Improving healthcare in northern communities through telehealth

Successful telehealth projects need to meet certain criteria, says a private telehealth consultant who has worked in many remote and rural areas in Canada that serve large aboriginal populations.In an interview following a forum on aboriginal health and remote access earlier this year, Rod Elford, a clinical assistant professor at the University of Calgary and director of Calgary-based Digital Telehealth Inc., described lessons learned in implementing telehealth projects targeting aboriginal populations.The overall health status of aboriginals in Canada is poorer than non-aboriginals, and is certainly cause for concern, stresses Elford, a staff physician at 8th and 8th Health Centre in Calgary and medical director of Health Link Alberta. With life expectancy being shorter, higher incidences of diabetes and significantly higher suicide rates requires a different approach," he says. "There should be a special strategy to improve the health of aboriginal people. Telehealth should be part of the strategy," Elford tells Network Letter. The expanded use of telehealth for aboriginal communities would result in increased health services to these Canadians, and more regular baseline screening to prevent worsening of disease, he adds."If we have videoconferencing, it is more likely a patient who needs mental health services will be seen by a psychiatrist in a timely manner," says Elford. "The patients can be treated at a distance. We can provide care where there was none before, decrease the delay to a consultation, and will ensure more regular follow-up of patients."But even before getting to the deployment stage, obstacles have to be identified and possible solutions found. "There are several barriers to providing telehealth in remote and rural communities," says Elford. "There are not a large number of healthcare providers in their community, and they may or may not have access to high-tech telecommunications or high-tech workstations."Consequently, connecting all workstations, peripherals, and telecommunications links together and testing the system is a necessary step to ensure efficiency of a system.The first step to implementing a telehealth project that serves remote and rural communities is to perform a needs assessment, says Elford. "The key is you have to figure out what the needs are for the project and what technology will be necessary," he explains. "If it is mental-health services, you need to see and talk in real time and videoconferencing is the best avenue. The bandwidth needs to be there in order to have a good quality image and good audio." If the project were focused on screening for diabetic complications, a high-resolution image is necessary, but real-time communication is not, according to Elford."It's important that the technology be able to take a very sharp image, and that it not be too dark or that there not be too much flash," says Elford. "The communication can be asynchronous and doesn't have to take place in real time. A method known as store and forward can be employed. Audio is not required either. The images can be captured and then forwarded to a dermatologist over a secure network for review at a later date."Elford was involved in a project on screening for retinal complications related to diabetes. A technician was present in a northern community who took pictures of patients' eyes and forwarded those images to a specialist in Edmonton, who reviewed the images for abnormalities."It was certainly less expensive to do this than to have all the patients fly to Edmonton, according to our cost analysis," says Elford. "The quality of images was satisfactory, and this method ensured that everyone got an annual exam. While the purpose of the exam was to look for problems in the eye related to diabetes, the clinician saw other problems that required treatment."Until the private sector sees a return on investment (ROI) in developing telecommunications infrastructure in remote areas, it will be incumbent upon government to do so. And just as levels of government infuse monies to build infrastructure like roads in northern communities, funding is necessary to create telecommunications infrastructure to allow telehealth to flourish, says Elford."There is not a business case to have broadband built up north to provide health services," says Elford. "This will have to be financed by federal and provincial funds."Ultimately, entertainment demands and e-commerce will likely spur private sector members to develop telecommunications infrastructure in the north if they see the ROI, predicts Elford.

Improving healthcare in northern communities through telehealth

News | April 3, 2007

Unlock all the Canadian telecom, broadcasting and digital media news you need.

FREE TRIAL

SUBSCRIBE

Inside The Wire Report

Information

Hill Times Publishing

Get in Touch With Us