UBC Reports | Vol. 51 | No. 12 | Dec. 1, 2005
By Hilary Thomson
When a child has a brain hemorrhage, a city doctor consults with a neurosurgeon — and fast. But what if the child lives in an isolated South Asian village and the closest neurosurgeon is hundreds of kilometres away?
Telemedicine, or e-health, could be the answer, says Dr. Kendall Ho, who is working with an international group of health-care practitioners interested in spreading health information through technology.
Associate dean of continuing professional development and knowledge translation in UBC’s Faculty of Medicine, Ho chairs an e-health steering committee within Universitas 21 (U21), an international consortium of research-intensive universities. Committee members are focused on the enormous challenge of delivering health care to underserved populations in both developing and industrialized countries.
“Telemedicine will completely change health care,” says Ho. “It gives us undreamt of opportunities to spread medical knowledge to the world.”
Members of the committee include health sciences representatives from Hong Kong University and University of Queensland in Australia. For the past three years, they have been looking at how telemedicine — health-related activities across distance that use computers and videoconferencing — can improve global health. They envision technology can play a substantial role to enable and facilitate improved access of care in remote areas that lack facilities and health-care personnel. The emerging field is commonly known as e-health.
Ho says about 10 per cent of the world’s population has access to 90 per cent of the world’s health-care resources, according to World Health Organization (WHO) data. In addition, approximately seven million children under the age of five die each year, most in developing countries, from conditions that could have been prevented if there was sufficient knowledge and access to existing, cheap methods of treatment.
“With the aid of e-health, we can be instrumental in preventing unnecessary deaths among children,” says Ho, who along with other committee members, works in collaboration with WHO to use information and communication technology in clinical work, health training and administration.
In July, a UBC medical student, along with two students from the University of Hong Kong, went to a Sri Lankan hospital to explore telemedicine opportunities. Working with local health-care professionals, the students identified clinical cases that might benefit from online consultation with health-care practitioners in U21 member countries. They used digital cameras and the Internet to document and communicate details of patients’ conditions.
“Computers were non-existent in the hospital,” says Anne Huang, currently a third-year UBC med student. “Electronic reports of lab results — things we consider standard practice here — just weren’t available. The whole experience cemented my belief that to provide the best care, physicians must be part of a bigger structure that requires systemic approaches, such as IT resources.”
The U-21 committee is now planning an e-health project in Papua New Guinea.
“Our goal is to build health-care capacity among a country’s own citizens,” says Ho. “E-health is intended as a support, not replacement, for local resources.”
E-health would be especially useful in providing distance specialist services, says Ho. Neurosurgical consultations and mental health assessments are possible via videoconference, specialists can confer with local practitioners by e-mail, and personal digital assistants offer improved access to specialized information to help doctors with their clinical decisions.
Health professionals in underserved and isolated locations could be electronically linked, and practitioners using e-health technology could provide effective global health surveillance of widely communicable diseases like SARS.
But there are significant challenges to implementing e-health innovations.
An immediate problem is access to technology and user skill levels. In addition, rapid evolution of technology may hinder long-term use of today’s hardware and software, which often become obsolete soon after introduction. Also, there is currently little research-based evidence to support telemedicine’s cost effectiveness and return on investment relative to traditional services.
“What we’re trying to do now is to conduct thoughtful evaluation to generate evidence about the sustainability of telemedicine,” says Ho. “The time is right to do this work. The technology is there, public awareness of global health issues is there and synergy between U21 institutions and WHO can kick start initiatives and investment in communication technologies.”
Health science students and faculty members interested in becoming involved in e-health projects can contact Ho at kho@cpdkt.ubc.ca or at www.cpdkt.ubc.ca.
