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Making the connection When health is at risk, an eight-hour drive and an overnight stay in another city doesn't seem like a lot, but repeating that kind of trip over and over begins to takes its toll. This is something Vic Dufresne understands well. When his 11-year-old daughter Theresa was diagnosed with stomach problems he made regular trips from La Ronge to Saskatoon for her to see a specialist. This meant missing work for two days each time, arranging for his daughter to be out of school, getting the car ready for a long road trip and booking a hotel room in the city. He knew that was what came with living in a remote location - the lack of specialized health care that is available in larger cities. But then one of Theresa's doctors suggested something that helped to change all of this - telehealth. Telehealth is all about connecting patients with doctors. This alone isn't all that ground breaking, what is, is the distance between those doctors and their patients. Telehealth is not an over-the-telephone health service; it connects patients and doctors through the latest in communications gear including two-way cameras, wired-for-video examination rooms and video examination tools that a few years ago might have only existed in science fiction stories. Dufresne's daughter was one of the first patients to use the La Ronge telehealth suite. By using the new service, the appointments with the Saskatoon specialist became more like regular appointments. “It's just like being in the doctor's office,'' says Dufresne. He describes walking into the room with the microphones and cameras and listening to the doctor talk to Theresa as if they were in his office hundreds of miles away. But Dufresne says one of the most convincing reasons he supports the system is that his daughter's stomach problems are now better. And, he is grateful for the time saving and personal financial benefits telehealth provides. “I feel we received the same amount and quality of care that we would have got if we made the long trip to Saskatoon ,” he adds. “I would 100 per cent recommend using telehealth to anyone who has to travel to meet with a doctor.” Today, travel time for medical appointments for rural, isolated patients from the far north to the far south is significantly cut as they can connect with city-based specialists who have access to a Saskatchewan Telehealth suite. Telehealth Saskatchewan is now available in 18 locations across the province. By the end of 2005, 26 sites will be in operation across the province with telehealth available in every provincial, regional, district and northern hospital.The Saskatchewan Telehealth system is designed to be used for patient care as well as distance training. However, “patients always come first,” says Mary Deren, telehealth coordinator for the Weyburn General Hospital . While a strange situation at first, these patients quickly become accustomed to seeing a doctor in a setting miles away through the use of technology. During a telehealth appointment different equipment may be used to allow the patient to see the specialist in another site, or to help the telehealth coordinator during the examination. Equipment used at a telehealth site includes video cameras, monitors, and communication lines that allow connection with other sites. A telehealth workstation looks like a typical office computer with a large webcam on top of the monitor. But similarities between a typical office computer and a telehealth workstation end with the monitor and keyboard. The workstations are about four times the speed of home users, so the video feed is like watching television rather than watching the jumpy video from an average web-cam. The security of a telehealth network connection is also much higher than the kind of network security of a home-based or office-based computer. The telehealth workstation is on its own network built to meet the strict codes set by the health care system's stringent privacy protection act. Along with the main camera, there is a patient camera. This camera is set for close-up viewing of wounds or whatever is necessary for that particular session. Other equipment connected to the system includes a microphone, a flatbed camera to view printed materials or X-rays and an adaptable screen interface to allow the user to display computer-based output on the screen - from presentation slides to patient care charts. Since its initial development in 1999, more than 1,600 patients have used telehealth. Currently Telehealth Saskatchewan offers physicians and other specialists access to three scheduled clinics based in Regina and 10 scheduled specialist clinics based in Saskatoon. Saskatchewan health care workers can also access specialist clinics, seminars and consultations from other parts of Canada connected to the telehealth network managed provincially through the Health Information Solutions Centre (HISC). While the benefits of telehealth are ideal for providing immediate service for patients in rural and remote areas, it also has other important uses. Deren sees it as a recruitment tool for rural hospitals and as a way to continue education in a remote hospital as it allows health professionals to conference with their colleagues no matter where they are located. “It offers doctors the chance to consult other specialists about cases that they would otherwise have no one else to consult with.” It is an important tool in reducing the sense of isolation often felt by rural health care providers. A unique use of telehealth in Weyburn is ultrasound testing as all ultrasound images are now viewed live by a radiologist in Regina . In Weyburn, a technician or nurse operates the ultrasound camera through the direction of a radiologist in Regina. On the monitor in Regina, the radiologist can see the image being scanned by the camera in Weyburn. The image appears in the radiologist's lab in Regina, just as it would if the camera was being operated next to the machine - but in this case it's being operated on a patient who is more than 100 kilometres away. The system also links health care facilities with two-way video conferencing tools to bring participants together through wires rather than through hours of traveling. It is used for very highly specialized training as physicians can learn new treatments or how to use new equipment through a telehealth seminar rather than booking time off from work, finding a replacement and traveling. Using the telehealth system allows health region staff the ability to learn new technologies fast, with the experts, without having to travel hundreds to thousands of kilometres. As well as courses for health care professionals and patients(such as surgery preparation), there are courses held through telehealth for the public. The Saskatchewan system also offers telehealth-based clinics on diabetes, and preparation for hip surgery. “Once people start leaning about it; the opportunities are endless,” says Deren. It's these opportunities that resulted in the expansion of the Saskatchewan Telehealth system. Later this year, the Stony Rapids Health Centre in the Athabasca Health Authority will become a part of the telehealth network. “Stony Rapids represents our most northern hospital and is a pilot for non-terrestrial connections between a hospital and the rest of the Telehealth network,” says Ron Epp, manager of Saskatchewan Health's Telehealth project. The Stony Rapids Health Centre will be connected to the province's telehealth system through a satellite connection rather than the physical hard-wired, land-based line connection used at the current telehealth locations in the province. If the test project is successful it will mean remote locations will be able to connect to telehealth no matter where they are. Earlier this year, Saskatchewan Health announced new telehealth locations in Saskatoon (City Hospital), Regina (Pasqua Hospital), Humboldt, Melfort, Tisdale, Estevan, Melville and Lloydminster. This expansion also means that every health region now has a telehealth coordinator. Next steps include making telehealth available to rural ambulance services. Telehealth would then be on location for paramedics to connect with trauma teams. This would result in providing help to paramedics from a hospital-based trauma team to assess and treat patients at the scene of the accident. In the area of education, Epps says he would like to see telehealth linked to other video conferencing networks in the province, to reach even more northern and isolated communities. “Someday soon, we will ask ourselves 'what did we do before telehealth?'” |
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