Adopting and Implementing Telehealth in Canada

Canada spans 9,976,140 square kilometers and has an approximate population of 32 million people (Statistics Canada, 2001). More than 90% of Canada’s geography is considered rural or remote (Government of Canada, 2001). Despite the highly dispersed population, and, indeed, because of it, Canada is committed to the idea that a networked telehealth system could provide better access and equity of care to Canadians. Growing evidence of the feasibility and affordability of telehealth applications substantiates Canada’s responsibility to promote and to develop telehealth. Telehealth is the use of advanced telecommunication technologies to exchange health information and provide healthcare services across geographic, time, social, and cultural barriers (Reid, 1996). According to a systematic review of telehealth projects in different countries (Jennett et al., 2003a, 2003b), specific telehealth applications have shown significant socioeconomic benefits to patients and families, healthcare providers, and the healthcare system. Implementing telehealth can impact the delivery of health services by increasing access, improving quality of care, and enhancing social support (Bashshur, Reardon, & Shannon, 2001; Jennett et al., 2003a). It also has the potential to impact skills training of the health workforce by increasing educational opportunities (Jennett et al., 2003a; Watanabe, Jennett, & Watson, 1999). Therefore, telehealth has a strong potential to influence improved health outcomes in the population (Jennett et al., 2003a, 2003b). Fourteen health jurisdictions—one federal, 10 provincial, and three territorial—are responsible for the policies and infrastructure associated with healthcare delivery in Canada. This article presents a telehealth case study in one of Canada’s health jurisdictions—the province of Alberta. The rollout of telehealth in Alberta serves as an example of best practice. Significant milestones and lessons learned are presented. Progress toward the integration of the telehealth network into a wider province-wide health information network also is highlighted.

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Adopting and Implementing Telehealth in Canada

Encyclopedia of Digital Government ◽

10.4018/978-1-59140-789-8.ch005 ◽

2011 ◽

pp. 26-33

Author(s):

P. A. Jennett ◽

E. R. Smith

Keyword(s):

Health Information ◽

Best Practice ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Skills Training ◽

Healthcare Services ◽

Lessons Learned ◽

Cultural Barriers ◽

Statistics Canada ◽

Government Of Canada

Canada spans 9,976,140 square kilometers and has an approximate population of 32 million people (Statistics Canada, 2001). More than 90% of Canada’s geography is considered rural or remote (Government of Canada, 2001). Despite the highly dispersed population, and, indeed, because of it, Canada is committed to the idea that a networked telehealth system could provide better access and equity of care to Canadians. Growing evidence of the feasibility and affordability of telehealth applications substantiates Canada’s responsibility to promote and to develop telehealth. Telehealth is the use of advanced telecommunication technologies to exchange health information and provide healthcare services across geographic, time, social, and cultural barriers (Reid, 1996). According to a systematic review of telehealth projects in different countries (Jennett et al., 2003a, 2003b), specific telehealth applications have shown significant socioeconomic benefits to patients and families, healthcare providers, and the healthcare system. Implementing telehealth can impact the delivery of health services by increasing access, improving quality of care, and enhancing social support (Bashshur, Reardon, & Shannon, 2001; Jennett et al., 2003a). It also has the potential to impact skills training of the health workforce by increasing educational opportunities (Jennett et al., 2003a; Watanabe, Jennett, & Watson, 1999). Therefore, telehealth has a strong potential to influence improved health outcomes in the population (Jennett et al., 2003a, 2003b). Fourteen health jurisdictions—one federal, 10 provincial, and three territorial—are responsible for the policies and infrastructure associated with healthcare delivery in Canada. This article presents a telehealth case study in one of Canada’s health jurisdictions—the province of Alberta. The rollout of telehealth in Alberta serves as an example of best practice. Significant milestones and lessons learned are presented. Progress toward the integration of the telehealth network into a wider province-wide health information network also is highlighted.

