Sault Star's From the Vault series
Nearly 22 years ago, the Sault Star’s Jeffrey Ougler observed as a Toronto physician treated a Sault Ste. Marie girl, Kassidy Rousseau, 6, via the miracle of remote medicine. Here is the story as it appeared in the Nov. 30, 2001 edition of the Sault Star.
The young patient is sprawled out on the examination table, one knee bent as the physiotherapist flexes the tiny leg back and forth.
The attending surgeon observes carefully. The timbre of his deep, confident voice fills the examination room as he directs the therapist to manipulate the limb as to afford him a better glimpse of what is believed to be a leg-length discrepancy. Moments into the examination, the physician’s mind is put at ease.
Yes, one leg is a few centimetres longer than the other, but that’s OK. Nothing to worry about, the doctor assures those present. The disorder can be rectified.
Next patient, please.
The succeeding patient is not greeted by a white-clad physician, but instead encounters the doctor’s televised image, plastered upon an immense screen. Audio equipment transmits voices and a small camera perched upon the top of the monitor helps deliver images countless kilometres if needed.
On this day, such technology is indeed imperative.
Dr. John Wedge, a pediatric orthopedic surgeon, is in Toronto, plying his trade from the Hospital for Sick Children. And six-year-old Kassidy Rousseau is one of about 15 Sault Ste. Marie patients Wedge will “see” during the course of a day-long clinic at the Children’s Rehabilitation Centre-Algoma.
TRIPS SOUTH A CHALLENGE
For years, children such as Kassidy would have had no option but to fly to Toronto — often at great expense — for what would often wind up as nothing more than a five-minute examination. Parents would ultimately have to book off a day or two from work and school-aged children would likewise miss classes.
Rose Rousseau, Kassidy’s mom, is all too familiar with such snags.
As an infant, Kassidy suffered from seizures, prompting a subsequent series of trips to Toronto specialists. Even with flight specials, the frequent excursions south were a challenge for the Rousseaus. Thankfully, Kassidy’s seizures ceased and the current orthopedic problem appears to be minor.
“I can’t shake (Wedge’s) hand,” Rousseau says, but adds that a knowing, gracious smile will suffice.
The Rousseaus are just one of the many Northern Ontario families to tap into telehealth, an innovative way to use electronic information and telecommunications technology to provide and support health-care services when distance separates the participants.
It’s a system tailored to the North, a region plagued by physician shortages, especially in certain medical specialties. And since the program was introduced here about three years ago, thousands of dollars that would have been soaked up by air travel to Toronto, London or any number of Ontario medical hubs, have remained in local families’ pockets — exactly where the cash belongs, says Julie Korab.
“There’s great impact because many of the families that we service have other children, so you have to worry about the siblings,” says the centre’s telehealth co-ordinator. “They’re going to be left at home. You have to leave your job. Sometimes both parents work … lots of organizing for families.”
The program was initially administered out of Sault College, a setting eventually deemed both not financially feasible and trying to patients.
Kick-starting this high-end computer equipment, complete with big-screen monitor and X-ray machine that allows images to be transmitted to the specialist at the other end of the line, was novel to those at the centre — and there were bugs.
Two telephone lines quickly developed into four lines, until finally, six lines had to be installed to shoulder the load.
Despite the technology’s complexity, the concept seems simple enough.
The specialist — located anywhere within range — appears on the screen and equipped with similar technology at his or her end, can clearly watch and listen to the examination. Problems, if any, can be detected and counsel is quick to follow.
The Sault is not the sole benefactor of Sick Kids’ telehealth program.
SUDBURY LINKED TOO
According to the hospital’s Web site, the service was launched in 1996 as a pilot project administered between Thunder Bay Regional Hospital and Health Sciences North, with Orillia joining the fold later that year. In 1998, the program forged a partnership with the Northern Ontario Remote Telecommunications Health Network, linking it to Sudbury, Timmins, Kirkland Lake, Cochrane and Sunnybrook and Women’s College Health Sciences Centre. Telehealth’s tentacles have also reached overseas to two international sites: Tel Aviv, Israel and Buenos Aires, Argentina.
A year-and-a-half after being launched at the rehabilitation centre’s Sault office, the wheels of technology appear to be turning smoothly. Orthopedic surgeons share screen time with a number of other specialists, and the technology is often used by other local medical and social service agencies.
Patients are referred to the service, and quite often are examined by the surgeon who performed the initial operation.
Wedge hails the program as a boon to remote and underserviced areas such as Northern Ontario.
Despite the lack of specialists to go around, Wedge contends the North lacks both the critical mass and infrastructure to support such individuals.
“It’s just not cost effective to provide the infrastructure,” he says. “Instead of taking the families to the specialist, this technology allows the specialist to come to the families.”
Over the years, Wedge has often visited the Sault to conduct clinics. He concedes that there is something special about the human touch, however, he maintains the telehealth model offers certain other advantages.
“In my specialty of orthopedics, the physiotherapist is generally as good if not better at performing the relevant physical examination,” he added. “That’s not possible for certain other conditions. If there was something in the abdomen I had to feel, obviously I couldn’t do that (via telehealth).
“(But otherwise) patients would have come down here, they would have sat in my clinic for whatever length (of time) it would have taken and would have been seen for five or six minutes because that’s all it would have taken.”
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