Project: British Columbia Telehealth Program

Canada Health Infostructure Partnerships Program

Project Synopsis

The objective of the British Columbia Telehealth Program Project was to establish a telehealth network of clinical, continuing education and administrative telehealth applications in order to deliver services to under-serviced communities. As partners in this project, clinical and education programs were provided by Children's & Women's Health Centre (C&W), Vancouver Hospital and Health Science Centre, the Division of Continuing Medical Education at the University of British Columbia (CME-UBC), and the Canuck Place Children's Hospice.

This telehealth network allowed health providers in rural and remote parts of the province to engage in real-time consultations with medical professionals in the areas of neonatology, perinatology, pediatric oncology, general paediatrics, paediatric mental health, paediatric cardiology, medical genetics, paediatric nutrition and child development and rehabilitation services.

In addition, the BC Telehealth Program provided health professionals across the province with access to a variety of learning opportunities. The UBC Division of Continuing Medical Education and the clinical departments at the speciality centres provided rounds, targeted courses, educational programs, and point-of-care learning opportunities via interactive or broadcast videoconference. Access to these educational opportunities proved successful in overcoming the long-standing barrier that isolation poses for the recruitment and retention of rural physicians.

Impacts: Services

Clinical: demand continued to grow in areas such as foetal ultrasound testing, paediatric echocardiogram interpretation, and patient care planning through multi-site rounds. There was increased access to continuing professional education programs for a wide variety of health professionals in rural and remote communities. This occurred at reduced costs, resulting in more efficient use of clinician time, and a growing community service capacity as a result of the additional training and peer support network.

Administrative applications: had the least focus during the project but proved to be the fastest growing use of video conferencing. The demand was primarily intra-regional and proved to be a cost-effective way of receiving input and dialogue on region wide planning, issue management, and communication requirements.

Impacts: Communities and Delivery Agencies

• Diminished sense of isolation for communities served
• Increased integration and connectivity of clinicians and service delivery modalities; new possibilities to improve service delivery by assisting clinicians, staff and management become more effective and efficient;
• Public provided with access to services that they did not have before; improved confidence in the health care services being provided to their communities;
• Community and health care professionals provided with education opportunities not previously accessible due to lack of time and funds;
• Health authority management teams provided with more time to carry out their duties; reduction in the time spent on traveling to different communities.

Policy and Research Implications

• Provincial health policies should include the use of telehealth as part of overall planning for health care service delivery, and in the allocation of speciality services;
• Impact on system capacity, workload and procedures must be considered in the implementation of telehealth applications. Such a reengineering of service delivery mechanisms requires a rethinking of organizational and provincial level policies, and the establishment of processes and procedures that go beyond the normal scope of staff responsibilities and involvement.
• A more thorough needs assessment, and accounting of market potential needs, have to be considered prior to developing services. Emphasis should be placed on the applications that have the highest potential for utilization, cost reduction, and patient/community impact.
• For telehealth services to continue to grow and develop, there needs to be a continued focus on establishing and managing a secure, reliable, standards-based video network throughout the province. This network must be integrated with the data networks, not compromise nor compete with data applications for bandwidth, and use interoperable equipment that does not require expensive bridging connections.
• Support is required for applied research projects that use existing telecommunications technologies in innovative ways or newly developed technologies for the delivery of clinical services.
• Policy and processes for physician reimbursement are needed before further expansion of clinical telehealth services will be achieved.

Future

The future of the BC Telehealth Program including key barriers, sustainability plans and on going leadership, coordination and development of telehealth services in the province is addressed in the BC Telehealth Program Sustainability for Telehealth Services Report of May 2003 (see Appendix B).

Appendix A: Documents or Products Generated

Document or Product Name	Form (Paper/ Electric)	Licence Fee Required (Yes/No)	Previously Provided to Health Canada (Yes/No)	Appendix Name /Number
Detailed Design Document	Paper and Electronic	No	No	Appendix A-BC Telehealth Program Detailed Design Document
Short Term Sustainability Strategy	Paper and Electronic	No	Yes	Appendix B-Sustainability Reports
Long-Term Sustainability Strategy	Paper and Electronic	No	No	Appendix B-Sustainability Reports
CHIPP Monthly and Summary Reports - ER/Trauma /CME Program (February to September 2002)	Paper and Electronic	No	No	Appendix C-ER/Trauma /CME Program Reports
CHIPP Academic Review - Selected Presentations - ER & Trauma Care	Paper and Electronic	No	Yes	Appendix D-ER/Trauma /CME ER and Trauma CME Program
Community Needs Assessment - Vancouver Coastal Health Authority	Paper and Electronic	No	No	Appendix E-Community Needs Assessment
Corporate Privacy Impact Assessment - BC Telehealth Program	Paper and Electronic	No	No	Appendix F-Privacy Impact Assessment
Ministry of Health Planning and Ministry of Health Services - BC Telehealth Program Project Evaluation Document	Paper and Electronic	No	Yes	Appendix J-Project Management Evaluation Report

For additional information on the B.C. Telehealth Program, please contact
Valerie Ashworth at vashworth@phsa.ca or at 250-519-5641.