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How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

American Journal of Law & Medicine ◽

10.1017/s0098858800002732 ◽

2002 ◽

Vol 28 (4) ◽

pp. 491-502

Author(s):

Mary L. Durham

Keyword(s):

Health Information ◽

Healthcare Delivery ◽

Healthcare Providers ◽

The United States ◽

Personal Health Information ◽

Personal Health ◽

Business Associations ◽

Electronic Information ◽

Healthcare Delivery System ◽

Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

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A Comparison of How Canada, England, and Denmark are Managing their Electronic Health Record Journeys

Human, Social, and Organizational Aspects of Health Information Systems ◽

10.4018/978-1-59904-792-8.ch012 ◽

2010 ◽

pp. 203-218 ◽

Cited By ~ 5

Author(s):

Denis Protti

Keyword(s):

Health Information ◽

Healthcare Providers ◽

Healthcare Quality ◽

Lessons Learned ◽

Healthcare Sector ◽

The Public ◽

Information And Communication ◽

Electronic Health ◽

User Friendly ◽

Electronic Health Information

Healthcare is one of the world’s most information-intensive industries. Every day, volumes of data are produced which, properly used, can improve clinical practice and outcomes, guide planning and resource allocation, and enhance accountability. Electronic health information is fundamental to better healthcare. There will be no significant increase in healthcare quality and efficiency without high quality, user-friendly health information compiled and delivered electronically. The growing use of information and communication technology (ICT) in the healthcare sector has introduced numerous opportunities and benefits to patients, providers and governments alike. Patients are being provided with tools to help them manage and monitor their healthcare, providers are able to seamlessly access up-to-date patient information, and governments are showing transparency to the public by reporting health data and information on their websites. There is mounting evidence that national, regional, and organizational e-health strategies are being developed and implemented worldwide. This chapter provides an overview of three different national e-health strategies, and identifies the lessons learned from the e-health strategies of Canada, England and Denmark.

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Supply Chain Thinking in Healthcare: Lessons and Outlooks

Manufacturing & Service Operations Management ◽

10.1287/msom.2020.0920 ◽

2020 ◽

Author(s):

Lidia Betcheva ◽

Feryal Erhun ◽

Houyuan Jiang

Keyword(s):

Supply Chain ◽

Supply Chain Management ◽

Supply Chains ◽

Healthcare Delivery ◽

Healthcare Services ◽

Lessons Learned ◽

Problem Definition ◽

Healthcare Organizations ◽

Chain Management ◽

Managerial Implications

Problem definition: The lessons learned over decades of supply chain management provide an opportunity for stakeholders in complex systems, such as healthcare, to understand, evaluate, and improve their complicated and often inefficient ecosystems. Academic/practical relevance: The complexity in managing healthcare supply chains offers opportunities for important and impactful research avenues in key supply chain management areas such as coordination and integration (e.g., new care models), mass customization (e.g., the rise in precision medicine), and incentives (e.g., emerging reimbursement schemes), which might, in turn, provide insights relevant to traditional supply chains. We also put forward new perspectives for practice and possible research directions for the supply chain management community. Methodology: We provide a primer on supply chain thinking in healthcare, with a focus on healthcare delivery, by following a framework that is customer focused, systems based, and strategically orientated and that simultaneously considers clinical, operational, and financial dimensions. Our goal is to offer an understanding of how concepts and strategies in supply chain management can be applied and tailored to healthcare by considering the sector’s unique challenges and opportunities. Results: After identifying key healthcare stakeholders and their interactions, we discuss the main challenges facing healthcare services from a supply chain perspective and provide examples of how various supply chain strategies are being and can be used in healthcare. Managerial implications: By using supply chain thinking, healthcare organizations can decrease costs and improve the quality of care by uncovering, quantifying, and addressing inefficiencies.

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Examining Stakeholder’s Views On Refugee Healthcare Needs, Current Barriers in Accessing Healthcare Services and Future Healthcare Direction in New Zealand: A Qualitative Phenomenological Approach

10.21203/rs.3.rs-877910/v1 ◽

2021 ◽

Author(s):

Bafreen Sherif ◽

Ahmed Awaisu ◽

Nadir Kheir

Keyword(s):

New Zealand ◽

Health Services ◽

Qualitative Methodology ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Healthcare Services ◽

