For patients in rural or remote places where there are no family doctors or specialists, or for those with limited mobility, it’s a remarkable technological advancement. Doctors don’t have to travel, nor do patients, and medical advice is delivered quickly.
Tens of thousands of BC patients, including those with cancer, are having their medical appointments this way now. We can expect these numbers to surge as tech-savvy doctors and others invest in the cameras, diagnostic instruments and computers to engage in new ways with patients.
For fee-for-service (FFS) doctors, there’s even an incentive: they get paid a slightly higher rate from the Medical Services Plan for telemedicine care. In the last fiscal year, MSP paid out about $400,000 in telemedicine fees.
That amount represents nearly $100 for every consultation if you consider there were about 4,300 MSP-billed telemedicine visits in 2013 (up from 594 in 2012). The MSP visits reflect only some of the telemedicine visits. Other doctors supplying telemedicine care are not FFS since they are hospital-based, often on salaries.
We can expect to see serious growth in all telemedicine treatment and the costs may even spiral out of control. And then we can even debate whether patients should be sharing in the costs since it’s new technology and governments typically put the brakes on new technology costs. Two examples come to mind: MRI tests (volume of tests are limited by restricted budgets) and robotic surgery (patients pay thousands of dollars if they choose to have their surgery done that way).
My story today is about a village called Taylor where a first-of-its-kind clinic operated by a new company called Livecare opened this week. Patients there can now have cyber-appointments with top medical experts sitting in their offices in Vancouver or other cities.
Taylor, a picturesque town of 1,500 that’s just south of Fort St. John, has been trying to recruit its own doctor for years, to no avail, said Mayor Fred Jarvis. Now it has access to a bounty of them. Jarvis told me:
“This is a high-tech type of service and it’s going to be tremendous. We’re all excited about it. I’ll likely use it myself.”
The official opening of the Livecare clinic, located in a house owned by the municipality, was scheduled for just after lunch Monday. By noon, more than a dozen people had already had appointments with a family doctor there to meet patients. Taylor’s history of doctor woes is hardly unique. Health Match B.C., the agency that helps recruit doctors for such remote communities, has 572 openings for doctors of which 332 are for family doctors.
Dr. Mark Godley, an anesthesiologist who previously co-owned and founded two private surgery hospitals — the False Creek Healthcare Centre in Vancouverand the Maples in Winnipeg — said technological advances in the past few years have paved the way for companies like Livecare. He co-owns it along with Dr. David Wilton, director of the Vancouver General Hospitalist program, and other investors.
Godley likens the high-speed Internet teleconference connection between patients and doctors to a modern-day house call. Livecare patients in Taylor will visit an on-site nurse or technician who will use diagnostic instruments plugged into the system so that doctors elsewhere can simultaneously see — on their own computer monitors — the results of tests, as if they were in the same room doing them.
Virtual appointments will be supplemented with occasional face-to-face appointments. That, combined with the real-time diagnostic capabilities, is what distinguishes the Livecare model from other telemedicine approaches like Medeo, according to Livecare’s head of marketing, Stuart Omsen. In traditional telemedicine models, he said, there’s usually just a teleconferencing chat between the doctor at one end and the patient at the other.
Godley concedes the telemedicine model of care isn’t always ideal:
“Obviously, this sort of technology has a few limitations — in the case, say, of patients you have to physically touch. A surgeon may have to palpate a patient’s abdomen. But even for a consult with an orthopedic surgeon, a specially trained physiotherapist can be in on the consult, to manipulate a joint (such as a knee) while the physician is at the other end watching on the screen.
“It’s a door opener, a medical care enabler.”.
In Taylor, Livecare expects to recoup its setup costs through the burgeoning LNG business and BC Hydro’s proposed Site C dam on the Peace River. The town was previously popularized a few years ago by a CBC reality show called Village on a Diet which I wrote about here.
Livecare’s first big customer was the Nisga’a Valley Health Authority, which uses the telemedicine company for access to family doctors and specialists. Maggie Patsey, spokeswoman for the Nisga’a Valley Health Authority, which serves 2,500 residents, said before the Livecare service was implemented, doctors would come and go.
“Our relationship with Livecare began from a more urgent need of physician services,” she said, noting there are four full-time family doctors servicing Nisga’a communities in either face-to-face visits or telemedicine examinations.
“This is of paramount importance to our elders who cannot travel and suffer from chronic diseases. We can now have patients seen for neurology in weeks, rather than waiting up to two years for an appointment in Terrace, for example.”
There are about 245 hospital and medical facilities providing telehealth access to over 100 communities in B.C., said Ministry of Health spokesman Ryan Jabs, and more than 36,000 consultations were conducted by telemedicine means last year, up from 25,800 in 2012.
Said Jabs:
“The ministry is looking into our existing telehealth services, and how we can improve and expand these services while ensuring our health care system remains sustainable and financially responsible with taxpayer dollars.
“The ministry is also reviewing the effectiveness of Livecare and others, like Medeo (another Vancouver telemedicine service), to determine if they would be useful in our primary-care strategy.”
“The protection of a patient’s private information is our top priority for this review. It is important to note that with Livecare, the physician is responsible for privacy and security of patient data and transmission.”
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Autor(en)/Author(s): Pamela Fayerman
Quelle/Source: The Vancouver Sun, 10.06.2014
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