The doctor will see you now

Home care providers and IT experts are cheering the results of one of the largest Canadian telehealth projects, but some people say increased broadband access has to be part of the prescription.

We Care Home Health Services

Thursday said 95.5 per cent of the 78 people involved in a six-month pilot gave high marks to technology that could allow nurses to conduct remote visits. Patients would interact with We Care staff via a videoconferencing link through their television sets. March Networks supplied the technology, while Aliant Telecom hosted patient data on a secure Web site. The interface was designed to allow patients to initiate a visit by clicking on a green button and ending it with a black button. Clips on a patient’s finger would allow nurses to remotely check for vital signs.

At a press conference and Webcast a March Networks employee in Ottawa checked the blood pressure of a patient, Sandra, at her home in Halifax, where the pilot was conducted. The measurement was 150 over 80 — somewhat higher than normal.

“”Sandra appears to be a bit wired today,”” joked Bob Webster, vice-president and general manager, March Networks Healthcare Applications.

Health-care providers and the IT industry have high hopes for telehealth as a means of treating the long-term problems we could face as the population ages and a nursing shortage looms.

Dr. Richard Scott, Health Telematics Unit, University of Calgary, provided an independent evaluation of the project. He said the 78 patients were divided into a control group that received traditional in-person care and other which also received telehealth visits.

He said the school reviewed 1,062 visits reviewed and concluded that 86 per cent of home care visits could be accomplished by home telehealth. This translates into approximately 16 to 20 visits a nurse could conduct a day rather than the average of nine in person.

“”It behooves all of us — the federal, provincial and regional health authorities — to partner with us and extend these pilots across the country,”” said John Schram, CEO, We are Home Health Services.

Webster and March Networks chief executive Terry Matthews said broadband was a natural for telehealth because the cost goes down the more it is used, while video connections aren’t as good over plain old telephone service (POTS) lines. But during the question and answer period following the presentation, several members of the audience grilled the executives over the lack of access to broadband among many Canadians — particularly in remote First Nations Communities — who could most benefit from telehealth.

“”What would you do?”” Matthews asked in response to an audience member who wondered what had to happen to increase broadband availability. “”What we showed here was the acceptability of the technology. We are in the process of making this a production for homes; that’s pretty much done. Where to go next — should we set up a separate company that would provide services across the country?””

Matthews added that all the stakeholders interested in telehealth need to have more discussions with the federal Ministry of Health to see if they can muster the same support that Industry Canada has put towards increasing access.

He also pointed out that the number of always-on broadband users is now about 25 million people across North America, indicating a shift is happening on its own. “”The ubiquity becomes assured. Without that, this would not have been possible.””

Dr. Rashid Bashshur, president of the American Telemedicine Association and director of Telemedicine, University of Michigan Health System, said there should be no problem making a business case for broadband.

“”When patients get sick, quite often they don’t just get sick with one problem. Medical imaging is a hog when it comes to bandwidth,”” he said. “”A prudent investment of the future is systems that are going to deliver.””

In the meantime, Bashshur said the industry has come a long way since he first began preaching telehealth back in the 1970. “”We were lucky if five people would listen to us,”” he said. “”I’m not going to say what I was referred to — it means something like a kook.””

Telehealth visits in the project took about 11 minutes and were conducted once or twice a week, officials said. The study population consisted of patients 45 years of age or older with chronic diseases including cardiac illness, respiratory illness and cancer.

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