telehealth part 1

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Telehealth : 

Telehealth Neena Buckborough Kerry Farthing Denise Gettle Denise Stymiest-Burns Judita Szilagyi

Introduction : 

Introduction The use of telehealth technologies is transforming how care is delivered across Canada and the world This presentation will offer you a glimpse into the world of telehealth as utilized by patients, their families & healthcare professionals Please make sure you have your computer speakers turned on as you make your journey through this presentation Enjoy

Objectives : 

Objectives Define telehealth Explore the benefits and limitations of telehealth Explore how telehealth is used across Canada Provide an overview of the international state of telehealth Compare telehealth across Canada

Definitions : 

Definitions Telehealth is defined as “the use of communications and information technology to deliver health and health care services, information and education where participants are separated” (PHA, 2009, p.1)

Telehealth in Canada : 

(Scott, 2007) Telehealth in Canada YT: Yukon TH Network NT: West Net TH Program NU: IIU Network BC: HealthNet BC + ‘BC Health Guide’ AB: Alberta Netcare + ‘Health Link’ SK: TH Saskatchewan + ‘Healthline’ MB: MB Telehealth +‘Health Links’ QC: Child Telehealth Network; Mother-Child Network; Eastern Quebec Telehealth Network + Infosanté ON: Ontario Telemedicine Network, + ‘Telehealth Ontario’ NL: (TETRA) PE: (2 site network) NB: Wellness Network + ‘Telecare NB’ NS: Nova Scotia TH +‘Telehealth Program’

Four Areas of Telehealth : 

Four Areas of Telehealth (Poole, 2007, p.4)

Telehealth in Action : 

Telehealth in Action The following video demonstrates uses of telehealth

Telehealth Benefits : 

Telehealth Benefits Improved clinical care and satisfaction (Frantz, Colgan, Palmer & Ledgerwood, 2002) Cost effective (Frantz et al., 2002; Telemedicine, 2005; CNA, 2000; Akesson, Inger Saveman & Nilsson, 2008) Provide health care services over large geographical distances (CNA, 2000) Enhanced patient education (Livingstone, 2002) Encourages clients to be active participants (Livingstone, 2002; Akesson et al., 2008) Specialty care more accessible to rural/urban populations (Telemedicine, 2005) Alleviate unwarranted travel and associated costs for patients (Telemedicine, 2005) Continuing education and training for rural health practitioners (Telemedicine, 2005) Allows nurses to deliver accurate and timely information (online support) (Akesson et al., 2008) Enhanced continuity of care by encouraging frequent encounters between health care provider and health care professional (Akesson et al., 2008)

Slide 9: 

(McKinnon, 2008, p.2)

Nunavut : 

Nunavut Due to remote location, large geographic area and limited medical resources, telehealth has become widely used Remote nursing stations are linked to medical centers in Alberta, Manitoba, Quebec, Ontario and Northwest Territories, for consultation of patients seen in the nursing stations Initially funded by IkajurutiInungnikUngasiktumi (IIU), a project to bring telehealth to Nuvavut All links via satellite (Ho & Jarvis-Selinger, 2006)

Nuvanut-Services : 

Nuvanut-Services Videoconferencing via satellite internet Specialist consultations Administration Patient education Continuing education for health care professionals Family visitation for patients hospitalized out of their communities (Ho & Jarvis-Selinger, 2006)

Nuvavut Challenges : 

Nuvavut Challenges Internet connections only available by satellite Cost of satellite is prohibitive Requires locals in community to maintain networks All communities are accessible only by land or sea Limited availability of healthcare professionals Ho & Jarvis-Selinger, 2006

Northwest Territories : 

Northwest Territories Telehealth sites: Fort Simpson Yellowknife Holman Fort Smith Ray Fort Resolution Hay River Ulukhaktok Deline LutselK'e (NWT Health & Social Services, 2008)

Northwest Territories : 

