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Newfoundland & Labrador : 

Newfoundland & Labrador Four regional integrated health authorities (RIHA) including: Central, Western, Eastern and Labrador (Ho & Jarvis-Selinger, 2006) Newfoundland does not have a provincial telehealth network (Ho & Jarvis-Selinger, 2006) Provincial Telehealth Strategy focuses on chronic disease management (Ho& Jarvis-Selinger, 2006) Home of the Telehealth and Education Technology Resource (TETRA) of Memorial University (Ho & Jarvis-Selinger, 2006) (Ho & Jarvis-Selinger, 2006, p. 15)

Newfoundland & Labrador-Services : 

Newfoundland & Labrador-Services Telehealth services in Newfoundland include: nuclear medicine, radiology, neurology and cardiology (Ho & Jarvis-Selinger, 2006) TETRA est. 1976 one of the most advanced telehealth and tele-education services in North America including: conference calling, video conferencing and web based technology (Memorial University, n.d.) Provides continuing education courses for physicians, nurses and other health care professionals (Memorial University, n.d.) TeleCare launched in 2006 partnering with NB to est. contact centre (Government of Newfoundland and Labrador, 2006) Toll free health line, operated by RN, available to residents 24/7 (Government of Newfoundland and Labrador, 2006)

Newfoundland & Labrador Challenges : 

Newfoundland & Labrador Challenges Telehealth not coordinated provincially Insufficient data collection Difficult to track telehealth specialties Most telehealth initiatives only pilot projects Lack of funding (Ho & Jarvis-Selinger, 2006)

Prince Edward Island : 

Prince Edward Island Nearly ½ of the province covered by forest Four health regions including: West Prince Health Region, East Prince Health Region, Kings Health Region and Queens Health Region Currently, PEI does not have a province-wide telehealth network (Ho & Jarvis-Selinger, 2006, p. 21) (Ho & Jarvis-Selinger, 2006)

PEI-Services : 

PEI-Services Canada’s first Telehospice service (Shaw, 2000) Participates in programs that are inter-provincial within the Maritimes such as the Child Health Network (CHN) and Health Infoway Atlantic (HIA) (Ho & Jarvis-Selinger, 2006) Telehealth programs in service in PEI: homecare and mental health (Ho & Jarvis-Selinger, 2006) Telehomecare in PEI started from the West Prince Telehospice pilot project and now has become a sustained telehomecare service (Ho & Jarvis-Selinger, 2006)

PEI Challenges : 

PEI Challenges Lack of telehealth activity Telemental health services focused on education, not on patients Telehealth not coordinated provincially (Ho & Selinger-Jarvis, 2006)

Nova Scotia : 

Nova Scotia First province-wide telehealth network created in Canada Provides inter-provincial services to residents in the Maritimes and in Newfoundland One of the most active and comprehensive telehealth networks in Canada (Ho & Jarvis-Selinger, 2006, p. 18) (Ho & Jarvis-Selinger, 2006)

Nova Scotia-Services : 

Nova Scotia-Services Telehealth services in NS include: dermatology, genetics, geriatrics, lung transplant, mental health, oncology, preoperative, rehabilitation, visitation and patient education Educational programs offered to patients and their families via videoconferencing including: arthritis, cancer care, diabetes, genetics, heart health, osteoporosis and seniors health (Ho & Jarvis-Selinger, 2006)

Nova Scotia Challenges : 

Nova Scotia Challenges Not all telehealth services available province-wide Referrals needed to receive certain telehealth services (Ho & Jarvis-Selinger, 2006)

Quebec : 

Quebec The Quebec Ministry of Health introduced the “Info-Santé” health professional help line to serve the public with health advice for non urgent cases It is a 24 hours,7 days a week service with 2,400,000 calls annually Health consumers simply dial 8-1-1 which will connect them to one of the 15 call centers (Sante et Services Sociaux Quebec,2009) Ho & Jarvis-Selinger, 2006,p.30

Quebec - Services : 

Quebec - Services The clinical applications supported by Teleconsultations are: Diagnostic procedures (pediatric) Pediatric abdominal and kidney ultrasounds Pediatric cardiac ultrasound Cardio-respiratory monitoring to newborns Radiology consultations Genetics consultations Pediatric telecardiology Speech and language teletherapy (pediatric) Tele-audiology (aligned with ENT consultations) Quebec Asthma Network Feeding disorders and failure to thrive consultations Telenephrology (adult) (The Child, Youth and Family Health Network, 2008)

