reroutes any calls back to the clinic’s front desk if a patient prefers to speak with a real person or if the agent is unable to handle a query or complaint.“The technology is able to deflect 30% to 50% of calls, so that’s a big win right there,” said Ahmed. Another benefit is that it increases the call answer rate at the front desk, resulting in fewer busy signals and voice mails.Strello Health’s AI virtual assistant is currently integrated with three EMRs—Telus Practice Solutions, Med Access and Accuro—with two more – Juno and Oscar Pro in the works. The Strello application is able to access the EMR’s calendar but doesn’t currently link to the patient chart, although that could change in the future.Both the Strello and Phelix applications use large language models that have ingested a wealth of knowledge, even including Canada’s LMCC and its U.S. equivalent, said Dr. Mirza, “so in some ways the system is even more capable than untrained front desk staff. If someone says, ‘I’ve fallen and hurt my elbow,’ the system might ask, ‘Can you move your elbow,’ or ‘Is it swollen?’”No data from the application is retained on the servers housing the large language model, nor is it used for training.Strello Health employs an experienced, Canadian-trained admin who reviews randomly selected call logs as well as those flagged for having “a negative sentiment” or taking too long to complete “because given that AI is a new technology, we strongly believe in the idea of a human in the loop,” said Dr. Mizra. If necessary, Strello staff will call the clinic to report an issue.While most of the existing implementations are geared to English speakers, Strello equipped one clinic in Toronto with a Russian voice model to better serve its Ukrainian and Russian patients. Additional languages can also be accommodated for clinics with large numbers of new Canadians.Dr. Mirza estimates that its virtual admin assistant technology is managing up to 70% of incoming calls. The technology is still in its infancy and will certainly evolve in terms of its functionality and potential client base, he predicts. Functionality can expand to include outbound calls, integration with fax servers to respond to queries about referrals and reminder calls for appointments booked by front desk staff. Potential clients, he noted, include hospital outpatient clinics and independent radiology clinics.Virtual AI admin assistants are more than a boost to efficiency. They’re cheerful, polite and empathetic all the time. Even when the caller is rude to them. They’re reachable 24/7 and there’s no being left on hold, no need to leave a voicemail, no busy signals.Here’s a link to some sample patient encounters with Amy. (Just scroll down.)Looking further into the future, Amplify Health’s Dr. Alarakhia predicts we will also see agentic AI patient coaches that can educate and coach patients with heart failure or other diseases, monitor their weight and glucose through integration with smart scales and other devices and offer advice.Also in the offing are personal coaches for medical students and practising doctors. “We’re not there yet, but that’s where it’s going,” said Dr. Alarakhia.In the meantime, the virtual admin use case can help to ease the pressures on Canada’s overstretched primary care system, he noted. “In Ontario we’ll be short 3,000 receptionists in healthcare as we expand team-based care. We need to hire more staff but we don’t have them. This is where agentic AI can play a role.”

Meet your new receptionist: How AI is answering the call in Canadian clinics

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