It has been recognized for some time that Canadians living in rural and remote communities have less access to health professionals and services. It has also been noted that despite having the same universal health coverage as
other Canadians, people living in these areas consistently report lower health status. The population as a whole is becoming increasingly urban. According to the 2006 Census more than two-thirds of Canadians live in the country’s 33 largest cities, leaving approximately six million people living in small towns and rural areas (Martel, L. and Caro-Malenfant, E., 2006).These six million people are spread across an enormous land mass and each area is unique; often having its own culture, language, and socio-economic struggles. It is a challenge to meet the health needs of these communities within the health budgets of each province. Telehealth is one strategy that holds promise in providing improved health care access for Canadians as well as support for professionals in smaller health facilities. The promise of telehealth is in its ability to link patients from across the country to family doctors, specialists and other health professionals. It allows patients to stay in their home communities longer avoiding or reducing the number of trips to larger centers. This means more time spent with support systems (family and friends), less stress from travel to unknown hospitals and locations and less time away from work. In a recent study on the impact of out-of–pocket costs on rural patients’ cancer care decisions the following conclusion was made. Rural residents are more likely than their urban counterparts to take costs related to travel, drugs and child care into account in their decisions about cancer treatment. Developing strategies to reduce financial costs for rural residents is essential to enhancing the accessibility of centralized specialist services such as cancer care (Matthew et al., 2009).
It is unlikely that specialized care will be offered “in person” in small rural communities. It is not cost effective or efficient to serve a small number of people spread over large distances. A specialist would have to devote too much time to travel, taking away clinic hours. Videoconferencing can allow a specialist to provide consultation and care to a patient without either of them having to leave home. In some of the more northern areas, communities are served by nursing staff and a visiting general practice physician. Without roads travel can be very weather dependent. Technology allows doctors to conduct a clinic even if s/he is unable to attend in person. Without this service a patient would have to wait until the doctor is scheduled to visit again or make the trip to a larger centre.
For the health professional in isolated areas, videoconferencing allows for a more thorough patient consultation and provides accessibility to ongoing educational opportunities, which would otherwise be too costly to participate in. This is a very important consideration in recruitment and retention.
Figure Source: 2006 Statistics Canada. Population Urban and Rural in Canada by Province and Territory.
