A look at telehealth in other provinces

CrossCurrents

Nova Scotia
Nova Scotia is one Canadian province that is almost completely "wired." "Our provincial department of health had tremendous foresight to develop province-wide telehealth services and fund 42 sites in the mid-90s," says Dr. Herb Orlik, chief of psychiatry at the Isaac Walton Killam Health Centre (IWK) in Halifax. The IWK program offers mental health clinics that visit remote sites monthly and therefore have a good understanding of the specific communities' needs and resources. The IWK also uses the network for research, conducting individual interviews with remote clients and linking up remote sites into focus groups for study. IWK also participates in Canada's first inter-provincial telepsychiatry project, which services Prince Edward Island with travelling clinics and telepsychiatry services.

Orlik says the main challenge is that the system is under-utilized. "I think that's a national if not international problem. Some psychiatrists embrace the program but others feel it creates more demand than they can handle. They feel it is an 'add-on' to their functions as doctors."

Alberta
The Alberta Mental Health Board (AMHB) launched the province's telemental health program in a 1996 pilot project involving five communities. Its success led to a province-wide telepsychiatry service. Pediatric services are delivered province-wide on a shared-care model with organizations like the Child and Adolescent Services Association (CASA). Psychiatrist Dr. Robert Drebit says the CASA program handles about 100 cases per year. The program also offers educational seminars. Drebit says local health workers value these learning seminars as highly as the consultations: "In the city, you get support and talk to each other about cases. Rural therapists are often by themselves. They'll have a heavy caseload and be treating children and adults. Support is so much a part of what they desire."

Cindy McGlynn

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