Can Canada’s rural health care services be improved with technology?
A recent review in the journal Chronic Respiratory Disease argues that Canada’s health care system needs to do more to provide services to Canadians living in rural and remote areas and that telehealthcare technologies should play an important role in providing these services.
Authored by Donna Goodridge and Darcy Marciniuk, both of the College of Medicine, University of Saskatchewan, the review discusses the challenges faced by Canada’s health care system in rural and remote areas and advocates the use of telehealthcare technologies and practices in order to respond to these needs.
“Remoteness, by definition, means increased cost and limited access to goods, transportation, and services, including health care,” say the study’s authors, “And at a population level, health status is often inversely proportional to the degree of remoteness.”
According to the Canadian Institute for Health Information, compared to Canada’s urban population people living in rural and remote areas experience shorter life expectancy, higher mortality rates, higher rates of smoking, higher prevalence of risk factors for chronic illness and higher hospitalization rates.
For clinical work, this involves remote monitoring of patients through the use of wearable sensors, smart phones and other methods of transferring biometric data from the patient’s locale to the health care professional at a distance.
All the more reason, say the review’s authors, to implement viable telehealthcare services for rural and remote Canadians. These services use the latest information and communication technologies to deliver patient care. For clinical work, this involves remote monitoring of patients through the use of wearable sensors, smart phones and other methods of transferring biometric data from the patient’s locale to the health care professional at a distance.
The authors specifically address the potential use of technologies to support the provision of care for people living with respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma and sleep apnea. For the care of COPD and asthma, the authors point out, remote monitoring has been shown to significantly reduce rates of hospitalization.
Along with remote monitoring, telehealthcare means remote consultations, via videoconferencing and the use of robotic remote presence technology, allowing health care workers to check vitals and perform various diagnostic tests at a distance using remote robotic equipment such as stethoscope, ultrasound and other tools. Indeed, Canada already has about 6000 telehealth sites for videoconferencing, according to the study’s authors, which serve 21 per cent of the Canadian rural and remote population including 284 First Nations and 46 Inuit communities.
The drawback to the telehealthcare approach, however, is cost. Although communication technologies are generally much cheaper and already more widespread than in the recent past, there is still a lack of evidence that telehealthcare, with its equipment, internet broadband and tech support requirements, is a cost-effective solution. Its critics further argue that the loss of face-to-face relationships in healthcare delivery is neither sustainable nor desirable. Writing in the journal Bio Med Central, Carl R. May of the Faculty of Health Sciences, University of Southampton, says: “Telehealthcare distributes more work amongst fewer people, and makes being a patient more difficult because it adds a new burden of co-ordinating and managing technologies and fragmented services.”
Nevertheless, authors Goodridge and Marciniuk project that telehealthcare will inevitably play a larger role in Canada’s health care future, stating that the (unchanging) vast distances separating rural and remote patients from health care providers coupled with the growing global pressure to reduce fossil fuel use will likely ensure that the demand for telehealth services continues to grow.