Using Supernet to Provide Teleorthopedic Consultations

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Using Supernet to Provide Teleorthopedic
Consultations

• Alberta Telehealth Clinical Forum June 1, 2007

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You want to do what?
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What Ive Learned

• Clinical objective of providing better service
  to rural family physicians has been disappointing
• Clinical objective of providing more convenient
  access to rural patients has great promise.
• Regional PACS in conjunction with
  videoconferencing has great potential

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Teleorthopedics

• Background
• Initial experience
• Present experience
• Future directions

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Background

• DTHR has 6 orthopedic surgeons

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Background

• DTHR has 6 orthopedic surgeons
• Service an area of 60,000 sq km stretching from
  Saskatchewan to British Columbia

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Background

• DTHR has 6 orthopedic surgeons
• Service an area of 60,000 sq km stretching from
  Saskatchewan to British Columbia
• Limited OPD capacity in our Red Deer hospital site

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Background

• Patients from some rural areas may travel 2 to 3
  hours to be seen for 5 minutes, then return home

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Background

• Patients from some rural areas may travel 2 to 3
  hours to be seen for 5 minutes, then return home
• Often these visits were for minor follow up exams

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Background

• Patients from some rural areas may travel 2 to 3
  hours to be seen for 5 minutes, then return home
• Often these visits were for minor follow up exams
• For patients the trips were full day adventures

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Initial Experience

• Focus on family physicians

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Initial Experience

• Focus on family physicians
• Goal was to provide a consultative service and
  enable patients to stay in their home communities

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Initial Experience

• Focus on family physicians
• Goal was to provide a consultative service and
  enable patients to stay in their home communities
• Consultations could be done live through
  videoconferencing and transmission of x-rays, or
  by emails with x-rays attached

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Initial Experience - Problems

• Not convenient for family physicians

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Initial Experience - Problems

• Not convenient for family physicians
• Videoconferencing not easy for the average doc or
  nurse, still easier to just pick up a phone

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Initial Experience - Problems

• Not convenient for family physicians
• Videoconferencing not easy for the average doc or
  nurse, still easier to just pick up a phone
• Xrays were being scanned by a document camera
  then sent. This was an awkward step and gave less
  than optimal images

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PACS

• May provide a breakthrough for us by removing the
  need to scan the x-ray
• Picture Archiving and Communication Systems, and
  digital modalities such as X-ray, MRI and CT
• Implemented as part of the Regional Shared Health
  Information Program (RSHIP). 

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December 2003
Collaborative initiative involving the 7
Non-Metro RHAs

• R1-Chinook Health Region
• R2-Palliser Health Region
• R4-David Thompson Health Region
• R5-East Central Health
• R7-Aspen Regional Health Authority
• R8-Peace Country Health Region
• R9-Northern Lights Health Region

Area of Alberta 661,790 sq. kms. 255,519 sq.
miles
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Present Initiative

• Focuses on patients

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Patient
Rural Hospital
Red Deer
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Patient
Rural Hospital
Red Deer
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Present Initiative

• Focuses on patients
• Patients readily see the benefits of avoiding
  travel and being assessed in their home
  communities
• Ideal patient is a routine follow up, no physical
  exam required
• Telehealth booth is right in our cast clinic
• No need to schedule times where surgeons wait by
  a computer for an x-ray to be sent PACS allows
  for instant access

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Future Directions

• Expand the service to patients living in more
  communities

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PC Anywhere
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Patient
Rural Hospital
Red Deer
Penitentiary
Hip Knee Clinic
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Future Directions

• Dedicated teleconsultation room in our new
  orthopedic office

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Patient
Central Dispatch
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What Ive Learned

• Clinical objective of providing better service
  to rural family physicians has been disappointing
• Clinical objective of providing more convenient
  access to rural patients has great promise.
• Regional PACS in conjunction with
  videoconferencing has great potential