Project: Central British Columbia-Yukon Telemedicine Initiative

Canada Health Infostructure Partnerships Program

Synopsis

The Central BC Telemedicine project involves the implementation of a secure, high-speed telehealth network built for the rapid transmission of X-ray images.

The data network uses a Picture Archiving Communications System (PACS) to allow 10 rural and remote hospitals and diagnostic and treatment centres to consult almost instantly with Radiologists in Kamloops, Comox, Williams Lake and major referral hospitals in lower mainland BC. Once the network is installed and in operation, its use can be expanded beyond tele-imaging to other telehealth applications.

Outcomes

The project has had major impacts in the following instances:

• Physicians who work in the remote smaller centres have immediate access to Specialists and other health care personnel in the region at any time of the day or night. The review of cases has prompted many instances of immediate patient transfer for surgery and expanded care;
• Bed management has been impacted by timely patient case review from referral centres which has greatly improved decision making regarding patient transfers;
• The turn around time for all imaging reports have improved to where previous examinations are now instantaneously available for comparison along with the reports;
• Reduction in the incident rate of "lost films" to zero. Films also do not get misplaced and fewer exams are repeated because of this.
• Archival of patient files has eliminated the requirement for images filed on shelves.
• Accessibility of reports and images has improved the imaging services response rates to physician practices. Treatment decisions are made faster; and
• The use of PACS is more environmental friendly resulting in reduction of plastic films needing disposal and the elimination of chemicals to City sewage systems and the elimination of "dark room" disease.

The effectiveness of the system developed an overall level of staff enthusiasm that was "contagious" and helped each site and installation welcome and use the new tele-imaging system. There is a strong desire to work cooperatively and regionally to build a modern and effective system.

Lessons Learned

The Central BC Telemedicine Project reported many lessons learned - a selection follows:

• A modest amount of contingency funding can be used effectively to install additional hardware or make simple changes to cabinetry and other resources to help ensure positive acceptance;
• Sometimes delays are not a bad thing. In the case of this project, delays and simply the implementation time of this project provided opportunities to purchase better technology at lower prices; and
• Ensure foreign exchange variations are considered if applicable.

The Future

The BC and Yukon Telemedicine initiative is an impressive example of how cooperation, good design, and effective implementation can produce a system that should be emulated elsewhere.

The success of the Thompson/Cariboo/Yukon PACS experiment has been so impressive that there is now considerable interest in expanding the technology throughout Interior Health.

Priorities for further development have been noted as follows:

• The most ambitious undertaking being considered is to expand PACS into other parts of Interior Health, starting with the Okanagan Service Area and then expanding into the West and East Kootenays at a later date;
• Over the next 12 month, there should be a major emphasis on two current functions to help maximize the benefits of the PACS technology:
  
  
  • more physicians on line; and
  • creating a fully integrated network of sites.
• Through the PACS system, effective tutorials on the following should be created:
  
  
  • patient placement;
  • image quality; and; and
  • policies/practices.

Appendix A: Documents or Products Generated

For more information, please contact:

Roy Southby at roy.southby@thr.bc.ca or at (250) 314-2777