{President's Report 2003}
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Telemedicine moves forward

Telemedicine, developed as a way to provide continuing medical education to physicians scattered throughout the province, celebrated its 25th birthday this pas year. It's been a quarter of a century since Memorial University pioneered early developments in the field of telemedicine. Led by neurologist Dr. Max House, the Telemedicine Centre. However, the days of an audio-only conference network in nine communities in the province have been replaced by a sophisticated teleconference system housed within Memorial's Telehealth and Educational Technology Resources Agency (TETRA) Centre.

It now reaches 240 sites in about 160 communities. TETRA's resources are now used by a province-wide consortium including health, education (secondary and post secondary), social, government and private agencies.

To celebrate 25 years of service and to provide a blueprint for the coming years, TETRA held a conference last October titled The Way Forward: Telemedicine to e-Health. Featuring plenary speakers and working breakout sessions, conference participants worked together to lay the groundwork for TETRA's future.

“This conference encouraged health information and telehealth to converge in the interest of small communities,” said Dr. Carl Robbins, chair of TETRA. “The conference exceeded my wildest expectations - there was a sense of enthusiasm and the sophisticated group of attendees worked well together. People are now getting on with a report that will bring TETRA and a better-grounded Newfoundland Centre for Health Information (NLCHI) together to provide a leadership model in healthcare for the country.”

One of the invited speakers at the conference was Gunther Eysenbach, senior scientist at the University of Toronto's Program in eHealth Innovation at the Centre for Global eHealth. He defined e-health as a new term needed to describe the combined use of electronic communication and information technology in the health sector. “Consumers demand e-health and their questions are simple and refer to very basic technologies - e-mail communication with personal physicians and a central database for their health record.”

Dr. Eysenbach said e-health refers to health services and information delivered or enhanced through the Internet and Internet-related technologies. He said e-health offers promises and challenges and can enhance the quality of care by increasing consumer control.

Dr. Francis Lau, a specialist in health informatics, design, implementation and evaluation at the University of Victoria, spoke about the interaction of informatics in medical schools. The University of British Columbia is planning to double the number of students enrolled in medical studies by 2010 through collaboration with the University of Victoria and the University of Northern British Columbia in Prince George. The current UBC curriculum will be used as the model for education, with 60 per cent of the curriculum distributed via technology in real time and enhanced locally through tutorials, seminars and on-line resources and tools.

Dr. Robbins and Steve O'Reilly, chief executive office of the Newfoundland and Labrador Centre for Health Information (NLCHI) also participated in a plenary session. Dr. Robbins said that provincial strengths in telehealth and health informatics have to take direction from the province's Strategic Health Plan, released in September. The long-term goals include improving the capacity of communities to support health and well-being, a goal that is supported by the technological capabilities of TETRA. “With the NLCHI we are continuing to develop improved systems for health surveillance and communicable disease management.”

Mr. O'Reilly explained the development of the NLCHI since it was established in October 1996. “We did a lot of thinking and planning in the early days and have come up with privacy standards and a Unique Personal Identifier (UPI) client registry. We have released over 40 reports and progress on a health information network is slow but steady. Now more than ever the need for privacy legislation is urgent.”

Dr. Robbins agreed that optimum protection of personal privacy is a challenge to the whole healthcare system. He said there has been great collaboration among players in the health field and a convergence of human skills, technologies and sectors. The questions for the future include what mechanisms to develop to implement needed changes, and the involvement of Memorial and the College of the North Atlantic, as well as the role of the private sector.