Insights October 2011

V-Health: The Virtualization of Care – Modern healthcare in a modern world

Will Falk

Healthcare is virtualizing around the world. Most diagnostics and as much as a quarter of all care will be delivered remotely by the end of the decade. Ontario has invested in modernizing health and, due to our challenging geographies, has created some of the world’s leading virtual health enterprises. These companies build upon our base of skilled workers and innovation to create healthcare firms that are changing the world.

Here are four Ontario examples of V-Health enterprises:

Across Ontario:Ontario Telemedicine Network is linking nurses to people in their homes and scarce specialist doctors to remote communities. At any given point during the average day, 200 consults are happening remotely across Ontario. This saves time and money and it greatly improves the care for people in remote communities. OTN’s Telehomecare program already collaborates with six FHTs and their CCACs to provide service to more than 800 Ontarians. OTN expects to grow this program to 40,000 patients a year in 2015

In Oakville: The PharmaTrust MedCentreTM is a remote pharmacy dispensing technology that allows people to access pharmacy services 24 hours a day, seven days a week.

  • patient simply touches the screen, inserts a prescription, picks up the phone and begins speaking with the pharmacist who appears on screen via two-way video technology.
  • After pharmacist counselling, payment is processed and the medication is dispensed.
  • Unlike an ATM, each patient experiences live interaction with a pharmacist throughout the dispensing process.
  • The pharmacist maintains complete control over the the PharmaTrust MedCentre, supported by integrated safety features that help ensure accuracy, while keeping private information just that - private

In downtown Toronto, the University Health Network has partnered with General Electric, Infoway. and Ontario’s HTX to create a unique network of telepathology that is serving hospitals across Ontario, across Canada, and soon around the world. In telepathology, a specimen that is taken in one place is photographed hundreds of times and the photos are sent and reassembled at the place where the skilled expert pathologist can read them and give the best diagnosis. In addition to hospitals across Ontario, Newfoundland and. Manitoba are part of the program and several countries around the world are interested in the excellent skills on University Ave.

In Hamilton: “Instead of transferring patients we need to move the expertise to where they are” says Dr. Mehran Anvari of the Centre for Surgical Invention and Innovation (CSII). “We have now opened two O.R.’s at St Joseph’s Health System in Hamilton which are purpose-built specifically for telesurgery in the future.” Since 2003, 23 telesurgeries have been performed in North Bay from Hamilton and the center is currently mentoring 50-100 a year. The barriers have been both equipment and regulatory. The next generation equipment will be available commercially in 2012 and will allow 100-150 cases a year immediately scaling to 1,000.
All four of these ventures are creating high tech health jobs in Ontario. By virtualizing care, we are able to delivery care anywhere and create great high wage jobs for nurses, pharmacists, and doctors in Ontario. This will both improve Ontario’s healthcare system dramatically and create the next generation of high tech jobs that we need in the 21st century economy.

Virtual Health Care (or V-Health) is one of the next great frontiers in medicine. As care virtualizes we may see several fundamental shifts that occur:

  • We remove geographic barriers to care. Allowing the best providers to be present and available in rural and remote communities
  • We greatly expand the capacity of providers removing the decade old constraints around health human resource shortages
  • We allow for improvements in organizing and scheduling care. Sometimes this is as simple as sorting e-renewals for prescriptions or more complex such as asking a dermatologist to review a primary care physician’s diagnosis or a wholesale change in practice patterns such as re-organizing which retinal exams need to be seen by ophthalmologist as opposed to an optometrist.
  • We bring into play techniques from quality improvement in manufacturing that allows massive restructuring of care
  • We challenge and break down provincial barriers and the assumption of provincially organized healthcare that is part of our Constitution and our federalism.
  • We allow for the creation of export markets for Canadian healthcare.

These successes build on a decade of investments by the provincial and federal governments in modernizing healthcare for their citizens. We have bean global leaders in digitizing health through Infoway and the provincial initiatives. Our great distances have given us economic and equity rationales to build V-Health to serve marginal(ized) groups. Now we are a world leader in V-Health. We need to build on this leadership position to change healthcare and improve quality and access for citizens. Doing so will create a lower cost health system that we can export to the rest of the world.

About the Author(s)

Will Falk (@willfalk) Executive Fellow in Residence, Mowat Centre for Policy Innovation, SPPG Adjunct Professor, Rotman School of Management, U of T Will Falk and Dr.Ed Brown will be discussing V-Health at Breakfast with the Chiefs on October 20th at the University of Toronto


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