Summary
Purpose:
To review the experience with a province-wide telehealth system in Canada, and its
implications for health care and health promotion. To explore whether group support
systems (GSS) based on networked computers can substitute for video conferencing technology.
Methods:
Key results of the evaluation of the BC Tele-health Program are summarized. The potential
of extending the successful principles through use of GSS is explored based on literature
review, demonstrations, and trial use for educational applications.
Results:
The BC Telehealth Program was designed to support health professionals at secondary
care facilities, such as regional and district hospitals in two application domains:
children’s and women’s health (C&W) and emergency room and trauma care (ER-Trauma).
Successful applications extended beyond health professionals and focused on chronic
conditions, the management of which is contingent on visual information, and involves
established teams in regular scheduled visits or in sessions scheduled well in advance.
Ad hoc applications, in particular applications under emergency conditions proved
problematic.
Administrative applications in support of telehealth implementation, e.g., through
facilitation of management and provider education, are essential for clinical success.
Savings from support of administrative applications exceeded the substantial capital
investment and made educational and clinical applications available at variable cost.
Educational applications were shown to have significant clinical benefits.
Exploration of GSS technology showed that it may not be mature enough to substitute
for video conferencing technology in support of sophisticated training and education
aiming at clinical impact.
Conclusion:
The substantial clinical and efficiency gains provided by video conferencing-based
telehealth may for now continue to depend on mature videoconferencing technology.
Keywords
Telemedicine - Canada - British Columbia - evaluation studies - health promotion
