TeleHealth
For many First Nations and Inuit communities, the nearest hospital,
doctor or nurse may be hundreds of kilometres away. In many cases,
this gap can be bridged using TeleHealth - technology that allows
patients, nurses and doctors to talk as if they were in the same
room.
TeleHealth can be:
- Two physicians discussing a patient's problems by telephone;
- Medical information being transferred, safely and confidentially,
between computers via high-speed telephone lines;
- A patient getting a face-to-face examination by a remotely
located doctor, through interactive video-conferencing; and
- Medical images, previously photographed and stored on computers,
being forwarded later to remotely located professionals.
In Canada, the TeleHealth strategy is to use information and communications
technologies in order to improve access to our universal health
care system.
TeleHealth technology comes in many forms
Some of the TeleHealth applications in use today include:
- Telemedicine - for delivering medical services at a distance;
- Tele-education - for meeting professional and patient education
and research needs;
- Telecare or teletriage - for diagnosing medical problems through
a call centre; and
- Telemonitoring and telehomecare - for treating patients in
their homes.
TeleHealth is a partnership
TeleHealth is not just about technology and information. It's
about people working together toward a common vision: the timely
and appropriate access to essential health care and information,
regardless of location. In Canada, TeleHealth is a partnership
between:
- Health care providers;
- Health care consumers;
- Communications providers;
- Regulatory agencies;
- Professional groups; and
- The community at large.
TeleHealth cannot replace clinicians or other health care staff.
But it can - and does - improve access to health care for people
in remote locations, or whose access is limited by culture, language
or clinical resources.
For patients, TeleHealth means:
- Less time away from home;
- Less time away from work;
- Fewer travel-related expenses, such as gasoline, meals and
overnight stays;
- Care in your own community, where you feel more comfortable
and your family and the medical staff who know you best are close
at hand;
- Local access to a far greater number of specialists to help
your care provider manage your care;
- Faster response times for medical tests and consultations between
your care provider and outside specialists; and
- The ability to participate in face-to-face conversations with
a specialist and your care provider at the same time.
For communities, TeleHealth means:
- Improved health care quality, through the ability to access
specialists when they're needed;
- Greater control to select and access the health care services
needed;
- Wider and more timely access to appropriate health information;
and
- Employment and training opportunities to develop the technical
expertise of local health care providers.
For health care providers, TeleHealth means:
- Improved peer-to-peer communication among health care providers
in remote areas;
- Better professional support, greatly reducing stress and improving
career satisfaction, recruitment and retention;
- Continuing education and training, through videoconferencing
and secure professional web portals; and
- Better integration of community and provincial health care
systems, enabling seamless delivery of services.
Here's how a typical medical TeleHealth exam might proceed, with
you as the patient.
Upon choosing to have a TeleHealth consultation, you are asked
to sign a form that gives permission to send your medical information
to the remote specialist or health professional who would be assisting
with your health care. If you don't sign the form your information
won't be forwarded, but you'll need to arrange a face-to-face consultation
instead.
At the time of your medical TeleHealth appointment, a specially-trained
staff member explains the process and prepares you for a clinical
exam. This exam takes place in a private room, where you can either
be by yourself or with others you choose to have with you - such
as your own doctor, a family member, or anyone else you want there
for support.
Through use of a TV or computer screen, a small camera, microphone
and special telephone line, the exam begins with your picture,
x-rays and other test results being transferred to the remote physician.
Special hand-held cameras are sometimes used to zoom in for tight
close-ups, providing a good view of the problem areas. Other electronic
tools, like a fibre-optic otoscope and digital stethoscope, allow
the physician to examine you as if he or she were there in person.
Everyone can talk freely back and forth during the examination
- and you, as the patient, are encouraged to ask questions. The
health professional, who is visible to you on the screen, is also
sitting in a private room, so your information and any conversation
between the two of you remains private and confidential - just
as if you were having an appointment in person.
There's more to providing care through TeleHealth than simply
installing cost-effective technology. TeleHealth operations must
also fit into the organizational structure of the health care facility,
have administrative and remote medical support, and have the operational
infrastructure to allow the clinical applications to work.
But first and foremost, TeleHealth operations need to meet the
clinical needs of the health care providers and their patients.
This means keeping the meetings personal. And this is where a properly
trained community health worker comes in.
The role of the TeleHealth coordinator is to facilitate the provider-patient
relationship. Whereas cameras, monitors and other pieces of equipment
can make the TeleHealth exam room seem cold and impersonal, the
TeleHealth coordinator's job is to promote the "human factor".
By keeping the use of technology to a minimum and focusing on ways
to increase human contact, the TeleHealth coordinator prevents
the technology from interfering with the relationship.
Before a TeleHealth service is implemented, the TeleHealth coordinator
spends time at the consulting specialist's site of practice, in
order to build their professional relationship. By observing the
specialist's personal methods of practice, the TeleHealth coordinator
is able to better recreate the experience of an in-person consultation
during the subsequent TeleHealth exam. The TeleHealth coordinator
also studies workflow patterns, in order to fit the TeleHealth
consultation seamlessly into the provider's practice.
Additionally, meeting other support staff in person helps establish
the interpersonal working relationships that lead to better cooperation,
communication and staff satisfaction. When the TeleHealth coordinator
is at the remote site, these enhanced professional relationships
encourage personal relationships between the patient and provider.
Research on TeleHealth in First Nations and Inuit communities
Evidence obtained through a recent research project reveals that
TeleHealth is an effective tool for providing health care to First
Nations and Inuit communities in Canada. The National
First Nations TeleHealth Research Project report shows how
the related research was planned, implemented and evaluated, and
also provides educational materials of potential interest to other
First Nations and Inuit communities who may choose to launch their
own TeleHealth projects.
TeleHealth in Alberta
The Alberta
First Nations TeleHealth Program (AFNTP) is an initiative
aimed at redefining health care service delivery to First Nations
communities in the Alberta Region. The initiative's objectives
include developing the technical infrastructure to support TeleHealth
programs, installing videoconferencing equipment, providing continuing
education for nurses in remote communities, and deploying an
information portal that will enable on-line access to thousands
of health-related documents.
Other related sources
These Web sites offer additional information related to TeleHealth.
Some of the following hyperlinks are to sites of organizations or other entities that are not subject to the
Official
Languages Act. The material found there is therefore in the language(s) used by the sites in question.
Canadian TeleHealth associations
Canadian Society for TeleHealth
- Through information and
communication technology, the Canadian Society for TeleHealth
(CST) enables optimal health and healthcare for anyone, anytime,
anywhere.
Telemedicine
International Society for Telemedicine
- The International Society
for Telemedicine (ISfT) exists to facilitate the International
dissemination of knowledge and experience in Telemedicine and
e-Health, and to provide access to recognized experts in the
field worldwide.
Telemedicine Information Exchange
- The Telemedicine Information
Exchange (TIE) is a comprehensive, international, quality-filtered
resource for information about telemedicine, TeleHealth and
telemedicine/TeleHealth related activities.
American Telemedicine Association
- The American Telemedicine
Association (ATA) is the leading resource and advocate promoting
access to medical care for consumers and health professionals
via telecommunications technology. ATA seeks to bring together
diverse groups from traditional medicine, academic medical
centers, technology and telecommunications companies, e-Health,
medical societies, government and others to overcome barriers
to the advancement of telemedicine through the professional,
ethical and equitable improvement in health care delivery.
|
