Not long ago, a Canadian girl who had experienced a serious head
injury could not be flown to the University of British Columbia (UBC) Medical
Center because of fog. So a general surgeon in her geographic area used
telehealth technology to communicate with a UBC brain surgeon on how to
prepare for performing the operation.
Thus telehealth "can bring huge amounts of benefits not just to
physicians but to patients," Kendall Ho, M.D., an associate professor of
emergency medicine at UBC, asserted at the annual meeting of the Canadian
Psychiatric Association in Vancouver in November. Telehealth, he added, is the
use of communication technologies to deliver health services.
In fact, he added, psychiatrists are leaders in telehealth in Canada. As of
December 2003, there were 18 telepsychiatry programs operating in Canada and
serving patients in such far-flung places as Newfoundland and the Northwest
Territories (Psychiatric News, December 5, 2003). There is ample
evidence to support the therapeutic benefits of telepsychiatry, he said, but
still needing to be demonstrated is whether it is cost-effective.
Yet telehealth, for all its advantages, is only a small part of a much
bigger e-health revolution taking place in Canada, the United States, and
other countries, Ho emphasized. "E-health," he said, means the use
of communication technologies in health.
For example, at the Mayo Clinic, people can book an appointment with a
psychiatrist via the Internet, he pointed out.
The public, he continued, can use Medline to search for medical information
The public can screen itself for depression online at<www.med.nyu/psych/screens/depres.html.>
Both patients and physicians can now access clinical trials on the
More than 50 percent of Canadian physicians use online journals, he added.
Psychiatric rounds at McGill University are available online. Online
continuing medical education (CME) for physicians is a growing trend in
Canada. The first randomized trial demonstrating the effectiveness of online
CME was published recently. It found that online CME was as effective as live
CME regarding knowledge gain.
Furthermore, Canadian, American, and European governments are investing
money to get physicians moving toward the establishment of electronic patient
health records, he stressed. Besides helping physicians follow individual
patients more effectively, such records could assist researchers in tracking
illnesses, linking illnesses with environmental factors, and pinpointing the
efficacy and safety of medications.
Certainly, physicians may be reluctant to participate in e-health because
of a lack of time, skills, or money or because of concern about patient
privacy. Nonetheless, he said, "E-health is here," and "We
have huge opportunities to innovate."
It is indeed crucial for psychiatrists to get involved, Donald Milliken,
M.D., current CPA president, urged at the conclusion of Ho's talk. ▪