Northwest Territories First telehealth services available in 1998 (NWT Health & Social Services, 2008) Video linked to large hospitals in Alberta (Ho & Jarvis-Selinger, 2006) Currently 10 telehealth sites (there are 33 communities in NWT) (Ho & Jarvis-Selinger, 2006) Services are delivered via satellite (Ho & Jarvis-Selinger, 2006) Some bandwidth challenges in rural communities which limits the services available (Ho & Jarvis-Selinger, 2006) Funded fully by the NWT government (Ho & Jarvis-Selinger, 2006)

Northwest Territories-Services : 

Northwest Territories-Services Nurse Advice Line Continuing education for healthcare professionals Videoconferencing Diabetes education Discharge planning Mental Health Predialysis training Services offered in 8 languages (Ho & Jarvis-Selinger, 2006)

Northwest Territories Challenges : 

Northwest Territories Challenges Only 1 tertiary center in NWT Telehealth services are limited at present with need to expand Limited capacity of locals to accept and maintain telehealth services Services must be provided by satellite which is costly Ho & Jarvis-Selinger, 2006

Yukon Territory : 

Yukon Territory Telehealth Sites: Whitehorse Haines Junction Watson Lake Mayo Dawson City Old Crow Destruction Bay Carmacks Pelly Crossing Teslin Carcross Ross River Faro Beaver Creek (Yukon Travel & Tourism, 2006) (Yukon Health & Social Services, 2009)

Yukon : 

Yukon First telehealth program in 2002 (Ho & Jarvis-Selinger, 2006) Partners with BC and Alberta (Ho & Jarvis-Selinger, 2006) In partnership with BC for access to BC’s nurse advice line for Yukon residents (Government of Yukon, 2009) 14 telehealth sites (Yukon Health & Social Services, 2009)

Yukon-Services : 

Yukon-Services Nurse Advice Line Radiology/Specialist consults Nurses in remote health centers are linked to large hospitals Videoconferencing: Patient education Continuing healthcare professional education Mental health counseling Administrative use (Ho & Jarvis-Selinger, 2006)

Challenges for the Yukon : 

Challenges for the Yukon Only 4 sites can link at one time due to limited bridging infrastructure. The development of bridging is prohibited by the high cost from the IP provider Lack of funding Resistance from the healthcare consumers Small remote communities with diverse population High turnover in rural staff who require training with equipment and ability to incorporate telehealth into their practice (Ho & Jarvis-Selinger, 2006)

Slide 21: 

(Natural Resources Canada, 2003, p.1) ATLANTIC PROVINCES

New Brunswick : 

New Brunswick New Brunswick is a rural province with a geographically diffuse population (Health Canada, 2007) Health services are offered in English and French, New Brunswick’s official languages (Health Canada, 2007) Tertiary health services are concerted in NB’s 3 largest cities Fredericton, Moncton and St. John (Health Canada, 2007) Approximately 80% of the province consists of forest while only 20% consists of agricultural land and urban areas (Ho & Jarvis-Selinger, 2006)

New Brunswick-Services : 

New Brunswick-Services Leader in telehealth “Bridging distance by bringing quality health services and information to all of New Brunswick” (Health Canada, 2007, p. 7) Telehealth services in NB include: cardiology, nephrology, oncology, genetics, pediatrics, nutrition, mental health, homecare, radiology, neurosurgery and rehabilitation (Ho & Jarvis-Selinger, 2006) Only 2 provincial-wide telehealth programs including: Virtual Interactive Telehealth Assistance Links (VITAL) and TeleCare (Ho & Jarvis-Selinger, 2006) (Ho & Jarvis –Selinger, 2006, p. 23) Telehealth Infrastructure of New Brunswick

New Brunswick Challenges : 

New Brunswick Challenges Geography (Health Canada, 2007) Clustered Population (Health Canada, 2007) Location of services (Health Canada, 2007) Accessibility (Health Canada, 2007) Wait times (Health Canada, 2007) Telehealth “the delivery of health care services across small or large distances using appropriate telecommunication and information technologies” (Atlantic Health Sciences Corporation, 2007, p. 1)