Manulife is piloting a tablet-based physio program with Sword Health for members on disability, but Canadian proof points are missing
Musculoskeletal (MSK) conditions are the second-largest driver of disability claims at Manulife, trailing only mental health. That burden is what pushed the insurer toward a partnership with Sword Health, a virtual MSK care provider that pairs licensed physiotherapists with AI-enabled technology, despite having no Canadian disability data to show for it yet.
“Although they don't have any Canadian disability data, they have a ton of evidence and data in other markets that gave us confidence that they could positively impact our members. They're a recognized leader in virtual MSK care. They combine licensed physio with innovative technology to deliver personalized treatment. They have a really good track record and a really big business in other markets,” said Doug Bryce, head of health at Manulife in Toronto, explaining the reasoning behind the partnership.
How AI-enabled physiotherapy works in practice
As for the program Manulife is offering, Bryce explained that members who enroll are shipped a tablet and perform their prescribed exercises while the device monitors their movement. The AI tracks form, flags corrections, and packages that feedback for a physiotherapist to review later.
He emphasized that all clinical decisions, like treatment plans, adjustments and recommendations stay with licensed physiotherapists.
“AI isn’t making any decisions. It’s simply an enabler of how the overall program works,” Bryce said. “The AI part is just the enabling of the technology that allows it to be asynchronous, which is what gives you the ability to do this you want it and helps solve that access gap. So if you want to do your physio at midnight, you can go ahead and do that with your tablet.”
Access barriers driving the shift to virtual care
According to Bryce, that asynchronous model is central to the pitch, particularly as physiotherapy access in Canada is a bigger problem than most people realize. While clinics aren’t hard to find, members dealing with mobility limitations, geographic barriers, or restricted schedules can struggle to get the care they need when they need it, he said.
“If you have to drive a long way or you have to get there during certain hours or you’re not able to get into your car, does leave you unable to access the physio that you need,” he said, adding that this drove the insurer to explore virtual delivery as a way to improve recovery times and return-to-work outcomes.
Bryce suggests the program should be viewed as another physio clinic in the Canadian landscape, just one that’s delivered virtually. Members who aren’t comfortable with the tablet-based format or with AI monitoring their exercises can opt out and continue seeing a local physiotherapist.
He framed the offering as part of a broader effort to keep adding options for members rather than replacing what already exists and said he does not expect the program to displace traditional in-person physio in Canada.
Still, the insurer is rolling it out cautiously. Phase 1 covers eligible members on disability. An expansion to all group benefit members with extended health coverage is planned for next year, but Manulife wants hard evidence before it gets there. The disability population was chosen first because the need is acute, outcomes are easier to measure with a case manager involved, and the right member can be matched to the right care more precisely, Bryce explained.
Measuring success across disability outcomes
On the measurement side, Manulife plans to cast a wide net as there isn’t one metric that tells employers whether a health intervention is working, Bryce noted.
Still, the insurer will track member participation, adherence, functional progress, clinical outcomes, member experience, and disability-specific markers like return to work. While plan sponsors are aware the program exists and is available to their members, specific reporting hasn’t started.
When the program does open to extended health coverage members, the billing model will mirror standard Canadian physiotherapy. Members would engage with a Sword physio and submit claims through their existing paramedical benefits.
He positions the Sword partnership alongside other Manulife disability initiatives, including its OSARA program, as part of a broader push to drive differentiated cost outcomes for sponsors.
“We want to keep our members healthier and create differentiated cost outcomes for sponsors,” said Bryce. “We are trying to prove that the program we’re rolling out is effective, that it’s going to drive outcomes for members and sponsors, before we broaden the availability of it,” he said.
