Rural Health Services Research Network of BC 

Funded through the Rural Coordination Centre of BC

March 2015 | Issue 43

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Dear RHSRNbc members,

We hope you are enjoying the Spring-like weather that has graced the West Coast.  February was a busy month at the network - we sponsored part of and attended the Healthcare Through the Locum Lens conference in Nanaimo on Feb 28th, continued working on our telehealth research strategy, and are gearing up for the SRPC annual conference in April.

This month's feature article highlights Dr. Michael Jong from Goose Bay, Newfoundland and Labrador and illustrates a very different perspective, use, and integration of telehealth in one the most rural pockets of Canada.  Stay tuned for future issues on other innovative clinical telehealth applications.

Happy reading!

Warm regards,
Emily Ryan, Network Coordinator
Clinical Telehealth in Goose Bay
Rosie, the telehealth robot, with Dr. Michael Jong on the screen.
Our past two newsletters have focused on innovative telehealth projects in British Columbia.  This month we're taking you to Goose Bay, Newfoundland and Labrador where Dr. Michael Jong's use of telehealth is no longer considered a cutting edge practice. Rather telehealth is one of the most important ways medical care is delivered to some of the most rural and remote communities in Canada. 
In Goose Bay, telehealth started more than 10 years ago and has grown to encompass primary care, emergency services (via a tele-resuscitation program), management of chronic disease, psychiatry, surgical consultations, oncology, telestroke, and maternity care.  Due to advances in technology, Dr. Jong is now able to assist medical teams managing traumas with a telehealth robot – an encrypted, password protected device that Dr. Jong can access with a laptop, iPhone, or iPad from almost anywhere in the world where he can plug into the internet.  This telehealth robot, which can be thought of as a ‘doctor in a box’, has been named ‘Rosie’ by the community who bought and own it.  Rosie is mobile and is driven remotely to any room where Dr. Jong and his colleagues may be needed.  With a secure, reliable connection Dr. Jong can instantly click into the room and assist with his virtual presence.
As we previously discovered and highlighted, the integration of telehealth into the traditional model of care has significantly decreased the amount of travel for rural patients, many of whom reside in fly in/fly out communities.  To illustrate, the traditional requirement for a surgical procedure involved a minimum of three visits to the hospital.  With Goose Bay’s model of practice and utilization of telehealth, patients are now only required to travel for the procedure, with pre- and post-operative consultations occurring remotely with telehealth, when appropriate.  In addition, the application of clinical telehealth has enabled health care practitioners in small rural communities to provide a greater scope of practice with secure, reliable access to specialist and experienced care provider back up from  Goose Bay. 
The most recent focus in developing this rural Labrador telehealth strategy has been to train residents and students.  A virtual doctor-patient interaction is different from an in-person visit and, as such, requires a particular skill set and strategies to interact and manage situations remotely.  The Goose Bay team has addressed this by including telehealth in residency training and supervising residents remotely.  Dr. Jong stressed that in order to increase the number of care providers and communities utilizing telehealth, opportunities to experience telehealth programs and training for virtual physician-patient interactions needs to be included in medical education programs.  With this, Dr. Jong explained that telehealth can be a ‘built in’ component of the health care system with expertise developed through mentorship and education during medical school and residency rather than an external feature developed and utilized on an ad hoc basis.
This telehealth platform is so much a part of routine care in Goose Bay and the surrounding area, it raises the question of whether additional research is actually needed to evaluate its effectiveness and, more broadly, the role telehealth can and perhaps should play in Canada’s rural and remote communities.  Comparing the current British Columbian telehealth context to that of Goose Bay raises questions about telehealth with respect to its efficiency, challenges, education, and both patient and provider experiences.  Most importantly, if telehealth is such a known success in several rural communities across Canada why isn’t it more broadly utilized and incorporated in our health care system? 

Article written by: Emily Ryan
Upcoming Events

Northern Health's Brown Bag Lunch
Facilitating Relationships: Northern Health's Partnering for Healthier Communities Approach
March 26 @12:15 | Prince George, BC | More information here
Sabrina Dosanjh-Gantner & Theresa Healy will be presenting on the Partnering for Healthier Communities (P4HC) - an initiative developed to reduce the number of health inequalities that exist in the north.  


SRPC Rural and Remote Medicine Course & Rural Summit on Generalism
April 8-11, 2015 | Montreal, QC |  More information here
The Second World Summit on Rural Generalist Medicine (April 8-9) is a follow-up to the first summit held in Cairns, Australia in 2013 and aims to strengthen healthcare systems in rural communities by promoting the practice of rural generalist medicine.

The Rural and Remote Medicine Course (April 9-11) is a conference that offers more than 150 small group sessions, hands-on workshops, and Rural Critical Care modules.  It also provides an opportunity for rural practitioners from across Canada to meet and network.

Medical Disorders and Pregnancy Conference
April 18, 2015 | Vancouver, BC | More information here
This conference is geared to all those interested in advancing their knowledge in the medicine of pregnancy and motherhood including: obstetricians, perinatologists, family physicians, internists and subspecialists, obstetric anesthesiologists, midwifes, maternity nurses, residents and students.

Over the course of the day attendees will be provided with a focused, expert review of common medical conditions in pregnancy and to provide practical strategies for their management.  Recent evidence, resources and clinical guidelines to support decision making will be highlighted.

RECC: Rural Emergency Continuum of Care
May 22-23, 2015 | Pentiction BC | More information here
Rural health practitioners, administrators, and health educators are all invited to learn about rural emergency medicine, physician support initiatives, and wilderness medicine. Registration is now open.

In this newsletter:
-Telehealth in Goose Bay
-Upcoming Events
-Abstract Submission Deadlines
-Funding Opportunities
-In the News
-Recent publications
Upcoming Abstract Submission Deadlines

1)  Critical Care Transport Medicine Conference (April 20-22, 2015 in Charlotte, North Carolina).  Deadline: March 20, 2015.  More information here.

2)  NAPCRG 2015 Annual Meeting (October 24-28, 2015 in Cancun, Mexico).  Deadline: April 17, 2015.  More information here.
Check out the Centre for Rural Health Research (CRHR)'s website for up to date research publications and policy implication documents.

Funding Opportunities

Island Health Collaborative Research Grant Competition

More information here. Deadline: March 16 @ 4pm

RHSRNbc Travel Bursary Competition

The RHSRNbc offers four bursaries to RHSRNbc members who have been invited to present their rural health services research at a conference. Find the application on our website.

In the News

SmartMom - Dr. Patricia Janssen's project to increase access to maternity care information for rural women in Northern BC

The resident experience from a resident perspective

We can't ignore the stark reality of rural health care - Dr. Robert Martel

Hundreds rally for rural PEI health system
Rural Rounds Videoconferencing 

The theme for Spring 2015 is Emergency Room Cases. More information and registration here.

Recent Publications

An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta.  

Developing a culturally competent, sustainable rural model for diabetes prevention

Community-wide cardiovascular disease prevention programs and health outcomes in a rural count

Role of the nurse in returning birth to the North. 
Copyright © 2015 Rural Health Services Research Network of BC, All rights reserved.

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