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 Thunder
Bay Regional Health Sciences Centre (TBRHSC) is a 375 bed
facility serving a community of 110,000 people and a catchment
area of 270,000. Northwestern Ontario encompasses 526,355
km (the size of France). At times distance, weather, cultural
issues, and bed availability have been barriers to receiving
care at TBRHSC. We have successfully integrated Telehealth
into the services delivered to the region eliminating some
of these barriers.
The Telehealth Program has several goals. First, to deliver
care to underserviced areas within Northwestern Ontario including
many First Nation communities. Almost every discipline has
incorporated Telehealth into how they service regional patients.
Telehealth has supported the delivery of more than 400 educational
events annually for local and regional healthcare providers
and patients. It has become an essential component of training
Family Practice and subspecialty residents in Northern Ontario.
It will be utilized by the new Northern Ontario School of
Medicine. The rapid adoption and integration of Telehealth
into healthcare delivery and education in Northwestern Ontario
has taken Telehealth mainstream. During the period of June
2002 to June 2005, 4961 patients received services via Telehealth,
while 50 specialists in 20 different specialties engaged in
Telehealth.
Vision
- Care Teams fully integrate Telehealth into their way
of providing care.
- Technology becomes available in physician’s offices.
- One of the recommendations of the “Closson Report”
is to ensure 24/7 Telehealth link between TBRHSC and the
region of NWO.
- Incorporate Telehealth into urgent and intensive care.
Steps To Success
- Caregivers at TBRHSC recognized the benefit of patients
in the region receiving care closer to home.
- Increasingly mobile units were taken to the speciality
area to enable Telehealth services to be integrated into
the daily clinical practice.
- NORTH Network’s commitment to support services
(ie: help desk, scheduling and training, and equipment)
have been integral in the success of the program.
Challenges To Success
- The Telehealth Team within Northwestern Ontario worked
through the challenges in communication and technology.
- The phenomenal growth in demand, has far exceeded the growth
of staff resources committed to the program.
- A recent government-appointed consultant report sees
Telehealth as a 24/7 operation for the region but did not
identify funding in order for the growth to occur (see Closson
Report – Integrated Service Plan for Northwestern
Ontario – June 2005).
 Physicians
at TBRHSC also utilized Telehealth for complex patients and
second opinions that required care or consultation from colleagues
in tertiary care centres such as: Hospital for Sick Children,
University Health Network, Ottawa Heart Institute and Sunnybrook
and Womens College Health Sciences Centre. The graph shows
the growth of Telehealth in each care team at TBRHSC during
2003 - 2005. The benefits experienced were tremendous. Healthcare
professionals appreciated the mentoring opportunities, specialists
recognized the desire of patients to receive care closer to
home, the community physicians enjoyed increased collegiality
and education accessed by video consults. The opportunities
for continuing medical education for physicians and all allied
health professionals were quickly embraced. It became an integral
part of training family doctors and subspecialty residents
in the North. The rollout of a regional PACS system in conjunction
with the Telehealth program added greatly to the efficiency
of clinical consults. The improved communication that happened
at a hospital administrative level lead to joint submissions
for PACS and EMR. Telehealth spurred many physicians to think
about eHealth and the positive role technology could play
in patient care. Many were eager for technology within the
office setting. The patients were satisfied that they were
receiving quality care close to home eliminating distance,
time and the danger of travel in the North. For situations
when families were separated by illness, family visitations
via Telehealth were a creative solution. Savings to Northern
Health Travel Program were documented. The program has obvious
value to all participants as seen by its quick adoption and
integration. Consults increased from 200 to 2500 per year
representing a 1250% increase between 2002 and 2005.
The top users of Telehealth at TBRHSC:
- Oncology
- General surgery
- Gastroenterology
- Cardiology
- Nephrology
- Psychiatry
- Orthopaedics
- Paediatrics
It is evident that Telehealth can be incorporated into every
service that a regional hospital provides. Whether it be clinical,
educational or administrative, Telehealth can play a crucial
role in the management of rural patients with complex and
chronic illnesses. Telehealth services integrated into rural
and remote communities offer an effective means of accessing
care closer to home. The expectation would be that improved
outcomes would occur in the elderly, very young and the chronically
ill. At TRBRHSC, Telehealth is an effective tool in assisting
in the education, support and training of all health care
professionals.
Laurie Sherrington
Regional Coordinator
Phone (807) 684-6713
Email: Sherrinl@tbh.net
Karen McPhail
Coordinator
Email: mcphailk@tbh.net
Dr. T. Bruni
Medical Director Telehealth
Phone: (807) 684-6712
Email: brunit@tbh.net
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