The purpose of this submission by the Canadian
Society of Telehealth is to detail the important benefits to the
health of Canadians by the comprehensive application of Information
and Communication Technologies (ICTs) to our Healthcare System.
As background, The Canadian
Society of Telehealth is comprised of more that 200 members
across Canada. The membership includes healthcare providers, academics,
individuals from the private sector, and professionals from federal,
provincial, and territorial Ministries of Health. Our vision "is
to be the nation's leader in the promotion of Telehealth and an
advocate for its integration into the healthcare system to improve
the health of all Canadians". Our definition of "Telehealth"
is broad and consists of 5 components: A. Medical treatment and
diagnosis at a distance (Telemedicine), which generally means
real time interactive videoconferencing between a patient receiving
advice from a consultant at a distant site. Participants are connected
over high-speed phone lines (e.g. ISDN) and high-speed private
networks. Examples include Telepsychiatry, Teledermatology, Telecardiology,
and Teleradiology.
The entire range and volume of Telehealth activities has increased remarkably especially in the last year aided by significant grants and other investments by all levels of government, most notably Health Canada. Telehealth activities now occur in all Canadian Provinces and Territories. As the Romanow Commission is aware, the Premiers' meeting on health in Winnipeg in August 2000 was an important milestone for the Canadian Health Care System. Agreement was reached on the principles of what is needed to sustain our publicly funded system. In addition to a Vision Statement, the Premiers published a plan for Priorities for Action on Renewal and Innovation. In the Paragraphs below, I have listed the Premier's 11 Priorities and indicate how Telehealth applications will aid in achieving success for each.
1. Access to Care
The Premiers agreed that access to health services is of highest
priority to all citizens. There is now ample experience in Canada
and elsewhere that Telehealth can provide quality health care
for a great variety of medical conditions, involving all specialties
of medicine, nursing, and other health disciplines. Telehealth
is obviously most important for Canadians in remote locations
or where an appropriate specialist is unavailable, but there is
much to be gained in urban settings as well. Examples of how Telehealth
and electronic links can increase and provide better provide access
in less remote areas include: access by individuals who cannot
leave their home or community; efficient connections between local
emergency rooms and specialists at central better equipped sites;
development of "a virtual intensive care units" in a
region minimizing transfers between units. With the advent of
robots and other new technologies it is already possible i to
perform surgery and other diagnostic and treatment procedures
remotely, adding an entire new dimension to distance consultations.
2. Health Promotion and Wellness
The Premiers recognized that all provinces and territories are
already engaged in strategies to promote health and prevent illness.
Increased Internet access for Canadians is improving our ability
to provide health and wellness knowledge to our entire population.
Strategies that are outlined by Industry Canada's National Broadband
Taskforce are supported by the Canadian Society of Telehealth
for they will further improve the quality of information that
can be delivered, and expand the number of communities and homes
that will have access to health information.
3. Appropriate Health Care Services- Primary
Care
The Premiers recognized that improvements
to primary care are crucial to Canadian health systems' renewal.
Wide deployment of Telehealth will ensure that the goal of having
health care as close to home as possible by the most appropriate
provider will be met. By providing expertise directly to local
primary care providers and minimizing travel, Telehealth will
improve the efficiency of care through more timely diagnosis and
treatment, less need for repeat studies, fewer inappropriate referrals,
and a decreased number of patient transfers.
4. Action on Health Human Resources
The Premiers directed the Ministers
of Health to identify approaches to improve the education, training,
recruitment, and retention of the health work force. Experience
in several Canadian Provinces has already shown that the scheduled
and impromptu education and training programs by videoconferencing
can be of great benefit to professionals in communities in which
these activities were never previously available. These electronic
meetings have been shown to reduce feelings of professional isolation
especially for providers in the more remote communities. When
coupled with the upgrading of skills that these sessions afford,
a positive effect on recruitment and retention in under-serviced
areas can be expected.
5. Home Care and Community Care
The Premiers noted that home care and community care are the fastest
growing health Services in Canada. At the same time, care in the
home and community is also identified as one of the weak points
of our current system. The provision of nursing services by tele-homecare
using video phones over ordinary telephone lines is now undergoing
extensive trials in Ontario, New Brunswick, the United States,
and elsewhere. A related use can be seen in the innovative PACE 2000 project in Ontario that uses videophones to provide social and medical
links for a community of seniors in the Ottawa region. Early results
indicate that these Telehealth strategies should have enormous
impact over the next several years in many homes and communities.
This application of Telehealth in home and community care deserves
very strong consideration in future plans in light of our aging
population needing more medical and social services as close to
home as possible.
6. Action on Pharmaceutical Management
The Premiers identified a need for Canadians to have access to
new, appropriate, and cost effective drugs and have pledged to
work to together to develop strategies to assess and evaluate
prescription drugs. Sharing of drug data that relate to effectiveness,
adverse affects, cost, and best practices will be facilitated
by new electronic data systems for communication between medical
professionals, consumers and the pharmaceutical industry.
7. Health Information and Communications
Technology
In this section of their report the Premiers focused on Telehealth
and information and communications technology.. They fully recognize
that investments in these technologies will lead to a more integrated
and coordinated delivery of health care services. By linking the
various elements of our health system, and making an individual's
health record simultaneously available to all involved medical
providers, Telehealth technologies have the potential to eliminate
much of the "chaos in care" now experienced. A single
Electronic Health Record will be an important component of a renewed
health care system. 8. Health Infrastructure The Premiers reiterated
their commitment to ongoing investment in new equipment, technologies
and facilities for sustaining and renewing the modern health system.
Investment in Telehealth applications is consistent with this
pledge.
9. Sustaining Health Care Services - Ongoing
Health Renewal and Innovation
The Premiers appealed for increased federal aid to health care.
Telehealth promises to maximize the dollar investments in health
care services through greater access, reduced delivery and travel
costs, reduced number of health interventions and tests, faster
treatment, and improved efficiencies. Because of this potential
for cost savings and increased health benefits, appropriate funding
should be directed toward Telehealth in the future. The economic
impact and health benefits of Telehealth have not yet been fully
evaluated, and economic data are often inconclusive. Studies often
focus on short-term economic benefits to governments, and ignore
cost savings to private citizens and long-term health benefits
to society. New investments in evaluation of Telehealth's health
and economic advantages are clearly indicated.
10. Clear Accountability- Reporting to Citizens
The Premiers recognized a responsibility to provide regular status
reports on health to all citizens. Electronic systems will be
important tools to disseminate this information on such items
as: health status of Canadians, health outcomes and quality of
service.
11. Working Together
The Premiers identified the need for various levels of government,
health care institutions, health care providers, and communities
to work together to meet the health care needs of the 21st Century.
The proper and widespread use of information and telecommunications
technologies is essential to overcome many of the current obstacles
to success. In conclusion, the Canadian Society of Telehealth
hopes that the Romanow Commission appreciates the enormous power
of Telehealth as an enabler of many of the important changes that
will be necessary for the evolution and renewal of our health
care system. Telehealth applications should have a prominent role
in the Commission's final recommendations.
©1999 PACE 2000 International Fondation |