Shirley Logan pulls her walker towards her as she backs into her living room, one of the many tricks she’s learned that makes life easier since she was diagnosed with supranuclear palsy with a Parkinson’s component.
The 68-year-old Trail woman takes her walker everywhere she goes, which some days only includes the rounds of her home at Silver City Gardens, but on occasion she’ll venture out in her wheelchair.
Mobility limitations, weakened strength, cognitivity and balance and difficulty focusing and swallowing previously made Logan a good candidate for a real-time teleconference with a specialist in Kelowna.
Traveling can take quite the toll on Logan, who feels privileged enough to have used a telehealth service out of Kootenay Boundary Regional Hospital (KBRH), which gives patients access to high-quality health care without having to travel hundreds of kilometres.
Telehealth refers to the use of communications and information technology to deliver health and health care services and information over large and small distances. It’s about transmitting voice, data, images and information rather than moving patients, health practitioners or educators. At this time, most sessions if not all are connected through video from one facility to the next, but in the future there could be more exposure to home-based connectivity.
The service continues to expand since it was first introduced over 10 years ago; Last year, 234 Trail patients were recorded connecting with an outside specialist while only 85 did so in 2007.
“We’re seeing an increasing number of physicians using the service, mainly because the windshield time is a real problem for them,” explained Mal Griffin, chief information officer for Interior Health. “They can see more patients and the care is timelier if they’re able to do it from their office or treatment room in the hospital as opposed to having to hop into a car and drive to another community to provide a visit.”
Since its introduction, the program has grown to include more than 20 different medical fields, including everything from surgical consults to wound care treatment to renal care.
Chi Zhang, kidney specialist at KBRH, said the renal service offered at the Trail hospital is unique to the rest of the province, noting the facility was the first to start a “telerenal” service.
Every Monday, Trail offers six hours of support to those living in the East Kootenay.
A remote nurse helps a patient into the room, measures their blood pressure and collects medical history before setting up equipment and eventually reporting vital signs and complaints or concerns to Zhang, who then offers his expertise from his Trail office.
“I don’t waste all those hours driving back and forth,” he said. “Those hours can be used instead to see patients.”
Renal virtual clinics were set up at the Trail hospital about seven years ago, mainly to provide equal opportunity to patients. Zhang used to travel to the East Kootenay once a month but now he only goes every six months, timing his visits when the weather is on his side.
Telehealth is flagged as an environmentally friendly way of providing service because it reduces greenhouse gas emissions. But with all of its benefits, professionals agree it doesn’t take away from the value of an in-person visit.
“There is obviously no substitute for that face to face, touch and feel of a visit and we would never suggest that that is going to be eliminated at any point in time,” said Griffin. “But when it comes to follow up, when a relationship has already been established, patients respond very positively to it. They feel it is so much more convenient for them than having to hop into a car.”
This was definitely the case for Logan.
Her symptoms came on gradually, starting with an obsessive thought disorder followed by foot freezing and losing her ability to write. She was diagnosed with supranuclear palsy with a Parkinson’s component seven years ago and she has since learned to live with it.
But when acid reflex was added to the list of symptoms, Logan sought out guidance from a specialist in Kelowna. She had to make the trip over on the first visit but connected to live videoconferencing for a follow up.
“What I liked about it was the fact that we could see him in his office and he could see us,” said Logan’s good friend and local seniors’ advocate Margie Crawford.
“It was as though you were in the same room with him and the nurse was able to facilitate anything that needed to be done beyond that, which worked out very well.”
Trail has telehealth patients receiving services for:
• home health monitoring (heart failure patients)• neurology• hereditary genetics• oncology• mental health / psychiatry• rheumatology• thoracic• wound
Trail has also provided telehealth services for:• cardiac• epilepsy• ultrasound (for high risk or possibly high risk pregnancy)