Quebec- Services : 

Quebec- Services Tele-platypus With the help of the technology and the patient consent health professionals are able to access from any hospital or health care facility in Quebec health information such as: lab results radiology reports risk and allergies previous admissions and emergency visits previous surgeries patient demographic data (The Child, Youth and Family Health Network, 2008)

Ontario : 

Ontario Telehealth Ontario, a 24 hour, 7 day a week telephone health advice or information provided by a Registered Nurse Confidential, free telephone health advice provided in English or French with translation support in 110 languages Provides a direct TTY help line for people with hearing or speech difficulties (Ministry of Health and Long-term Care, 2002) (Ho & Jarvis-Selinger, 2006,p.37)

Ontario - Services : 

Ontario - Services Ontario Telemedicine Network Ontario Telemedicine Network (OTN) is an independent not for profit organization supported with funding from the Government of Ontario, Canada Health Infoway and other sources OTN helps deliver clinical care and professional education among health care providers and patients (Ontario Telemedicine Network, 2008)

Ontario – ServicesOntarioTelemedicine Network – Clinical Programs : 

Ontario – ServicesOntarioTelemedicine Network – Clinical Programs Cardiology Oncology Orthopedics Rehabilitation Medicine Teleradiology Endoscopy Urology Neurology Speech Pathology General Surgery Physicians or Nurses Mental Health Dermatology Pediatrics Telehomecare Ophthalmology Tele-Stroke Endocrinology Nephrology & Dialysis Occupational Therapy Primary Care Physical Therapy (Ontario Telemedicine Network,2008)

Ontario – Services : 

Ontario – Services Tele-Stroke Patients presenting to an Emergency Department with signs and symptoms of an acute stroke have a window of 3 hours from the onset of symptoms to administer thrombolytic therapy Many hospitals in Ontario do not provide Neurologist consultation on site Tele-Stroke program enables patients to receive a videoconference consultation with a Neurologist and have treatment within the defined timeline This program has significantly improved the stroke patients outcome. (RNAO Nursing Best Practice Guidelines,2005.p.29)

Ontario –Services : 

Ontario –Services Telehomecare Phase One Patients with chronic illnesses use telehomecare to link with health professionals to manage their conditions from the comfort of their home (Ontario Telemedicine Network, 2008)

click on the site http://www.otn.ca/and click on the “Telemedicine in action”? for a short video. : 

click on the site http://www.otn.ca/and click on the “Telemedicine in action”? for a short video.

Telehealth Manitoba : 

Telehealth Manitoba There are 46 sites and four areas of telehealth within Manitoba: Clinical services for special consultation, discharge planning and case conferencing Education services provide Grand Rounds & Nursing research seminars Televisitation - links patients and family who have been separated for extended periods due to health issues. Health information lines (Manitoba Telehealth 2009) (Manitoba Telehealth, 2009)

Telehealth Manitoba - Services : 

Telehealth Manitoba - Services Pediatric teleradiology project (Picot & Cradduck, 2000) Telepsychiatry link (Picot & Cradduck, 2000) "A Model for Integrated HealthCare Delivery for children With Disabilities” (Picot & Cradduck, 2000, p12) Referral centre for patients in remote communities of Northwestern Ontario (Ho & Jarvis-Selinger, 2006)

Telehealth Manitoba - Services : 

Telehealth Manitoba - Services Berens River – One of the original telehealth sites in Canada First Nations Expansion Project – 2007 The University of Manitoba Project Télésanté (Manitoba Telehealth, 2009)

Telehealth Manitoba – Services Government of Manitoba’s (2009) Infohealth Guide : 

Telehealth Manitoba – Services Government of Manitoba’s (2009) Infohealth Guide 24 hour access to a province wide help line that addresses several medical issues such as : domestic violence, sexual assault, farm & rural stress, kids help line, suicide prevention and addictions Non-emergency health situations through the Health Links Info-Sante Community Resources providing help, support and information

Challenges for Manitoba Telehealth : 

Challenges for Manitoba Telehealth Vast province with many people residing in rural areas Geographical challenges for access to care – specialists in Winnipeg Reached its technical capacities Concerns about data/information security (Ho & Jarvis-Selinger, 2006)