By Edward Brown, M.D.
Telemedicine is no longer the stuff of science fiction. We now have tools that can improve access to care, quality of care, and the sustainability of healthcare systems. As a long-time advocate for telemedicine, finally having these new technologies at our disposal is exciting to me. The technology of the future really is here – but it’s just one piece of the puzzle.
We’re now in the midst of trying to integrate technological solutions into a more patient-centred healthcare system in a way that supports better care. A critical part of that process is engaging patients and providers in virtual care. The key is to get all stakeholders thinking about how to use virtual care to solve problems, and convincing them to embrace new ideas as opportunities to improve patient care.
But implementation requires change, and change is difficult because it’s not just dependent upon the technology. Part of the implementation process involves people being asked to do things differently, taking on different roles, and working with different sets of people. It will empower some and disempower others, and unfortunately those aren’t always easy adjustments to make.
Successful implementation also means making changes in our policies. No one anticipated virtual healthcare when our current financial business models were initially laid out, so funding is a challenge. It’s like fitting a square peg into a round hole. Fortunately government is moving to change and is undertaking bundled care. My hope is that virtual care will become part of that bundled care planning.
Leadership and partnership are important components when it comes to embracing and implementing change. It’s important for people to try new things, and critical for them to spread the word when they do. OTN has a long history of helping to improve access to specialist care in rural areas. Over the past few years we’ve also been looking at the following big problems and working with partners to address them:
- Chronic disease: Patients must be engaged in their own care, and we now have amazing solutions that support and track patient health.
- Access: We have the electronic means to support patient access to primary care anywhere.
- Continuity of care: When patients are discharged home from the hospital, there’s a gap when it comes to information and collaboration that often results in re-admissions.
- Complex care/palliative care: Navigating the system is difficult when it comes to complex care. Technology can bring teams together and enhance outcomes.
- Mental health: There is a shortage of service providers and an access problem when it comes to mental health. Technological solutions can provide an online social network, as well as access to mental health courses and supports.
The Telehomecare Program at OTN has resulted in an approximately 50% reduction in hospitalizations and ER visits. Funded by the government of Ontario and Canada Health Infoway, and operated in collaboration with 11 Local Health Integration Networks across the province, this program provides simple, in-home monitoring equipment that patients with heart failure or COPD use to send their vital signs via tablet to a nurse who tracks their condition at a distance. The technology is supportive; when you add it to the individualized health coaching the nurse provides weekly to the patient by phone, you get a complete strategy that helps patients live life to the fullest in their homes.
We are excited to help lead the charge when it comes to useful and scalable innovation because we know firsthand that it makes a difference. OTN is actively engaged in projects designed to evaluate mobile solutions in the areas of diabetes, mental health, chronic kidney disease, palliative care, wound care, and enhanced consumer access to primary care. Our goal is to help our partners make these successful models of care available to all Ontarians.
On November 7th I will co-chair an event at HealthAchieve designed to look at the integration of virtual care into the home and its impact on overall health and well-being across the care continuum. It’s an exciting opportunity to look at innovation, but also an important chance to explore the value of virtual care and the ways we can integrate it seamlessly into our models of care to streamline and improve the care we deliver to our patients. Learn more at www.healthachieve.com.
Dr. Edward Brown, MD, is founder and Chief Executive Officer of the Ontario Telemedicine Network (OTN).