With all levels of government in on the action to cures what ails the health care system, it is not surprising that e-health talks at this week’s Showcase Ontario e-government conference in Toronto were well attended.
Like the recent meetings between the federal and provincial governments, there were no panaceas offered though there was a general agreement that technology will play an important role in the future of Canadian health care.
But there is some catching up to do. Health care is “actually very far behind” other industries when it comes to its use of IT, said Lorelle Taylor, CIO of the Human Services Cluster with the Ontario Ministry of Health and Long-Term Care. In the travel industry an agent can usually book a reservation for a customer with a single phone call or click of the mouse. But when an Ontario doctor is looking for a specialist to see a patient of hers, she has to call each doctor individually until she finds one with an opening. IT could help create a centralized booking repository so a doctor could find the right doctor, in the right location at the right time.
The fundamental problem, Taylor said, is that medicine in Canada is still too paper-based and because of this patient records do not easily follow them from one location to another. She said the number one complaint of medical interns and residents is the time they spend physically searching for patient documents such as x-rays.
Though she admitted IT will play an important role in solving this sort of problem, she was adamant that “this is not where the emphasis of the discussion should be,” rather that the focus should be on more patient-focused health care.
Several regions in Ontario are doing just this. One problem in a country like Canada is the geographic limitations of medical care. Patients are often hundreds if not thousands of kilometres from specialists. The Telemedicine Networks of Ontario brings remote patients together with their family doctors into a virtual world where real-time diagnostics can occur between, for example, Sioux Lookout and Toronto.
It is essentially two-way video conferencing over a secure IP pipe, said Ed Brown, a Toronto-based doctor who is part of the North Network which services cities as far north as Hudson’s Bay. “We are doing that every day in Ontario.”
An example of telemedicine is a doctor in Fort Severn using a handheld patient camera, a device even Dr. Brown admits looks like it is made by toy maker, to photograph a mole, transmit it live to a dermatologist in Toronto and have a diagnosis right then and there. The result is no travel and no lost days of work for the patient — as was the case in the past — if they were to go to Thunder Bay or further south to see a specialist.
“We are seeing real patients in real time,” said Kathy Crone, executive director of Care Connect. It is the Ottawa-based equivalent of North Network. She said in 2004 they have seen a 142 per cent increase in the use of their network for clinical activity. An Ottawa-based cardiologist can “dial into Renfrew, Pembroke, Deep River or Cornwall” and see a dozen patients in a day, she said.
The network used by CareConnect, North Network and VideoCare (a telehealth network covering south-western Ontario) is the Smart System, run by the Smart Systems for Health Agency. It is a privately run IP network where all data is encrypted during transmission to protect patient privacy.
Crone and Brown both admit there are hurdles to overcome for telemedicine to really take off. One problem being worked on is the integration of CareConnect, North Network and VideoCare’s IT systems. “Right now the three networks are not interoperable for clinical work,” Brown said. This means an Ottawa-based specialist, who might be both available knowledgeable, can not help a patient in Sioux Lookout. Over 100 telemedicine sites are connected over the Telemedicine Networks of Ontario helping to diagnose thousands of patients annually.