Healthcare Personnel ◽

Structured Interviews ◽

Health Seeking ◽

Healthcare Needs

Abstract Background The annual New Zealand refugee quota was increased to 1500 places from 2020 onwards as a response to the global refugee crisis. The specific healthcare needs of refugees are not clearly understood globally and communication between healthcare providers and refugees remains poor. Methods A phenomenological qualitative methodology was employed to conduct semi-structured interviews among purposively selected stakeholders who work in refugee organisations and relevant bodies in New Zealand. Results The participants indicated the need for a national framework of inclusion, mandating cultural competency training for frontline healthcare and non-healthcare personnel, creation of a national interpretation phone line, and establishing health navigators. Barriers to accessing health services identified included some social determinants of health such as housing and community environment; health-seeking behaviour and health literacy; and social support networks. Future healthcare delivery should focus on capacity building of existing services, including co-design processes, increased funding for refugee-specific health services, and whole government approach. Conclusion Policymakers and refugee organisations and their frontline personnel should seek to address the deficiencies identified in order to provide equitable, timely and cost-effective healthcare services for refugees in New Zealand.

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Search Functionality Within the Electronic Health Record and Health Information Exchange Databases

Proceedings of IMPRS ◽

10.18060/24610 ◽

2020 ◽

Vol 3 ◽

Author(s):

Brandon Gregory ◽

Jordan Hill ◽

Titus Schleyer

Keyword(s):

Electronic Health Record ◽

Health Information ◽

Patient Information ◽

Information Exchange ◽

Health Information Exchange ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Health Record ◽

Search Function ◽

Electronic Health

Background and Hypothesis: In the US today, over 95% of healthcare institutions operate using the electronic health record (EHR). While proven to be a substantial improvement to medical practice, the substantial amount of retained information within those records has made searching the EHR for relevant material difficult and too time consuming. We hypothesize that by providing a search function within the EHR with added capability of collaborative filtration, physicians will be better able to retrieve important patient information and thus provide more efficient care. Project Methods: Emergency Department physicians of Sidney & Lois Eskenazi Hospital and Indiana University Health Hospital were recruited to partake in this study based on their use and familiarity of the EHR Cerner and/or Health Information Exchange (HIE) CareWeb Search function. Participants filled out a pre-interview, Likert-scale questionnaire to determine their general impressions of search functions and the frequency with which they were used. Additional insight was obtained during an interview focusing on participants’ previous experiences searching within the EHR/HIE. Participants were then shown a mock-up of potential collaborative filtering integration into CareWeb in order to collect opinions regarding the feature’s usability/practicality, display/format, and a number of suggested terms. Results: From the pilot study, current challenges that limit clinician search function use include limited time in clinician workflow, information overload, and inaccurate results. Clinicians are more likely to conduct searches when treating patients who have limited medical history, complex histories, known recent visitations, and/or who have been seen at other institutions. Participants demonstrated interest in a collaborative filtration search feature; they expressed a preference to have the feature recommend five related search terms. Potential Impact: The data from this study aims to refine the way healthcare providers search within the EHR/HIE. This will allow healthcare providers to more efficiently extract relevant patient information for improved healthcare delivery and proficient clinician workflow.

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A Context-Aware Authorization Model for Process-Oriented Personal Health Record Systems

Certification and Security in Health-Related Web Applications ◽

10.4018/978-1-61692-895-7.ch003 ◽

2011 ◽

pp. 46-65

Author(s):

Eleni Mytilinaiou ◽

Vassiliki Koufi ◽

Flora Matamateniou ◽

George Vassilacopoulos

Keyword(s):

Care Delivery ◽

Personal Health Record ◽

Healthcare Delivery ◽

Healthcare Providers ◽

Healthcare Services ◽

Information Support ◽

Personal Health ◽

Health Record ◽

Healthcare Organizations ◽

Process Oriented

Healthcare delivery is a highly complex process involving a broad range of healthcare services, typically performed by a number of geographically distributed and organizationally disparate healthcare providers requiring increased collaboration and coordination of their activities in order to provide shared and integrated care. Under an IT-enabled, patient-centric model, health systems can integrate care delivery across the continuum of services, from prevention to follow-up, and also coordinate care across all settings. In particular, much potential can be realized if cooperation among disparate healthcare organizations is expressed in terms of cross-organizational healthcare processes, where information support is provided by means of Personal Health Record (PHR) systems. This chapter assumes a process-oriented PHR system and presents a security framework that addresses the authorization and access control issues arisen in these systems. The proposed framework ensures provision of tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

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A80 IMPACT OF THE COVID-19 PANDEMIC IN IBD PATIENT CARE

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwab002.078 ◽

2021 ◽

Vol 4 (Supplement_1) ◽

pp. 48-49

Author(s):

M Dahiya ◽

L Olayinka ◽

G G Kaplan ◽

L Reeb ◽

C Ma ◽

...

