BY NORM TOLLINSKY
A teledermatology service offered by the Ontario Telemedicine Network (OTN) is dramatically reducing the amount of time it takes for preliminary assessments of moles and rashes. Launched in April, the service allows primary care providers to take a photograph of a patient’s mole or rash, add notes about the patient and transmit it to a participating dermatologist using the OTN’s secure store forward technology.
“It can take six months or more to get a face-to-face appointment with a dermatologist, especially in rural areas,” said Dr. Ed Brown, the OTN’s CEO. “With store forward, primary care providers are getting an opinion back in 5.9 days.”
To date, eight dermatologists and 53 referring sites are offering the service and many more are in the process of signing up.
“Any dermatologist who wants to can sign up and tell us what catchment area they serve, so when the family physician or nurse makes a referral, they pick from a list of providers making themselves available in their area,” said Brown. “If they need to see a patient, they see them urgently now because they already have a good idea of what the problem is. Having the store forward consult first allows them to prioritize their waiting list much more effectively.”
Telehomecare
The OTN is also looking to roll out a telehomecare service for chronic disease management. Piloted by eight family health teams, including the Timmins Family Health Team, the telehomecare service enabled daily monitoring of 800 patients with congestive heart failure and chronic lung disease. Patients reported their health status to their family health team using weigh scales, glucometers, peak flow meters, blood pressure cuffs and terminals attached to their home phone. A nurse at the family health team reviewed the data and intervened if the numbers indicated a developing problem. Coaching was also provided to teach patients how to cope with their disease.
“The pilot was quite successful,” said Brown. “PricewaterhouseCoopers evaluated it and found that besides the patients loving it with a 98 per cent satisfaction score, the program also reduced hospitalization rates by 65 per cent and ER visits by more than 70 per cent. Now, we’re working on a plan to roll it out as broadly as we can.”
Funding by the Ontario Ministry of Health and Long-Term Care and the federal government’s Canada Health Infoway has run out, but several of the pilot sites are still offering the service.
Online directory
The OTN has also launched an online directory to help primary health care providers find telemedicine services.
“You can go online, specify the type of service you’re looking for and click on the service for more information about how to schedule with that person, what types of patients they take and what catchment area they serve,” said Brown.
In the absence of the Telemedicine Directory, “they kind of had to know people or they would call our scheduling office and we would help them identify services that were out there. This makes it simpler. It’s almost like a dating service.”
There are currently more than 100 services listed and, within the next few months, the OTN hopes to add hundreds more.
“What usually happens is that referrals are based on relationships, so it’s the professor you met in school, a classmate or someone you know,” said Brown. The telemedicine directory will be especially helpful for rural and remote family physicians and nurse practitioners “who don’t run into consultants every day.”
PC Video
To date, telemedicine services have relied on expensive hardware-based platforms, but a PC Video Program currently being piloted will bring telemedicine capability to physician desktops using a “radically less expensive” software-based solution.
“You go to the web site and download it and all you need is a webcam and some speakers,” said Brown. “It’s the same idea as Skype, but it’s medical grade with the required privacy, security and reliability.”
The PC Video Program is being trialed by 50 users this year and is scheduled to be rolled out across the province in 2012. In the future, it will also work on an iPad and other mobile devices.
Professional development
The OTN is also active in professional development, delivering twelve thousand workshops and courses last year to approximately 390,000 learners.
A new OTN Learning Directory at http://learning.otn.ca is available to help health care professionals find educational events of interest to them. Users can also sign up for learning alerts and receive emails informing them about workshops or courses on topics of interest to them.
Last year, the OTN reported 135,000 patient encounters, representing a 30 per cent increase over the preceding year.
www.otn.ca
