Inject health care with IT

ROMANOW REPORT

The long-awaited Romanow report says technology will be one of the most important building blocks in the reform of Canada's health care system. Building On Values, which was recently released by the Commission on the Future of Health Care in Canada, says although there is general consensus in the industry about the importance of making betler use of IT, progress in adopting it has been slow. Technology, the report says, "can forge a strong link between quality on the one hand and accountabilty on the other."

Commissioner Roy Romanow and his colleagues have recommended the creation of a pan-Canadian personal electronic health records system. Government agencies and health care providers are already developing these systems in several provinces. But the work so far has not been co-ordinated and initiatives are developed largely in isolation, the report says.

Michael Guerriere, managing partner and CEO of Torontobased Courtyard Group Ltd., agrees. He says he's surprised that such a complex and enormous enterprise as a nationwide health care system is being allowed to operate without a more modern infrastructure.

"It's absolutely phenomenal that something that really makes up 10 per cent of the economy is still largely managed on paper," he says. There are many areas in health care in sore need of a technology injection, from the operating room to the furthering of tele-health services, Guerriere says. Even something as simple as appointment scheduling is a challenge in many practices and hospitals right now, he adds. Scheduling applications are not widely used, leading to unnecessary time and financial strains on patients. The system would run more efficiently if health care facilities adopted solutions similar to those the airline industry uses, he says.

"You can imagine (what would happen) if you were going to go from point A to point B and go through a connecting city, if you got the first flight the first day and then three days later they gave you the second flight," Guerriere says. "But we don't think anything of that in health care." Instead, he says, we tell patients, "Come to the hospital and we're going to give you your CT scan today. Then come back three days later and we're going to give you an ultrasound."

The simple process of scheduling can be a huge inconvenience for patients who have to travel hours, sometimes days, from remote areas to see their doctor, he says.

To address that issue, the report calls for the use of money from the federal Rural and Remote Access Fund to expand telehealth services. That's good news for organizations such as the NORTH Network. The telemedicine organization operates out of Sunnybrook and Women's College Health Sciences Centre in Toronto and now provides support services to 75 sites across Ontario. Some of the communities it serves are so small that they not only have no local hospital, they don't even have a doctor, points out NORTH Network director Dr. Ed Brown. "We've partnered with a number of First Nations communities that are remote and have no doctor. So we're supporting the nurse that's there or the community health worker," he says.

With help of videoconferencing equipment, NORTH Network has been able to provide patients with remote access to specialists in over 40 areas of medicine. The network has now also been able to roll out its first emergency services program, which has doctors on call 24 hours a day to assist in the management of stroke patients, Brown says.

Telehealth is a great tool to improve the delivery of health care services for provinces like Newfoundland, which has about 50 per cent of its population living in rural areas, says Dr. Carl Robbins, professor of family medicine at St. John's Memorial University in Newfoundland and chair of the Telehealth and Educational Technology Resources Agency at the university. He says telehealth should not be treated as the ultimate solution to rural and remote area health care woes. "We've had a number of evangelists out there almost pretending that it is a panacea and that you don't need physicians and nurses in remote communities because you have telehealth," he says. "Nothing could be crazier and further from the truth, or certainly further from the agenda I happen to hold."

- ITBusiness.ca

Copyright Plesman Publications Ltd. Jan 2003
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