Spotlight on: Telemedicine

Dr. Michael Humer is a thoracic surgeon working in central British Columbia, where he serves an elderly patient base living in a large, sparsely populated area. The biggest challenge to providing effective healthcare to his patients is their ability to access the system. His solution is telemedicine.A typical telemedical consultation involves a patient in one location and at least one specialist in another location, all linked by cameras and computers. For the patient, it means a visit to the local doctor’s office, where a coordinator, usually a nurse, facilitates the interaction. Specialized instruments make it possible to effectively evaluate patients by transmitting images, recordings, and other diagnostic materials.Dr. Humer estimates that approximately 30 per cent of his patients benefit from the regular use of telemedical services. By providing a proximal, convenient location for patients to engage with the system, telemedicine reduces the financial, physical, and psychological burden on patients of having to travel significant distances to meet with their healthcare providers.

The concepts behind telemedicine seem quite basic but, in fact, this type of coordination and information sharing represents a significant innovation. There is opportunity for improved efficiency and minimization of error in this integrated system, which is why it is useful not only for people living in remote areas, but for everyone who deals with more than one healthcare provider.

In many parts of Canada, electronic health and medical records are being created alongside, or in addition to, telemedical services. These records allow family practitioners, specialists, and other healthcare professionals to access particular, but pertinent, pieces of information relating to the medical history of a patient.For example, knowing what medications a patient is on and associated allergies can be an obstacle to effective care. The onus currently resides with patients to provide a full medical history, a particularly challenging task for the elderly. With that information stored in a central, accessible location, the risk of a bad interaction or duplication of service can be effectively eliminated if records are maintained properly. This can result in an overall savings for the healthcare system, a lesser risk of medical error, and an improvement in care for patients.The other benefit of increased communication that telemedicine provides is the ability to collaborate. Specialists looking at an x-ray can consult with others in different locations about the proper diagnosis. Speech pathologists whom patients used to visit face-to-face by travelling to their practices, can now meet with local speech assistive workers as well. Together they can create coordinated treatment plans, rather than the onus being on the patient to accurately relay treatment information from their specialist to their primary provider.

Privacy, security, and confidentiality are, of course, a concern for patients and doctors alike. While records, associated images, and other diagnostic materials are thought to be secure, these issues have been identified as needing a more adequate resolution in order to increase country-wide adoption of an integrated electronic healthcare/telemedical system. There are still challenges to be overcome. Balanced with the benefits of coordination, the potential to create a secure, integrated system remains on the horizon for Canadian healthcare.