ONTARIO in Canada's north, so familiar with the tyranny of distance problems that plagues essential services delivery in Queensland looks likely to provide the initial blueprint for this state's proposed telehealth program.
The Health and Community Services Committee, which is tasked with finding out the best way of delivering telehealth services including The Rural Telehealth Services, which was announced last February, yesterday heard from Dr Ed Brown, the Chief Executive Officer of the Ontario Telemedicine Network.
Ontario's OTN, started in 2006, has found success especially in the rural north where aboriginal communities in particular are distanced from everyday and emergency services.
"The OTN models offers five main services," said Dr Brown. "Clinical video conferencing which uses equipment like digital stethoscopes, handheld exam cameras and audioscopes to provide care over distance just as if the patient is in the office.
"The service is largely free to the patient because they use their own devices, can download software and be integrated into the network."
The program also offers E-consulting that allows GPs and nurses to collect patient information and send it on to a specialist, acute care that makes it possible for specialist doctors in cities to consult on emergencies in rural environments and education and information sharing through webcasting.
The final part of the Ontario telehealth system is improving telehome care, a combination of monitoring and coaching patients with significant chronic disease.
While the committee was quite vocal in its praise about the benefits of the Canadian system, it was equally forthcoming about the challenges of implementing a similar program in Australia.
Committee chair Trevor Ruthenburg pointed to the issue of internet security and the possibility of patients using their own devices passing on bugs through the network.
Ontario countered that danger by technically targeted access and writing their own software but Australia has the added problem of an internet network that may not be fast or efficient enough.
Doctors who prefer to be present at initial consults despite the distance and the difficulty of ensuring that people actually turned up for the video conference at their designated telehealth centre were two more issues that will have to be looked at.
But probably of greatest concern to the committee is the obstacle presented by the Federal government funding and its defence of the gateway when it comes to sharing information.
"We've got this problem where someone has to take responsibility," said Dr Alex Douglas, a committee member aufait with rural and distance medicine. "You can't take responsibility until you know what the problem entirely is so that is a barrier we would have to overcome.
"We have two major central hospitals with competing ambitions and as a doctor we become the default option when whatever they are doing doesn't work. We don't know a lot of the time what they've done and you see this a lot in managing oncology patients managed by outreach programs.
"A person suddenly rocks into your rooms because what they were doing isn't working and you have to fill in and you have no idea what's going on and you don't have the capacity to access that gateway to get into that system. You don't even know who has done it. This is a very very real situation and that sort of thing can be a major obstacle."
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