Psychiatrists in Vanguard Of Telehealth in Canada

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 at<www.nlm.nih.gov/portals/public.html>. 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 Internet.

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. ▪