Telemedicine offers hope for patients and challenges for IT

In five years, more than half the population of Ontario might be able to skip the waiting room and talk to their doctors through a display or monitor – allowing them to get better without having to leave home.

At least, that’s the hope for Dr. Edward Brown, founder and CEO of the Ontario Telemedicine Network (OTN). He was one of the speakers at the Mobile Healthcare Summit on Tuesday, a two-day event bringing together healthcare professionals and IT solutions providers in downtown Toronto.

“Our vision is simple. We want to be able to use telemedicine in a simple way, the way you use a pen,” he said. “Where this is going, of course, is the home … a lot of this activity will move right into the home, right where the patient is.”

Ontario has a relatively small population spread out across a large geographic area, so it’s easy to see why the province was an early adopter of telemedicine. In fact, it’s been remotely connecting physicians and patients for about 15 years. However, thanks to advances in IT, there may come a point soon when this is readily available throughout the province, Dr. Brown said.

Based in Toronto, his non-profit organization receives funding from the provincial government, and it aims to make telemedicine easy and cost-effective, saving the Ontario government about $60 million in subsidized travel costs within the last year, he added.

During his talk, he named about five different ways IT can be used to bridge the gaps between patients and physicians.

First of all, there’s the obvious one – clinic videoconferencing, where patients and healthcare providers use voice and video to interact. Beyond giving people a portal for this on their desktops, the OTN will also be releasing an app for the iPhone and iPad this quarter, Dr. Brown said.

Then there’s also the e-consulting side, where healthcare providers connect to other healthcare providers to share patient data. For example, if a patient comes in with a rash, one provider can get data from another to figure out what caused it – and for a patient waiting to hear back from a dermatologist, this can cut down their wait time to as little as three days, though patients in Toronto often wait for as long as six months.

The third channel is acute care. If a patient suddenly has a stroke, a burn, or requires psychiatric care, using this channel would mean a healthcare provider could be on call, 24 hours a day, seven days a week.

Then there are people who can use telemedicine for educational purposes. There are more than 40,000 events organized in Ontario each year, with many of them held online as webcasts or web conferences, said Dr. Brown.

And then, there are people who have chronic health problems and need to manage their symptoms. For these individuals, one of the best ways to provide care for them is to remotely monitor them, allowing them to stay home. The OTN has a system that matches nurses with patients, and the nurses will ask the patients to set their own goals. Those goals could be as simple as asking how to store up more energy to play with the grandkids, Dr. Brown said.

“That’s kind of radical for us here. Health professionals here, we’re used to telling people what to do. Take this drug, lose weight, go do this, go do that,” he said.

“And the idea here is that you ask the patient – so you ask the patient, what do you care about? And you get some interesting answers … and that kind of work is incredibly motivating, and it actually works.”

However, implementing telemedicine has its share of challenges – many of which are IT-related. For example, vendors need to figure out how to integrate new solutions with the older, legacy systems that providers have been using for years, Dr. Brown said.

Plus, it can be very difficult to scale some of these solutions.

“It’s fun to run a boutique app,” he said. “But to roll it out to 10 or 20,000 people – that’s a different problem.”

And then there are issues with patient privacy and data security. For instance, it’s one thing to authenticate all the physicians who will be practicing telemedicine, but it’s very difficult to authenticate patients who want to video conference with a doctor – after all, there are so many patients within Ontario.

So physicians won’t be using FaceTime as a videoconferencing platform any time soon, Dr. Brown added. Still, he sees this as both a challenge and opportunity for IT companies in the next few years.

“I think there’s a revolution afoot. Like all good revolutions, you don’t know about it ‘til it’s over … like the Renaissance or the Industrial Revolution,” he said. “I think we’re in the throes of the telemedicine revolution right now.”

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Jim Love, Chief Content Officer, IT World Canada

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