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Wednesday, June 6, 2012

Telehealth in Canada – A Real eHealth Success Story

John Schinbein is the Executive Director of COACH’s CTF: Canadian Telehealth Forum.

It is no surprise to anyone in the health care system that we are struggling to meet the seemingly never-ending demand.  The costs of health care continue to skyrocket and, increasingly, there are just not enough care providers – didn’t anyone read Boom Bust Echo?

So, decision makers are looking for proven strategies to reduce costs, improve access, quality and productivity.  Technology has been identified in all the health system studies as an important tool to help reform the system. But, based on experience, many decision makers are often weary of technology investments; they want to see demonstrated ROI and tangible benefits.  As anyone involved in technology implementations knows, historically you couldn’t have “Good, Fast and Cheap” – if you were diligent you might get two out of the three. The majorities of technology projects were late, over budget or more generally failed to meet expectations.  There are always exceptions. Recent studies by the CTF: Canadian Telehealth Forum and Gartner, Inc./Praxia Information Intelligence, as commissioned by Canada Health Infoway, have clearly shown that telehealth is proving to be a welcome exception to the old technology maxims. 

The studies highlighted some incredible results:

•    In the last five years the use of telehealth in Canada has grown at an astounding rate, averaging 35% per year over the last 5 years.
•    In 2010, there were nearly 260,000 telehealth events in Canada delivered through 5,710 telehealth systems, to at least 1,175 communities.
•    Rural and remote patients saved an estimated 47 million kilometers of travel in 2010, resulting in an estimated cost savings of over $70 million.
•    Access was improved by reducing wait times for a number of specialties, in some cases, from months to days
•    Quality was improved – a number of Telestroke programs have demonstrated that, in about 20% of consultations, tPA was able to be administered in rural hospitals within the critical 3-hour window, with outcomes comparable to patients treated at major hospitals.
•    Telehealth contributes to reducing demand by reducing avoidable health system utilization by an estimated $55 million in 2010.
•    Telehomecare helped the health system avoid an estimated $21 million in hospital utilization.
•    Governments saved an estimated $34 million through reduced medical care related travel and subsidies.
•    More than 80% of patients reported satisfaction with telehealth vs. face-to-face visits with their care provider.
•    If the growth of telehealth continues as it has over the last 5 years, Gartner/Praxia predict it could mean additional benefits to the Canadian health system valued at approximately $730 million, and an additional $440 million in cost avoidance for patients.

With ever-increasing ubiquity and lower costs of technology, especially mobile devices, light applications and the Internet, telehealth is no longer restricted to facilities, expensive video conferencing equipment and wired networks. In fact, health care systems in many third world countries are now benefiting from this lighter and cheaper technology and using telehealth to provide many health services.  While traditional telehealth such as video conferencing and store and forward will continue to expand, I believe the real growth will be in the mobile sector and its use for supporting care for those with chronic disease such as congestive heart failure, diabetes, asthma, and hypertension.  Using mobile technology to deliver health services does, however, bring with it increasing challenges for professional service policies, privacy and security, but these are not insurmountable.

Telehealth continues to capture interest across Canada and the world – Canada is seen as world leader in telehealth use, as evidenced by the number of foreign delegations that come here to learn from our world class telehealth networks. Additionally, the CTF Canadian Telehealth Report received significant attention both in Canada and internationally. It received more than 60 media mentions, including a segment on Canada AM. It was also mentioned on or cited in 111 different websites and publications, with significant mentions in a number of Australian, Spanish, and U.K. publications.

Telehealth is already contributing to a better health care system in Canada by improving access, quality and productivity. When coupled with other eHealth components, such as electronic health records, it has the ability to help transform our struggling health system. CTF members can be justifiably proud of their contributions in helping to bring telehealth into mainstream delivery of health care. The path ahead will, no doubt, have its cracks and bumps, but a good foundation has been laid and the evaluations to date suggest that all three of the goals “Good, Fast and Cheap” are within reach.

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