Keyword(s):

Healthcare Delivery ◽

Healthcare Providers ◽

Healthcare Services ◽

Survey Study ◽

University Of Alberta ◽

Virtual Care ◽

Specific Care ◽

Strongly Agree ◽

The Impact ◽

Virtual Clinic

Abstract Background The COVID-19 pandemic is affecting patients and healthcare providers worldwide. During the first wave of the pandemic, healthcare delivery shifted from in-person to virtual clinics. Non-urgent and some emergent procedures, including endoscopies, surgeries, and imaging, were delayed to limit the spread and divert resources to COVID-19. Aims To assess the impact of the COVID-19 pandemic in care to IBD patients Methods A survey study was conducted to assess the impact of the COVID-19 pandemic on IBD care. All patients had a virtual clinic appointment between March to July 2020 at either: University of Alberta Hospital or the University of Calgary Clinic. A section of the survey assessed patient experience of virtual clinics and delays in access to IBD care during the COVID-19 pandemic. Results A total of 1581 patients were contacted to complete the survey. 628 patients agreed to participate in the survey, however not all patients completed each component. The mean age of patients who participated in the survey was 48 years (SD = 15.19). 408 patients responded to satisfaction/future use questions: 84.3% (344) patients agree/strongly agree they were comfortable communicating to the physician using the remote system, 77.5% (316) of patients agree/strongly agree that virtual clinic is an acceptable way to receive healthcare services, 84.8% (346) of patients agree/strongly agree they would use virtual care services again, and 82.6% (337) agree/strongly agree they were satisfied with the telehealth system. Additional challenges were reported by 228 patients. Fear and stress (infection risk/mental health concerns/unemployment) was reported by 57.4% (131) patients. Access to healthcare services, PPE, and community resources was a challenge experienced by 26.3% (60) patients. Additionally, 16.2% (37) patients experienced uncertainty around IBD-specific care, including procedures, treatments, labs, and medications. Overall, 17.3% of patients reported some type of delay in care by July 2020. Table 1 shows the proportion of patients with a delay by type of care and the median delay: 5.7% of patients with IBD had surgery delayed by a median of 10 weeks (8–16 weeks). Conclusions While some delays in healthcare delivery occurred during the first wave of the pandemic, overall 82.7% of patients with IBD maintained their care without disruption. Sustaining healthcare delivery to the IBD community required adaptation to virtual care; however, patient satisfaction was overwhelming positive among patients with IBD. Funding Agencies None

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Colors and Imagery in Tailored Infographics for Communicating Health Information to Patients and Research Participants

10.31219/osf.io/mp834 ◽

2019 ◽

Author(s):

Adriana Arcia

Keyword(s):

Health Information ◽

Best Practice ◽

Subjective Experience ◽

Empirical Studies ◽

Health Condition ◽

Lessons Learned ◽

Value Judgments ◽

Research Participants ◽

Low Health Literacy ◽

American Adult

Information visualizations, such as infographics, can be used to support comprehension of health information, but they must be well designed to be effective. Although a known best practice is to select colors and imagery that are culturally appropriate to the target audience, few specifics are offered in the literature, necessitating empirical studies. This article represents a synthesis across three studies to describe our lessons learned about the colors and imagery that supported comprehension of health information among urban Hispanic and African American adult research participants and patients in the Northeast, the majority of whom had low health literacy. Familiar palettes such as stoplight colors were effective for conveying value judgments. We saw a strong tendency toward strictly literal interpretation such that images were successful only if they were intended to be interpreted literally or if they were clearly meant to be metaphorical in nature. Images that included people were preferred over those that featured only objects. Patients strongly preferred imagery that reflected the subjective experience of their health condition over images that used abstract metaphors.

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