The Alberta SuperNet Broadband eHealth Sector Initiative

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Health Telematics UnitGlobal e-Health Research
and Training Program
The Alberta SuperNet Broadband e-Health Sector
Initiative Facilitating non-traditional alliances
and impacting organizational boundaries Dr.
Penny Jennett P.I. Co-Investigators Dr. M.
Yeo, Dr. R. Scott Dr. M. Hebert www.ucalgary.ca/t
elehealth E-Health 2004 Challenges Today for
Success Tomorrow The 5th Annual Conference of
CIHI and COACH Victoria, British Columbia May
8-11, 2004
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Overview

• Background
• Purpose
• Methods
• Results
• Challenges
• Conclusions and Next Steps

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What is the Alberta SuperNet?

• 4700 linkages
• 422 communities
• Federally funded
• Multi-sectored
• 14 multi-disciplinary researchers from 4
  universities
• Broadband ISPs - 10 times dial-up - 560 kb

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BackgroundEight sub-projects

• Public consultation
• Distance learning
• Disaster emergency
• Health
• Discrete choice
• Virtual clusters
• In home/community
• Libraries

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Purpose

• Share the views of rural remote communities,
  households, care sites, health care providers,
  and the public and consumers (including patients)
  regarding
• How they will use the SuperNet.
• How they believe the SuperNet should be
  evaluated.
• Outline challenges identified, including shared
  infrastructure
• Discuss implications and future steps.

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Methods

• Planning and base line (done centrally)
• Household telephone interviews (n161)
• Town hall meetings (n8)
• Symposium (n1)
• 2. E-health sub-project survey (done by health
  team)
• Key Informant (n14)
• Questionnaires (n50-60)

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ResultsHousehold Telephone Interviews
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Baseline ResultsHousehold Telephone Interviews
(n161)

• If your community currently has or plans to have
  telehealth in place, do you think that the
  Internet (SuperNet) should link with this service
  (telehealth)?
• Yes 59 42.45
• No 10 7.19
• Uncertain 70 50.36
• If Yes, how? Provide health information (EHR,
  diagnostics) teleconferencing online advice
  with health professional etc.

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Baseline ResultsHousehold Telephone Interviews
(Contd)(n161)

• Value and Uses
• Reduce isolation
• Easier and improved access (to health
  professionals, diagnostic tests, electronic
  health records, prescriptions, and general health
  information i.e. seniors or people with
  disabilities.)
• Personal Health Record

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Baseline ResultsHousehold Telephone Interviews

• Value and Uses (Contd)
• Renewing pharmacy prescriptions
• Reduction in wait times and travel, time, better
  scheduling of appointments
• Increased knowledge, training, information about
  health/medicine using credible, reliable and
  timely websites.

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ResultsTown Hall Meetings
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Baseline ResultsTown Hall Meetings (n8)

• Key Issues
• Context Situated - agriculture oilgas
  ranchers farmers dairy forestry tourism
• Economic Development
• Nature of Applications (e-learning e-work
  e-health disaster/emergency e-business)
• Multi-sectoral and Multi-disciplinary

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Baseline ResultsTown Hall Meetings (n8)

• Key Issues
• Training and Support
• Costs (e.g. public sector private sector
  partnerships businesses and homeowners)
• Technical Infrastructure connectivity (high
  bred model)

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Baseline ResultsTown Hall Meetings (Contd)Key
Health Issues

• Sites
• Home, care sites
• Clinical
• Suggested applications mental health, child
  health, improved diagnostics, trauma.
• Access to specialists and consultations (e.g.
  videoconferencing trauma and mental health).
• Secure information exchange/confidentiality
• Health Professionals
• Recruitment and retention
• Professional networking
• Professional development and training
• Business viability and costs

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Baseline ResultsTown Hall Meetings
(Contd)Value and Uses

• New Services
• Access to health/medical information
• Health professional networking

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ResultsKey Informant Interviews
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ResultsKey Informant Interviews
(Contd)General Uses

• Imagery
• Teleradiology
• Teleultrasound
• Teledermatology
• Current Services
• Clinical
• Educational
• Admin
• Global Opportunities

Image Rich Store and Forward
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ResultsKey Informant InterviewsGeneral Value to
Rural Communities

• Unique infrastructure backbone in Alberta that
  gives rural and remote communities opportunities
  for socio-economic development and more job
  opportunities
• Health Sector Jobs
• Health Sector Support Businesses
• Telework
• Home-based businesses work
• Professional Education
• People moving back to smaller communities from
  urban areas.

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ResultsKey Informant Interviews (Contd)Value
to the Health System

• Value-add of a broadband infrastructure to usual
  health service delivery and current telehealth
  services.
• Community readiness (i.e. providers,
  organizations, patients/public).
• Operationalizing strengths and limitations of the
  SuperNet.
• E-Health recommendations for policy and decision
  makers.

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ResultsKey Informant Interviews (Contd)Value
to Health Regions

• Allows rural health care teams to keep more
  complex patients with video conferencing support.
• Facilitates administration of Health Regions.
• Better sharing of health care resources.
• Expansion of staff development and mentorship
  opportunities.
• Development of new e-health clinical applications
  that improve access and/or quality and reduce
  costs.

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ResultsKey Informant Interviews (Contd)Value
to Health Care Organizations

• Allows organizations to think and strategize
  differently regarding level of service and
  support.
• Supports health care organizations working better
  intersectorally.
• Provides mentorship and clinical support to
  expand knowledge and skills of rural providers.
• Screens patients in their own communities to
  determine if they require specialized services.
• Increases the number of telehealth clinical
  applications available in rural communities.
• Improves access, quality and costs of patient
  care.

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ResultsKey Informant Interviews (Contd)Value
to Health Care Providers

• Decreased travel time and costs.
• More efficient use of time.
• Improved access to telehealth services,
  consulting resources / support, research
  resources.
• Capacity building for rural and urban providers
  Improved image and sound quality for diagnostic
  assessments.

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ResultsKey Informant Interviews (Contd)Value
to Consumers/Patients

• Improved quality of care in rural communities.
• Improved access to services and information.
• Access to health care services in home
  communities.
• Increased health care options within and outside
  of the Region
• Decreased travel time and costs.
• Decreased stress, particularly for elderly.
• Unknown what kind of SuperNet high speed Internet
  services or applications will be available to the
  very small communities.

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Evaluation

• Patient/Public/Consumer patient outcomes
  quality of life isolation wait times time
  saved
• Providers time saved efficiencies capacity
  building.
• System (layers) cost benefits of clinics
  of pts seen wait times time saved capacity
  building
• Technology Infrastructure connections quality
  reliability functionality internet service
  providers

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Evaluation (Contd)

• Hard indicators and soft indicators
• Short term, intermediate and long term
• Arms length or internal
• Comparison
• How frequently?
• Quantitative or Qualitative
• Little mention of context workflow, workplace,
  change management

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Evaluation (Contd)
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Challenges

• Informed Awareness
• Costs
• Sustainability
• Business Case
• Technical Infrastructure
• Reliability
• Gateway bridge interface
• Security/Privacy

• People
• Staffing
• Education
• Support
• Readiness
• Shared Infrastructure

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Conclusions and Next Steps

• Multi-sector and discipline approach
• Various stakeholder groups within health and
  medicine
• Community economic lens
• Triangulation within and across sub-projects

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Summary

• Background
• Purpose
• Methods
• Results
• Challenges
• Conclusions and Next Steps

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• Thank You!

Dr. Penny Jennett jennett_at_ucalgary.ca Health
Telematics UnitGlobal e-Health Research and
Training Program www.ucalgary.ca/telehealth