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Telemedicine Practice within Canada

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Ashley Elie

on 11 November 2013

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Transcript of Telemedicine Practice within Canada

Telemedicine Practice within Canada
Telemedicine in Canada
Northern, remote and Aboriginal communities in Canada experience a lack of medical resources and services.

Access to medical care is hindered by higher demands in urban areas, lack of provider commitment in remote communities as well as long travel distances and costs of travel (CHI, 2011).

Telemedicine was introduced in the 1970s to address these barriers of health care services to select populations.
Benefits and Limitations to Consumers
Telemedicine Services
Telemedicine services commonly use videoconferencing to virtually connect patients to physicians. Some telemedicine services currently available in Canada include...

The psychiatrist remotely provides patient assessment and care plan to be administered by the family physician.

Telepsychiatry
Immediate connection of neurologist to emergency physician treating the stroke patient. Imaging/scans sent to neurologist for review.

Telestroke
Monitoring of patients with acute conditions, chronic conditions such as congestive heart failure or diabetes, and provision of post-operative care within their own homes.

Telehomecare
Nicky and his family consult with a specalist through telemedicine...
Benefits of Telemedicine
Limitations of Telemedicine
References
World Health Organization. (2010). Telemedicine: Opportunities and developments in member
states. Global Observatory for eHealth Series, Volume 2. Retrieved from http://www.who.int/goe/publications/goe_telemedicine_2010.pdf
McGonigle, D. & Mastrian, K. (2012). Nursing informatics and the foundation of knowledge
(2nd ed.). Boston: Jones and Bartlett Publishers.
Canada Health Infoway. (2011). Telehealth benefits and adoption connecting people and
providers across Canada. Retrieved from https://www.infoway-inforoute.ca/index.php/programs-services/investment-programs/telehealth
Jong, M. (2013). eTELEMED 2013: The Fifth International Conference on eHealth,
Telemedicine, and Social Medicine. Retrieved from
http://www.thinkmind.org/download.php?articleid=etelemed_2013_10_10_40008
Leong, J. R., Sirio, C. A., & Rotondi, A. J. (2005). eICU program favorably affects clinical and
economic outcomes. Critical Care, 9(E22). doi: 10.1186/cc3814
Hjelm, N. M. (2005). Benefits and drawback of telemedicine. Journal of Telemedicine and
Telecare, 11, 60-70. Retrieved from http://telemedicina6.unifesp.br/set/curso/2006-10-23-pgsaude/Fundamental_BenefitsandDrawbacksofTelemedicine.pdf
Chau, P. Y. K., & Hu, P. J. H. (2002). Investigating healthcare professionals’ decisions to accept
telemedicine technology: an empirical test of competing theories. The International Journal of Information Systems Theories and Applications, 39(4), 297-311. Retrieved from http://etidweb.tamu.edu/faculty/beasley/ENTC489/2012_Spring_ENTC489/Chau-InfoManag-2002-telemedicine_adoption.pdf
College of Physicians and Surgeons of Ontario. (2007). Telemedicine. Policy Statement #1-07.
Retrieved from http://www.cpso.on.ca/policies/policies/default.aspx?id=1642&terms=telemedicine

Telemedicine is described as the use of information and communications technology for the delivery of health care services particularly where geographical barriers limit access (WHO, 2010).
Quality of Care
Canada Health Infoway (2011) indicates that quality of care is improved through telehealth programs which support enhanced chronic disease practices, support the application of best practices, develop knowledge and skills in local care providers and enhance the coordination of care.

Telemedicine facilitates the education of primary care physicians and specialized care for patients, as well as promotes an increase in the frequency of consultation for consistent and regular care.
Local Care
Nurses experience less stress as a direct response to the increased access to physicians (Jong, 2013). This enables nurses to devote more time to their nursing specific responsibilities.

More frequent consultation with experts is conducive to knowledge and skill transfer to primary care physicians (CHI, 2011).

Patients receive improved local care as professionals become less overburden by responsibility and gain access to expert support.
Productivity & Efficiency
Reduced time in which a provider travels as well as the ability to work at locations closer to home frees up extra time for them to see an increased number of patients (CHI, 2011). As a result wait times will decrease and treatment becomes more cost-effective. Consultations conducted through telemedicine have been proven to take less time than in person appointments and accommodate tighter scheduling (CHI, 2011).
Access & Availability
Hjelm (2005) indicated the following benefits resulting from the improvement in information and communications technology:

quicker access to health providers
improved equitable access between regions subject to socioeconomic limitations
improved accessibility between primary and secondary care
access to expert care

Location and financial barriers have become less of a concern as healthcare technology improves, facilitating timeliness and availability of services.


Reduced travel costs for consumers and prevention of lost income due to time absent from work.

Reduced healthcare costs allotted for travel assistance to physicians and patients.
Cost Savings
Resistance to Technology
Individuals may be resistant to the use of unfamiliar technology.
Feelings of depersonalization; particularly with the elderly (Hjelm, 2005).
Patients may be inclined to offer less information to providers via videoconferencing.
Physician Commitment
Primary and secondary care physicians both need to commit to providing knowledge and care through information and communications technology (ICT), in addition to their regular practice. Some physicians are opposed to the use of ICTs and others may require extensive training (Chau & Hu, 2002).
Possibility of internet connection failure and hardware malfunction.
In emergency situations the failure of the system could compromise care of a patient.
Vulnerability of the System
Regulation
Telemedicine programs are subject to potential breaches of security and confidentiality.
Concerns of physician compliance to using approved communications technology (ie. use of Skype is prohibited).
Physicians are responsible for ensuring the appropriate and secure storage of patient records.
Discussion
Discuss your personal experiences with telemedicine (clinical consultation/treatment via telehealth services) or type of medical service you would expect to receive through telemedicine as it gains popularity.

How does your province regulate the provision of care through telemedicine?
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